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Home> Workers' Comp> What Are The Benefits of Workers' Compensation In Texas? > Medical benefits

What Are The Medical Benefits Available To Workers' Compensation in Texas?

Medical benefits pay for necessary medical care to treat your work-related injury or illness. Your employer's workers' compensation insurance company pays medical benefits directly to the health care provider who provides your medical treatment.

Medical benefits are paid only for the treatment of your work-related injury or illness. The insurance carrier does not pay for the treatment of other injuries or illnesses, even if the treatment was provided at the same time you received
treatment for your work-related injury. Your health care provider may not bill you for treatment related to a work-related injury or illness, but may bill you for treatment of other injuries or illnesses.

When Can I Seek Medical Treatment Under Workers' Compensation?

You may receive necessary medical treatment immediately after the work-related injury or illness. You have the right to an initial choice of doctor. The doctor you choose must be on the Divisions's Approved Doctor List (ADL).

How Do I Know If A Doctor Is On The Approved Doctor List (ADL)?

1. First, go to:
   www.tdi.state.tx.us/wc/information/locatedoctor.html.
2. Click on "TXCOMP Healthcare Provider System".
3. Place the cursor on main menu, and then click on "Locate Doctor". You can then search for a doctor by name, city, county, or specialty.
4. If you do not have access to the Internet, you may call 1-800-252-7031 and request a list of Division approved doctors in your area, which can be mailed or faxed to you.

What If I Need To Change Doctors?

After you have chosen a doctor, any request to change doctors must be approved by the local Division office handling your claim. If you or your doctor move, or the doctor becomes unavailable to provide medical treatment, you will be allowed to choose another doctor from the ADL. This will be considered an exception to the law and will not be viewed as a request to change doctors.

You will need to complete the Employee's Request to Change Treating Doctors (DWC Form-53) and file it with the local Division office. Your treating doctor may refer you for medical treatment to another doctor, without permission or approval from the Division or the insurance carrier.

Will I Have To Pay The Medical Bills From A Doctor on the ADL?

A doctor may not bill you for treatment of a work-related injury or illness. The doctor may send you a copy of the bill marked as "information only" upon your request.

The doctor cannot try to contact you for payment using any of the following methods:

• send you a bill when you did not request an information copy
• have a collection agency send you a letter or contact you
• file a lawsuit in court against you
• collect, charge or require you to pay a co-payment when filing a claim with private health insurance.

A doctor may only request payment from you when the work-related injury or illness has been reviewed through dispute resolution hearings before the Division or the Courts and has been finally determined to be an injury or illness that is not work-related.

It is beneficial to everyone involved that you return to work as quickly as possible. Injured workers that continue to work as part of their recovery and treatment plan, in medically appropriate productive work, heal faster, and may retain their job skills.

It's a good idea to seek advice via Texas Workers Comp Help if you have any questions. Contact us today .