If you suffer a compensable work-related injury, the workers’ compensation carrier must pay the medical bills for all treatment that is reasonable and related to the injury. There is no time limit on this obligation. For so long as the treatment is deemed to be reasonable and related to the injury, the carrier must pay the bills.
Carriers will often try to evade this obligation, however, by arbitrarily denying medical bills. If the injured employee does nothing in response to this, the carrier will get away with not paying the bill. Don’t let the carrier get away with this!
If you are an injured employee, and your workers’ compensation carrier denies a bill for treatment that your medical providers believe is reasonable and related to your work injury, you should appeal the denial to the New Hampshire Department of Labor within 18 months of the date the carrier denies the bill.
You should enlist the aid of an experienced workers’ compensation attorney if you find yourself having to appeal the denial of a medical bill. The attorney will not charge you anything to represent you on a medical bill issue before the Department of Labor. How does the attorney get paid? If the attorney prevails for you and obtains a Department of Labor Order requiring the carrier to pay the disputed bills, the carrier must pay your attorney’s fees. The carrier must also pay the injured employee’s attorney’s fees if the carrier denies a bill, forcing an employee to request a Department of Labor hearing, and then reverses its position and accepts the bill fewer than seven (7) business days before the hearing date. This new provision in the law, which became effective January 1, 2011, is designed to discourage workers’ compensation carriers from “playing games” with an injured employee’s medical bills.
Some carriers try to avoid their obligation to pay medical bills by ignoring them. Instead of issuing denial letters, they simply do nothing. Carriers break the law when they ignore medical bills. New Hampshire law requires carriers to either accept or deny medical bills within 30 days of receiving them. Specifically, within 30 days of receiving a medical bill the carrier must either a.) pay the bill; or b.) deny the payment, with notice to the health care provider, the injured employee, and the Department of Labor. A denial letter must state a valid reason for the denial and must advise the injured employee of the right to petition for a hearing.
If your carrier ignores your medical bills, failing to pay them or properly denies them within 30 days, you or your attorney should notify the Department of Labor so that the Department may take appropriate enforcement action. Call Douglas, Leonard & Garvey or fill out our contact form if you are having problems getting your medical bills paid.