I have represented many individuals over the years who come to the office under the mistaken impression that their work injury is “covered” because the worker’s compensation insurance company has paid medical bills related to the claim.
This situation typically occurs when someone is hurt at work and continues to work often in a light duty capacity. In other words, they do not miss work as a result of the injury. In that scenario, the worker’s compensation insurance company often pays medical bills without formally acknowledging the injury.
I do not necessarily have an objection to that. It is a good thing. When the bills are paid that is one less worry for the injured worker.
The problem is that an injured worker is often lulled into a false sense of security. They mistakenly believe that the claim has been “accepted” because the bills are being paid. That is a false assumption. To the contrary. A claim is only accepted when the appropriate documents are filed with the Bureau of Workers Compensation. That document is typically, but not always, a Notice of Compensation Payable.
So the mere fact that the insurance company is paying medical bills DOES NOT mean that the claim is “accepted”.
The law allows the insurance company to pay bills without admitting liability or responsibility for the claim. This means that the insurance company can still deny the claim after paying medical bills for the injury.
If you have question regarding whether your claim has been accepted consult with a Certified Workers Compensation Specialist. Call me for a free consultation at 717-584-9429.