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Can Injured Workers Refuse Medical Treatment?

refuse medical treatment

If you recently suffered from a workplace accident in Kentucky, you may wonder if you have the right to refuse medical treatment. There may be treatments you are nervous about or have concerns about pursuing. At the end of the day, it is up to you and your medical provider what treatment is most appropriate for your condition. However, it’s critical that you receive medical treatment as soon as possible, even if you only have only mild injuries. This is important not just to make you better but also to document your symptoms and conditions. 

In this blog, we answer the question, “Can an employee refuse medical treatment,” and we unpack critical details regarding workers’ compensation claims. 

Have any additional questions regarding workplace injuries and compensation? You can contact the Kentucky workers’ compensation lawyers at McCoy & Sparks Attorneys at Law. We have many years of experience assisting victims of workplace injuries, and we’re ready to help with your case. 

Can an Employee Refuse Medical Treatment?

KRS 342.035 states that an injured worker cannot receive compensation for their injury, if the disability being claimed by the worker was “aggravated, caused, or continued, by an unreasonable failure to submit to or follow any competent surgical treatment or medical aid or advice.” This does not mean that a worker has to submit to a risky surgical treatment, or a procedure that has a low chance of success. But an injured worker cannot refuse to follow their doctor’s medical advice if that advice is reasonable without consequences in their claim.

It is very important to follow through with all scheduled appointments. If you skip physical therapy visits or doctor’s appointments, the insurance company will likely argue that you failed to follow your doctor’s advice by not following through with a treatment plan, which can decrease the value of your claim. Missed appointments can also lead to the insurance company stopping payment of your temporary total disability benefits. 

The critical point is that you need to prioritize your health and safety above everything else. If you suffered from a workplace injury that requires immediate medical attention, you should accept it. 

Should I Refuse Medical Treatment from the Workers’ Compensation Doctor?

Under Kentucky law, employees can choose their own treating physician. In emergency situations, an injured worker will likely be taken to the nearest emergency room or trauma center for emergency care. However, in all other circumstances, employees can choose their own treating physician rather than the workers’ compensation doctor. The Kentucky Administrative Regulations at 803 KAR 25:096 Section 3.1 state that: “Except for emergency care, treatment for a work-related injury or occupational disease shall be rendered under the coordination of a single physician selected by the employee.”

Many employers may have a preferred medical provider that they like for their employees to see after an injury, but you are not required to see that provider. Often, an injured worker is more comfortable seeing a doctor of their choosing, or even their primary care physician, if that office is comfortable handling workers’ compensation claims. You can choose any physician to provide treatment for your work injury, as long as that doctor is able to accept workers’ compensation claims. One exception to this is that some workers’ compensation insurance companies have a managed care network. Unfortunately, you may have a smaller selection of available physicians if your employer is part of a managed healthcare network. With a managed healthcare network, you are required to select an in-network physician unless you receive emergency treatment. 

Kentucky law is very clear on this topic and states

“In the absence of designation of a managed health care system by the employer, the employee may select medical providers to treat his injury or occupational disease. Even if the employer has designated a managed health care system, the injured employee may elect to continue treating with a physician who provided emergency medical care or treatment to the employee.”

To designate your doctor, there is a form that you and your doctor have to sign. It is important that you trust and feel comfortable with your doctor when relying on his or her opinion about your treatment options. For that reason, it’s crucial that you choose your own treating physician who prioritizes your full recovery. Your treating physician will be responsible for your primary treatment, and they can also refer you to medical specialists and other providers if needed. 

What Does Workers’ Compensation Cover?

Your employer’s workers’ compensation should cover a wide range of expenses related to your medical treatments. Some covered expenses include:

  • Ambulance bills
  • Emergency room fees
  • Doctors visits
  • Chiropractic visits 
  • Diagnostic tests
  • Prescriptions
  • Surgeries
  • Physical Therapy
  • Braces and prosthetics 
  • Ongoing care
  • Mileage for travel to and from medical appointments

Additionally, workers’ compensation covers disability as well as vocational and occupational rehabilitation. If you’re unable to work due to your injuries, you may receive Temporary Total Disability (TTD) benefits that compensate you ⅔ of your pre-injury earnings. 

Once you reach your maximum medical improvement, meaning you’re not expected to significantly recover further, you may qualify for Permanent Total Disability (PTD) or Permanent Partial Disability (PPD) benefits. Please be aware that reaching MMI does not necessarily mean that you are all better or you don’t need ongoing treatment, just that there is not other treatment that will improve your condition. 

PPD benefits will compensate part of your pre-injury earnings based on the severity of your disability, and you can receive these benefits for either 425 or 520 weeks. With PTD, you can receive ⅔ of your pre-injury wages up until you reach the age of 70. 

What If My Workers’ Compensation Is Denied?

If your employer’s insurance company denies liability or refuses to pay for the full extent of your medical treatments and disabilities, you need to contact a workers’ compensation attorney as soon as possible. 

Your workers’ compensation attorney will represent you and communicate with your employer and their insurance on your behalf. They’ll help you gather and present evidence proving that you were injured at work, and your attorney will fight to secure you fair workers’ compensation for medical bills and disabilities. 

For experienced workers’ compensation lawyers in Kentucky, contact McCoy & Sparks Attorneys at Law. You can schedule your free, no-risk consultation today online or by calling 844-459-9467.