Jonathan H. Poznansky, Attorney at Law

Will workers' compensation pay for my medications?

For New Yorkers who have a medical issue because of their work, whether it is an on-the-job injury or a condition that arose from their employment, there are many concerns that will arise. For those who need medication to treat their condition, there are often questions about how they will be paid for. Many people who are seeking or already receiving workers' compensation benefits do not know that their prescriptions and medications can and should be paid for by the insurer. If there is a refusal to pay or a dispute over which medications and prescriptions are covered, having legal advice is vital.

When medications or prescriptions are purchased, the injured worker should save the receipt and send it, along with a letter from the treating physician, to the insurer. This must say that the person needed to buy the medication or fill the prescription based on the physician's diagnosis and recommendation. According to the law, pharmacies have the authorization to send the bill to the insurer directly. It also states that the insurer must pay for the prescription or it must provide reimbursement to the injured worker. This must be done within 45 days of getting the receipt.

The insurer can have a contract with a pharmacy to provide the medications. The worker must use the designated pharmacies to buy their prescriptions. There are exceptions, however. They are: if there is an urgent medical need and there is no possibility of getting the prescriptions from the pharmacy that has a contract with the insurer; if there is no offer of mail order service to fill the prescriptions; and if there is no location within a reasonable distance to the injured party.

Being injured or ill because of work can make a person fearful about many issues, including their wages, their medical treatment, and what they will do if their claim is denied. Workers' compensation benefits are a necessity for injured workers and part of that is their medication. Should there be a denial of payment for medication or there is any problem with a claim, having legal guidance is a must. A legal firm that helps injured workers with their workers' compensation claims should be contacted as soon as possible.

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