Does Workers Comp Pay for Medication?

Workers’ compensation is a lifesaver for those injured or made ill due to work-related causes. It provides medical benefits, such as hospitalization, surgery, and rehabilitation therapy, as well as wage replacement. The goal is to help injured workers get back on their feet.

Many people don’t realize workers’ comp pays for specific treatments, such as medications. If you’re dealing with a work-related injury or illness, here’s what to know about the cost of and payment for medication.

Know Your State’s Regulations

When it comes to medication, it’s worth noting that every state has different workers’ compensation laws and regulations. Therefore, workers’ comp benefits can differ from state to state, including what medications are covered and what copayments, if any, the injured workers are expected to pay.

You can learn more about Maryland’s guidelines by visiting MD’s Workers’ Compensation Commission.

What Drugs are Covered

In states that cover medication, injured workers may receive reimbursement for prescription drugs that their physicians prescribe to treat their work-related injuries or illnesses.

These drugs may range from painkillers to antibiotics to antidepressants, depending on the severity of the injury or illness. However, it’s important to note that the reimbursement amount also varies depending on where the worker lives.

Some states have reimbursement caps. This means that injured workers can’t receive prescription coverage more substantial than a set amount of money. This is true regardless of the actual cost of their prescription drugs.

Injured workers must adhere to their state’s requirements for obtaining approved medications and for filling their prescriptions. Otherwise, their benefits may be denied. This means that they should follow their doctor’s instructions, including filling their prescriptions at insurance or worker’s comp-approved pharmacies.

They must also describe their injuries and treatments accurately and completely at every healthcare appointment to ensure that they get the right amount of medication for the correct condition.

Adhering to Ethical Standards

Finally, injured workers must adhere to certain ethical standards when it comes to filling their prescriptions. Some states have a criminally punishable law against using workers’ comp funds to purchase unlawful drugs such as illegal opioids. Instead, they need to use their compensation to purchase medications that their doctors prescribe to treat their injuries or diseases properly.

The question of whether workers’ comp covers medication costs requires a case-by-case analysis of the specific circumstances. This includes the medications needed to treat their injury or illness, and the laws, as well as state regulations. While some injured workers may receive full reimbursement, others may have to pay a portion of the cost of their medications.

A workers’ compensation attorney can help you understand your rights and support you in navigating the complicated workers’ comp system.

For more information or to schedule a consultation to discuss your options if you’ve been injured, contact Shugarman & Mehring at 410.783.4200 or toll-free at 888.342.7200.