Can You Go to Urgent Care or ER for Workers’ Comp?

Yes, you can go to urgent care or the ER for a workers’ comp injury that happened on the job. There are many situations where waiting for a doctor’s appointment is not an option. Even though those medical professionals may not be approved by the insurance carrier, your health comes first.

After medical treatment, you may need to see a medical provider on the approved list for your workers’ compensation claim to confirm what happened to you and what the best course of treatment is for your workplace injuries.

If your employer or the workers’ compensation insurer tries to tell you that you cannot go to urgent care clinics or to the hospital emergency room, you need legal representation. They may be trying to deny your workers’ comp claim. Contact our Atlanta workers’ compensation lawyers for help.

Will Workers’ Comp Cover the Cost of an ER Visit?

Workers’ compensation will almost certainly cover the initial visit, especially if you had a legitimate medical emergency. If you need emergency room treatment, there’s no time to tell your employer what happened. You need medical care right away.

Additional trips may not be covered, though, unless you can prove your work-related injury worsened and needed emergency treatment again. The approved medical provider may not be available if you suddenly need further medical services, so don’t ruin your health by not getting care when you need it.

One problem with ER visits is that doctors in emergency rooms see many patients. They may not have time to write up thorough medical documentation or detailed medical notes. If you can, tell them when you go in that your injury is work-related, that you need a copy of your medical records, and make sure all billing information is accurately recorded. 

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What are Some Injuries That May Need ER or Urgent Care Treatment?

In cases of severe or life-threatening injuries (such as the ones listed below), you should always go to the nearest emergency room immediately:

• Severe bleeding
• Head injuries with loss of consciousness
• Suspected broken bones
• Chest pain or difficulty breathing
• Severe burns

For less severe workplace injuries that still require prompt attention, an urgent care facility or occupational clinic may be appropriate. This could include:

• Sprains and strains
• Minor cuts requiring stitches
• Non-life-threatening burns
• Persistent pain from an injury

Remember, if you’re unsure about the severity, it’s always better to err on the side of caution and seek immediate medical attention. Some injuries that seem minor (like a sprain) can turn out to be serious and affect your return to work and return-to-work timelines if left untreated.

Do I Need My Employer’s Permission to Go to the ER or to Urgent Care?

No, you do not. However, you do need to notify your employer about the work injury and your visit as soon as you can, preferably within 24 hours.

Injury reports should be filed promptly: when you notify an employer about an injury, they must make a report to their employer’s insurer by law. Your report will help them make their report. In some states, specific forms  (like Form 827 or Form 801) may be required depending on your jurisdiction.

Sometimes, employers or their insurance carriers may question the necessity of an emergency room or urgent care visit. The panel provider rule in some states may require you to choose from an approved list for follow-up care, but it does not prevent you from seeking emergency treatment.

If your employer or their claims administrator disputes your visit, go anyway and then seek legal guidance. Our skilled attorneys can help you demonstrate that your visit was medically necessary and should be covered under workers’ comp.

Should I Go Back to the ER or Urgent Care for Follow-Up Care?

Only return to the ER or an urgent care facility in a true medical emergency. For follow-up care, visit one of your employer’s approved workers’ comp doctors. Your employer should have a list of at least six to choose from through their insurer.

Bring your medical records from your initial visit when you see the approved medical provider. This helps them understand your work-related injury and your care instructions.

Medical bills for follow-up care should be covered under your workers’ compensation claim as long as you’re seeing approved providers. If you used your health insurance to cover initial costs, you may be entitled to Reimbursement of Expenses once your claim is approved.

When to Seek Legal Assistance With Your Workers’ Comp Claim

While many workers’ compensation claims proceed smoothly despite an ER or urgent care visit, there are situations where legal assistance becomes necessary. Here are some signs you may need to consult with a workers’ comp attorney:

• Claim denial: If your workers’ compensation claim is denied because of the ER visit, an attorney can help you understand the reason for the denial and guide you through the appeals process.
• Disputed medical treatment: If your employer or their workers’ compensation insurer is refusing to approve necessary medical treatment or medical care, a lawyer can advocate on your behalf to ensure you receive proper, personalized care.
• Retaliation: If you face negative consequences at work, such as demotion or termination, because you went to the ER, legal representation can protect your rights.

Many workers’ compensation attorneys, including John Foy & Associates, offer free initial consultations. Seeking legal help early can often prevent issues from escalating and ensure your access to workers’ comp is protected.

Workers’ Comp Can’t Stop You From Going to the ER or Urgent Care

There is no rule in workers’ comp that stops you from going to the emergency room or an urgent care clinic for work-related injuries or a medical emergency on the job. The insurer may insist that you follow up with one of their approved medical providers, but when you’re in an emergency situation, your health takes top priority over bureaucracy.

Should you receive retaliation from your employer or a claim denial from the insurance carrier because you went for emergency medical care, get legal assistance immediately. John Foy & Associates can help you with your workers’ compensation questions. 

Contact us now for a free consultation.