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Costs and Healthcare Providers

The employer or insurer is required to provide the medical treatment and care to cure and relieve the employee from the effects of the injury. This includes all costs for authorized medical treatment, prescriptions, and medical devices. There is no deductible and all costs are paid by the employer or its workers’ compensation insurance company. If you do receive a bill, contact your employer or the insurance company immediately.

The employer (or the insurer, on behalf of the employer) has the right to choose the healthcare provider or treating physician. However, the employee has the right to select a treating physician at the employee's own expense. Section 287.140.13 RSMo, precludes a hospital, physician, or other health care provider, other than one selected by the employee at the employee's expense, from billing or attempting to collect any amount from the employee for health care services provided in a workers' compensation case and the hospital, physician, or health care provider has received actual notice in writing by the employee, employer, or the employer's insurer. However, the employer and insurer may authorize you to see your own doctor. You should check with the employer and insurance company with respect to any medical treatment you seek.

Related: Doctor and Medical Care FAQs

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Use of Leave Time

The employer may allow or require an employee to use any of the employee's accumulated paid leave, personal leave, or medical or sick leave to attend to medical treatment, physical rehabilitation, or medical evaluations during work time.

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Traveling for Medical Treatment

Sometimes it is necessary to travel to see a physician. In situations in which an employee is required to submit to treatment at a place outside of the local or metropolitan area that is the employee's principal place of employment, the employer is required to pay the necessary and reasonable expenses. In no event is the employer or insurer required to pay transportation costs of more than 250 miles each way from the place of treatment. If the injured worker resides outside of Missouri, the employer has the option of selecting the treatment at a location within 100 miles of the injured worker's residence, place of injury, or place of hire by the employer.

Related: Doctor and Medical Care FAQs

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Medical Examinations and Evaluations

Examinations

Section 287.210.1 RSMo states: “After an employee has received an injury he shall from time to time thereafter during disability submit to reasonable medical examination at the request of the employer, [or] his insurer, . . .” The only restriction on medical examinations is the word “reasonable.” Multiple exams may be reasonable when the employee has multiple injuries or conditions, or treatment continues for several years. Section 287.210.1 RSMo also states that if the employee “refuses to submit to the examination or in any way obstructs it, his right to compensation shall be forfeited during such period unless in the opinion of the [administrative law judge] the circumstances justify the refusal or obstruction.”

Evaluations

Section 287.143 RSMo states: “An employee shall submit to appropriate vocational testing and a vocational assessment scheduled by an employer or its insurer.” Vocational testing and assessment are generally performed by “vocational rehabilitation counselors;” these persons are usually not physicians, but do have specialized training or experience in the area of vocational rehabilitation job training and placement. Vocational testing and assessment are usually done only in cases in which the employee is alleging that he or she is permanently and totally disabled (that is, no longer able to work at any job).

Related: Doctor and Medical Care FAQs

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Copies of Medical Records

Under the law, every hospital or other person that provided the medical care and treatment to the injured employee shall allow its records to be copied and to furnish full information to the Division or Commission, the employer, the employee or his dependents and to any other party to the workers’ compensation proceeding. The Missouri Workers’ Compensation Law does not address the copying costs that may be charged by the hospital or other health care providers. Pursuant to Section 191.227.2 RSMo, a health care provider may charge a fee for copying, in an amount not more than seventeen dollars and five cents plus forty cents per page for the cost of supplies and labor; postage, to include packaging and delivery cost; and notary fee, not to exceed two dollars, if requested. The Missouri Department of Health and Senior Services is required to report the annual adjustment and the adjusted fees that are authorized in Section 191.227 RSMo on its Web site.

Related: Doctor and Medical Care FAQs

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DISCLAIMER - More Information

The Injured Workers section of the Workers' Compensation portion of this web site is targeted specifically to injured workers and is intended to be a resource throughout the workers' compensation claim process. It is NOT intended to be a substitute for legal representation.

Employers seeking information about the workers' compensation process and their responsibilities regarding workers' compensation should use the Employers section of the Workers' Compensation portion of this web site to find information targeted specifically to them.

Additional information about Missouri Workers' Compensation laws, the Division of Workers Compensation, the Second Injury Fund and more may be found via the Workers' Compensation home page.

Please keep in mind the information specialist cannot act as your legal counsel and cannot give you legal advice. The information specialist can provide you with general information but cannot advise you whether the settlement offer is appropriate for your injury.