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When Can Workers' Compensation Refuse to Pay My Medical Bills?

The workers compensation insurance company must pay all of the medical bills that are "necessary and reasonable" and "related to the work injury." The insurance company can refuse to pay the medical bills only in the following circumstances:

(1) it has denied your workers compensation claim;
(2) it has filed a "Form 2 Denial" because (i) the treatment is not related to the injury or (ii) the treatment is not reasonable and necessary.

The workmans comp insurance company cannot refuse to pay for a medical bill simply because you are at "medical end result" or "maximum medical improvement." It must continue to pay all medical bills for the rest of your life (as long as they are related to the injury and are reasonable and necessary). After you reach medical end point, the insurance company must continue to pay for "palliative care," which is medical treatment which helps you remain functional and decreases pain. Examples of palliative care are medications, chiropractic care, acupuncture, physical therapy, massage, etc.

For more help with figuring out what to do if the insurance company refuses to pay your medical bills, go to www.vermontworkerscompensationlaw.com

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