Can I Get Treatment While My Workers' Comp Claim Is Disputed?

What the law says about collection during a dispute

If an employee informs a provider that a claim is on file at the Commission, the provider must cease all efforts to collect payment from the employee. The time limit for the provider to collect is paused while the claim is pending. The provider may still mail reminders that the employee will be responsible for the bill once collection can resume.

What happens when the claim ends

After a final award or settlement, a provider may resume collecting from the employee, and the employee is responsible for outstanding bills plus any interest awarded. If the service is found to be covered, the provider may not require payment above the workers' compensation rate, apart from interest.

What this means in practice

A dispute over the claim does not by itself stop a worker from being evaluated and treated. Each provider decides whether to see a patient whose claim is disputed, and it is reasonable to ask the provider's office about that before the first visit.

Keep your paperwork

• Every bill and letter from a provider
• Any written denial from the employer or insurer
• Your claim number at the Commission, if one has been filed
• Work status notes from each visit