What You Need To Know About “Medical Only” Workers’ Compensation Benefits

July 14, 2016

We recently wrote about what you can expect after filing a workers’ compensation claim in Philadelphia. While the workers’ compensation system can be complicated, your claim is generally either approved or denied. In certain cases, however, an insurer may offer medical compensation without approving wage compensation. These cases are typically complicated, and even the letter of the law isn’t entirely clear about your rights after being awarded “medical only” damages.

Why did I receive a Medical Only Notice of Compensation Payable?

Insurance companies can use the Medical Only Notice of Compensation Payable to deny responsibility for lost work while simultaneously acknowledging an injury requiring medical treatment. Payment of medical benefits does not mean that a workers’ compensation claim has been accepted. In some cases, it is issued simply because you needed medical treatment but were able to continue working your normal schedule.

Unfortunately, “medical only” benefits are most commonly used when you are already receiving another form of compensation. For instance, you may have been awarded partial disability benefits and then been injured again. Because you are already receiving compensation, the insurance agency will issue benefits only for treatment related to your recent injury.

What this means for you

The simplest scenario is that a minor injury occurred on the job that did not require emergency treatment. You inform your supervisor, visit an approved healthcare provider, and medical benefits are awarded to pay for the required treatment. In reality, it almost never happens this way.

Workerscompensation.com wrote that last year, the Pennsylvania Commonwealth Court issued two decisions that addressed workers’ compensation claims that had been accepted as “medical only”. These decisions were intended to clarify exactly how you can petition to receive lost wage benefits. Unfortunately, even the clarifications were mired in dense legal language surrounding extremely complicated cases.

So how do you know what to do? The best advice is to seek an expert legal opinion. While that might seem self-serving, even the Pennsylvania Workers’ Compensation Services website says, “You may represent yourself in WC [Workers’ Compensation] proceedings, but a non-attorney cannot represent you. However, you should be aware that WC litigation is complex, and your employer or your employer’s insurance carrier will be represented by an experienced attorney [emphasis ours].”

If you believe that your claim has not been handled properly, or that you are entitled to wage benefits in addition to your medical benefits (or you are simply confused), the experienced Philadelphia workers’ compensation lawyers at Larry Pitt & Associates can evaluate your case and help get you the compensation you deserve. Contact us today, or call 888.PITT.LAW for a free consultation; we serve all of Berks, Bucks, Chester, Delaware, Montgomery and Philadelphia counties.