If the work-related injury qualifies for coverage and the worker is treated by a BWC-certified provider, the injured worker will not have to pay for any approved medical care that is needed. Unlike regular health insurance, there are no deductibles or co-pays for workers’ compensation benefits. However, there are limits to what treatment an injured worker can receive.
The employer's Managed Care Organization (MCO) manages the medical portion of the claim. This includes medical treatment and surgery approvals, payment of medical bills, rehabilitation referrals, and any return-to-work services.
The injured worker and their employer have the right to appeal medical decisions made by the MCO. Refer to the Appealing treatment decisions page for more details.
Needing additional treatment
Sometimes a medical provider will request that an additional condition or treatment be added to your workers’ compensation claim. However, BWC must agree to allow that additional condition or treatment before any medical bill for that request can be paid.
To request treatment, the injured worker's doctor (POR) will submit a Physician's Request for Medical Service or Recommendation for Additional Conditions for Industrial Injury or Occupational Disease (C-9) form to the assigned MCO for pre-authorization of the additional treatment or services. The injured worker will receive a letter from the MCO stating whether the medical treatment is approved or denied.