Even if your doctor has formally recommended a surgery, getting authorization from L&I can be challenging for injured workers in…
Many injured workers, especially those residing out of state, encounter medical providers who are unfamiliar with Washington state’s workers’ compensation rules so it is essential to understand your rights when it comes to medical bills related to your care.
Washington State’s Medical Treatment Fee Schedule
All medical expenses related to your work injury should be covered under your workers’ compensation claim. That said, the state of Washington has a fee schedule. This means that regardless of the specific medical treatment needed in relation to your work injury, all expenses are paid according to their fee schedule. Even if the state’s fee schedule does not meet the provider’s private practice rates they cannot bill you for the difference.
What If My Medical Provider Billed Me Directly?
A medical provider is not allowed to bill you directly for the difference between the fee schedule and their private rates. If you receive a bill for medical services related to your work injury, you should follow these steps:
Respond Promptly: Address the bill as soon as possible in an effort to avoid any further complications.
Contest the Bill in Writing: Write a clear and respectful response to the medical provider. We have prepared the appropriate language for you to use when doing so:
“I respectfully hereby contest this bill because it is my understanding that the applicable workers’ compensation law, RCW 51.36.085, doesn’t allow the patient to be billed any amount of the services charged, so please contact my attorney at Washington Law Center at (206) 596-7888 if you have any questions or disagreement. My attorney will handle all further inquiries; so please do not bill me directly again.”
Keep Records: Make sure to keep copies of your response and all related correspondences.
Your Rights as an Injured Worker
As an injured worker in Washington, you are entitled to the following rights:
No Direct Billing: You have the right to quality medical care for your work injury without the financial burden for the cost of doing so.
Refer To Your Attorney: You have the right to refer any inquires about medical billing to your attorney.
Protection Under the Law: All medical providers who agree to treat injured workers in Washington (or with Washington workers’ compensation cases if the provider is outside of Washington state) are bound by the fee schedule and are not allowed to ask you to pay any potentially difference in cost.
Receiving a medical bill for medical treatment related to your work injury can be confusing, especially if you live out of state, but you have rights as an injured worker and it is important to handle any incorrect bills appropriately. If you encounter a situation where a medical provider is trying to bill you directly Washington Law Center is here to protect your rights and ensure it is handled correctly. For any questions or concerns, please reach out to our office at 206-596-7888 and speak with an experienced attorney.
We Can Also Help Your Medical Provider
If your medical provider has questions about billing procedures or process in Washington state, please refer them to Washington Law Center. We support the team that supports and advocates for you, which means that we stand ready to provide no-fee representation to medical providers whose bills have been improperly denied by the Department of Labor & Industries or a Washington Self-Insured Employer.
ABOUT THE AUTHOR:
Spencer Parr is a litigation and trial attorney at Washington Law Center focused primarily in the areas of Labor & Industries claims and injury pension benefits. Before co-founding Washington Law Center, Spencer served in the U.S. Army. He has litigated major issues in the law, represented clients from coast to coast, and dedicated his professional life to assisting the injured and disabled. Click here to learn more about Spencer. View More Labor & Industries and Work Injury Resources.