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Medical Benefits Attorney Washington State

Medical Benefits Attorney Washington State

Seasoned Medical Benefits Lawyers Advocate for Full Compensation of Injured Workers’ Treatment and Rehab in King County, Lewis County, Pierce County, Thurston County, and Throughout WA

When you have been injured at work or have been diagnosed with an occupational disease, arguably the most important benefit you can receive from the Washington state workers’ compensation system is medical benefits. These benefits cover the cost of treatment and rehabilitation that you need for your workplace injury or occupational illness. Medical benefits can also help cover some of the costs of traveling to and from doctor’s offices and hospitals for appointments and procedures. When you need help securing benefits that can help in your recovery, turn to a medical benefits attorney in Washington state from Smith Duran Law

Our firm is focused on representing the interests of hard-working people throughout Washington state who have been injured or become ill on the job. Our attorneys have dedicated their careers to serving people, not companies. We understand the devastating physical and emotional consequences that occur due to work injuries and occupational illnesses. We also have seen the obstacles that injured people have had to overcome just to get the benefits and medical care they need. That’s why we fight hard to win justice for each of our clients. 

If you have more questions about what kind of medical benefits you may be entitled to after suffering a work injury or occupational illness, reach out to Smith Duran Law today for a free initial case evaluation to get the answers you need from a medical benefits attorney in Washington state from our firm. 

What Kinds of Medical Benefits Does Workers’ Compensation in Washington State Offer?

Under Washington state’s workers’ compensation system, you may be entitled to medical benefits to help treat a work injury or occupational disease. These medical benefits cover bills or expenses that are directly related to treating your injury or disease. Examples of covered treatments include:

  • Emergency room visits and hospital care
  • Surgeries or other invasive medical procedures
  • Doctor’s appointments
  • Physical/occupational therapy
  • Prescription medication
  • Medical/mobility equipment 

Workers’ compensation will not cover treatment that:

  • Is unrelated to your work injury or occupational disease
  • Cannot be objectively measured for success by a medical professional
  • Takes place after your work injury or occupational disease has been declared medically stable

Your medical benefits are overseen by a primary care or attending provider. The doctor who serves as your attending provider is responsible for managing your treatment, helping you to return to work, and advising the L&I claims manager as to the progress of your recovery. Your attending provider is also responsible for referring you to specialists, such as surgeons, orthopedists, internalists, or physical therapists.

In order for care rendered by a provider to be covered by medical benefits, the provider must be registered with the L&I network. If you obtain treatment from a non-network provider, the bill will not be covered by medical benefits and you will be responsible for the cost (although you might receive partial reimbursement pursuant to L&I’s fee schedule). However, a first emergency room or doctor’s office visit will be covered even if the provider is out-of-network.

In addition to medical benefits that cover the cost of medical care, you may also be entitled to reimbursement of certain travel expenses that you incur in traveling to and from doctor’s appointments or medical procedures. Expenses will be reimbursed if:

  • Pre-authorized by your claim manager
  • The appointment or procedure is located more than 15 miles one way from your home
  • There are no providers within 15 miles of your home qualified to treat you or perform the procedure

Getting Additional Medical Care After Your Workers’ Comp Claim Is Closed

Your attending provider may declare your work injury or occupational disease to be medically stable. This means that no further treatment is reasonably expected to improve the condition of your injury or disease. When your condition is declared medically stable, your workers’ compensation claim may be closed. If you find that you require further medical treatment for your original work injury or occupational illness, you can seek to have your workers’ comp claim reopened to resume medical benefits. If your claim has been closed for 60 days or less, you must file a protest to L&I’s decision to close your claim. After 60 days, you must file an application to have your claim reopened. 

You may reopen your claim at any point to resume medical benefits. However, if you file an application to reopen your claim more than seven years after it was closed, you will be ineligible to also resume receiving other workers’ comp benefits, such as wage loss replacement. 

Contact Our Firm for a Free Case Review to Learn More About Your Rights to Medical Benefits

Don’t delay if you have had your workers’ compensation claim denied or if L&I or your employer is seeking to terminate your medical benefits. Contact Smith Duran Law for a free, no-obligation consultation to learn more about how a medical benefits attorney in Washington state from our firm can assist you with getting the medical treatment and rehabilitation you need and deserve for a work injury or occupational illness.

Frequently Asked Questions about Medical Benefits in Washington State

Can I choose my own doctor to treat my work injury or occupational illness?

Under Washington state’s workers’ compensation system, you may seek treatment for a work injury or occupational illness from any medical provider that is part of the Washington Department of Labor & Industries’ network of authorized providers. You may also switch providers at any point during treatment of a work injury or occupational illness, so long as the provider you are switching to is part of L&I’s network and your claims manager approves the switch.

How long do medical benefits last?

Typically, you will continue to receive medical benefits until your primary physician certifies that your injury or occupational illness has stabilized and no further medical treatment or rehabilitation is expected to provide any improvement. If your claim is closed and you later discover that you require additional medical treatment, you can protest the closure of your claim or apply to have your workers’ compensation claim reopened.

  • Workers’ Compensation

    The Department of Labor and Industries manages claims for injuries at work. You are entitled to money for lost wages, medical treatment, vocational retraining, loss of body function, and in some cases a pension

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  • Personal Injury

    If your injury was caused by someone other than a co‑worker, an auto accident, or defective equipment, you may be entitled to additional compensation. Our attorney will evaluate your case.

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