Archive for July, 2023

Jul 2023

Does Workers’ Compensation Cover a Torn Meniscus?

torn meniscus at work; RI and MA workers' compensation lawyer

A torn meniscus is a common work-related injury that can be painful and debilitating. This type of injury affects your ability to work and engage in daily activities. If you suffered a work-related torn meniscus, it’s important to understand your rights and the process involved in recovering workers’ compensation benefits.

Know what to do if you experience this type of knee injury

The meniscus is a C-shaped piece of cartilage located in each knee joint. There are two menisci in each knee, one on the outer side (lateral meniscus) and the other on the inner side (medial meniscus). These structures act as cushions or shock absorbers between the thigh bone (femur) and the shinbone (tibia).

How a workplace injury can happen

Menisci play a crucial role in maintaining knee stability, distributing weight across the joint, and reducing friction during movement. But each meniscus is vulnerable to injury due to its location and structure and the demands placed on the knee joint during various activities.

The structure of the meniscus is soft, rubbery cartilage that is more prone to tearing compared to other structures in the knee, such as ligaments. The pressure placed on the meniscus during weight-bearing activities increases the risk of injury, especially if excessive force or twisting motions are involved.

Workers involved in physically demanding jobs or those required to perform repetitive motions are more likely to suffer a torn meniscus. Some common scenarios that may lead to this injury at work include:

  • Lifting heavy objects
  • Twisting or pivoting motions during work activities
  • Repeatedly kneeling or squatting
  • A sudden, forceful impact to the knee during workplace accidents.

Is a torn meniscus covered under workers’ compensation?

In Massachusetts and Rhode Island, the answer is “yes” if the injury is work-related and occurs during the course of employment. Workers’ compensation benefits should cover all medical expenses related to your injury, as well as partial wages while you are unable to return to work.

But there are steps you should take to ensure that you meet the requirements for a workers’ compensation claim. After you are injured:

  • Inform your employer about the injury as soon as possible.
  • Get medical treatment. A doctor can begin treatment and document the injury to help establish a link between the torn meniscus and your work-related activities.
  • Contact an experienced workers’ compensation lawyer. An attorney can help you file a claim for benefits and guide you through the process every step of the way.

Do I need a lawyer for a claim involving a torn meniscus?

There is no requirement in Massachusetts or Rhode Island to have an attorney when seeking workers’ compensation benefits. But the process can be complicated, and claims are often disputed or denied. An experienced attorney will be familiar with state laws and how the system works.

A lawyer can:

  • Complete all necessary paperwork correctly and ensure all deadlines are met
  • Gather evidence in support of your claim (such as medical reports and witness statements)
  • Negotiate with insurance companies and adjusters
  • Make sure that healthcare providers who treat your injury take you seriously
  • Help you file an appeal if your claim is denied
  • Represent you at all hearings.

The Law Offices of Deborah G. Kohl fights for injured workers. We know what it takes to get a workers’ compensation claim approved. Our firm puts in the work to build a strong case for benefits and will fight for you right from the start.

If you suffered a torn meniscus on the job, learn more about how we can help. Contact us to schedule a free consultation.

Jul 2023

Will Worker’s Compensation Pay For My Prescriptions in Massachusetts?

prescription medication, pad, and stethoscope; Massachusetts workers' compensation lawyer

Suffering an injury or illness while on the job can impact your life physically, emotionally, and financially. Workers’ compensation benefits are supposed to cover all of your medical expenses, but injured workers may still have concerns. For example, will the prescription medications I need be covered?

A lawyer can guide you through the claims process

Under Massachusetts workers’ compensation laws, injured workers are entitled to medical benefits that cover reasonable and necessary medical treatment related to their work-related injury or illness. This includes coverage for prescription medications that are deemed essential for the recovery and rehabilitation process.

But it can get complicated.

The coverage of prescription medications in a workers’ compensation claim varies depending on the specific circumstances of the injury and the treatment plan prescribed by your doctor. If you’re unsure about the coverage for your prescription medications or need assistance with your claim, consult an experienced workers’ compensation attorney right away.

What’s covered under workers’ compensation laws

Before obtaining prescription medications through workers’ compensation, your healthcare provider must obtain pre-authorization from the insurance carrier. This process involves submitting a written request and medical documentation justifying the medical necessity of the prescribed medication.

For a prescription to be covered under workers’ compensation, it must be considered reasonable and necessary for treating the work-related injury or illness. This means that the medication should be directly related to the medical treatment plan and tailored to your specific needs.

In some cases, the insurance company may suggest or require the use of less expensive alternative medications that provide similar therapeutic benefits. You have the right to discuss treatment options with your doctor and can appeal this decision.

The insurance company will periodically review the medical treatment and prescriptions provided. Your doctor must support the medical necessity of the prescribed medications to ensure ongoing coverage.

A lawyer can assist you in understanding your rights and options regarding the insurance company’s suggestions or requirements for alternative medications.

Seeking legal representation

An experienced attorney can help you navigate the claims process in Massachusetts to ensure you get the prescription medication and other medical care that you need. A lawyer can:

  • Explain the pre-authorization process, the criteria for medical necessity, and the potential coverage of alternative medications.
  • Work with your doctor to ensure that all necessary paperwork is submitted correctly and promptly to the insurance company.
  • File an appeal on your behalf if your medication request is denied and provide additional evidence supporting the medication’s necessity.
  • Negotiate with the insurance company to ensure that you receive appropriate coverage and timely access to necessary medication.
  • Ensure you receive all of the medical treatment you need for your injury or illness in addition to prescription medication and work to prevent delays or disruptions in treatment.
  • Monitor reviews to ensure that the insurance company continues to cover necessary prescription medications.

Get an experienced attorney on your side

Having an experienced workers’ compensation lawyer by your side can provide peace of mind during a difficult time. Your lawyer can handle your claim so you can focus on your recovery and well-being.

At The Law Offices of Deborah G. Kohl, we understand the importance of receiving proper care for your work-related injury or illness. That includes being able to take the medication your doctor prescribes. If you’ve been hurt on the job in Massachusetts, we can help. Contact us now to schedule a free consultation.