Who pays my medical bills in a New York workers’ comp case?

One of the most important protections in New York workers’ comp law is that your employer’s insurance carrier must pay all medical bills related to your accepted work injury. This obligation is set out in NY Workers’ Compensation Law §13.

You should never receive a bill for workers’ comp treatment. Not a co-pay. Not a deductible. Not a balance bill. If a doctor’s office or hospital bills you personally for a workers’ comp injury, tell them immediately that this is a workers’ comp case and give them your claim number. Many billing errors happen simply because the front desk does not flag the visit correctly.

For the insurance carrier to pay, your doctor must be enrolled as a WCB-authorized provider. Treatment from non-authorized providers can be denied, leaving you personally responsible for the bill. Before any scheduled procedure or specialist visit, confirm the provider is authorized by checking the WCB’s online provider directory.

The carrier can dispute whether a specific treatment is necessary or related to your work injury. Common disputes involve surgery authorization, physical therapy frequency, MRI requests, and pain management procedures. When a carrier denies authorization, your doctor submits a Request for Authorization (RFA). Disputes over necessity go to the WCB Medical Director’s office for a determination.

Emergency care is always covered, regardless of provider authorization status. If you require emergency treatment for your work injury, go to the nearest facility — sort out the billing details afterward.

Unpaid medical bills create pressure on injured workers to settle prematurely. Do not let outstanding bills force you into a bad Section 32 deal. Call us and let us help manage the medical billing side of your case.