Medical Expenses Covered

Most employers in Pennsylvania are required to carry workers’ compensation insurance to compensate injured workers for expenses associated with their workplace injuries. Under the Pennsylvania Workers’ Compensation Act, workers may receive compensation for any reasonable and necessary medical expenses related to their work injuries. Medical expenses covered by the Act may include:

  • Doctor or other health care provider visits
  • Hospital expenses, including tests and X-rays
  • Medical supplies and devices
  • Orthopedic appliances and supplies
  • Physical therapy
  • Prescription medication
  • Surgeries and related expenses
  • Travel expenses to and from doctors’ appointments

Medical Expenses Billed Directly

Generally, if a worker’s claim has been accepted by the workers’ compensation company, the worker is not required to pay for medical treatment. The medical provider is required to bill the insurance company directly and may not seek compensation from the worker to compensate for the difference between what they charge and what workers’ compensation pays. There are also pharmacies available that will fill prescriptions for pending claims and bill workers’ compensation insurance carriers directly.

Retain Copies of Medical Bills

Medical expenses may be covered even in cases where other types of workers’ compensation benefits, such as lost wages, were denied. However, the process may be delayed because insurance companies often seek to avoid paying benefits. Therefore, workers should retain copies of all out-of-pocket medical bills and related expenses while their cases are pending. It is also advisable for workers to speak with a qualified attorney in their area who can explain all their legal options to help ensure maximum recovery.

Limitations of the Act

There are certain limitations to the type of medical treatments that are covered under the Act. Alternative medicine or therapies are typically not covered by workers’ compensation. Also, certain medical fees are limited to a capped percentage of the Medicare reimbursement amount for similar services and pharmaceutical fees of the average wholesale price of medication.

Other Types of Expenses Covered by Workers’ Compensation

In addition to reasonable and necessary medical expenses related to their workplace injuries, workers may also be eligible to receive several other forms of compensation, including:

  • Lost wages: If a worker’s injuries caused him to miss work, he may receive either total or partial disability, which will grant either two-thirds of his average weekly wage or two-thirds of the difference between his pre- and post-injury wages, respectively.
  • Vocational rehabilitation: Retraining and rehabilitation to help workers re-enter the workforce may be available under the Act. This includes diagnostic services, placement assistance, restoration and support services, and job training.
  • Specific loss benefits: Workers who suffer severe injuries, such as facial disfigurement, scarring, amputations, or vision loss, may be eligible for specific loss benefits, which are lump sum payments based on several factors, including the type of injury suffered and the worker’s experience.

Philadelphia Workers’ Compensation Lawyers at Larry Pitt & Associates, P.C. Help Injured Workers Obtain Payment for Medical Expenses

If you were injured at work, contact a Philadelphia workers’ compensation lawyer at Larry Pitt & Associates, P.C. You may be eligible for various workers’ compensation benefits, including payment for all your reasonable and necessary medical expenses. For a free consultation, please complete our online contact form or call us at 888-PITT-LAW.

We represent injured workers in the communities of AbingtonAmblerArdmoreBala CynwydBensalemClifton HeightsCrum LynneDarbyDowningtownDoylestownDrexel HillEssingtonFolcroftGlenoldenHaverfordHavertownHolmesKutztownLansdowneMediaMerion StationMortonNarberthNorristownNorwoodPhiladelphiaProspect ParkQuakertownReadingRoxboroughSharon HillUpper DarbyWest Chester, and Wynnewood.



Larry Pitt

Larry Pitt

If you've been injured, Larry Pitt & Associates can provide you with the legal assistance and representation you need to ensure that justice is served. Get in touch today for a free consultation to discuss your case. Whether it’s a work injury, auto accident, medical malpractice, or any other injury-related matter, we are here to help make sure your rights and interests are respected. We understand the stress and frustration that can accompany an injury, and we are committed to providing thorough legal guidance and support throughout the entire process.