Case Study: Future Medical Coverage | Klezmer Maudlin

The Indiana Worker’s Compensation Act and the case law which interprets the Act permits a hearing member to enter an award for palliative future medical coverage. Just because a worker injured on the job reaches the maximum medical improvement, he/she might still need continued treatment of pain or injury from the underlying accident.

Medical evidence for future expenses

To obtain an award for future medical coverage, the injured worker has the burden of proof and must establish that she will have future needs that are medically necessary to limit or reduce the impairment. It is imperative that you have solid medical evidence to support a claim for future medical expenses.

If you are seeking compensation for future medical expense, you will need to request a narrative report from your treating physician to help support your claim. Most doctors are willing to supply you with a one-page report at little to no cost to you.

This report should include:

  • a history of the injury, past and present symptoms, diagnosis, what type of treatment (if any) the injured worker can expect to receive in the future to either get back to pre-injury state, or a state where symptoms are controlled.
  • the physician’s opinion regarding a causal relationship between a work accident in the injury and a statement outlining the probability or likelihood that the worker will require future medical care to limit or reduce the impairment
  • the physician’s original signature.

Carefully consider a permanent partial impairment (PPI) rating before accepting a settlement

Our office sees many of these cases in which a worker accepts a PPI (Permanent Partial Impairment) settlement and overlooks a claim for future medical coverage. If a worker accepts a PPI rating, the worker may be precluded from obtaining future medical coverage.

In a recent case, a worker was offered a seven percent PPI  valued at $9,800.00. The worker wished to accept the offer. At that same time, the worker needed three different medications to limit the degree of her pain. The cost of these medications plus doctors’ visits, amounted to over $6,000.00 per year. Our office was able to reach a settlement for the worker which included additional money to help pay for these future medical costs.

If you have been injured at work and believe you deserve future medical coverage, contact a lawyer at Klezmer Maudlin, PC, by calling 317-569-9644.

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