Work Comp Prescription
Workers’ compensation covers the cost of treating a work-related injury or illness and replaces part of the income you lose while you cannot work. What it does not cover is anything unrelated to that injury. Most disputes come down to that boundary rather than to the list itself.
Medical treatment
All reasonable and necessary medical care for the accepted injury, at no cost to you. In practice that includes:
- Emergency treatment and hospital care
- Doctor visits, specialist referrals and follow-up appointments
- Diagnostic imaging and testing
- Surgery where needed
- Physical therapy and rehabilitation
- Prescription medication
- Medical supplies, braces, and durable medical equipment
- Travel costs to and from medical appointments in many states, sometimes including pharmacy trips
There is no copay, no deductible and no coinsurance on any of it. If you are being asked to pay for treatment for an accepted work injury, something has gone wrong and it is worth querying.
Prescriptions and supplies specifically
Prescriptions related to the accepted injury are covered in full. So are medical supplies and equipment where prescribed, from wound care and braces to mobility aids. The complication is not whether they are covered but how they get paid for: the pharmacy has to bill the carrier directly, and many cannot. Our guide to whether workers’ comp pays for prescriptions covers this, and we deliver medication and supplies together to injured workers in 24 states.
Lost wages
If the injury stops you working, workers’ comp replaces part of your wages, typically a percentage of your average earnings rather than the full amount, and usually after a short waiting period. Where you can work but only in a reduced or light-duty capacity, partial benefits may make up some of the difference. The percentages, waiting periods and maximums are all set by state.
Permanent impairment and longer-term benefits
Where an injury leaves lasting effects, most states provide additional compensation based on an impairment rating. Some also provide vocational rehabilitation where you cannot return to your previous role. These are among the most state-variable parts of the system.
What workers’ comp generally does not cover
- Injuries unrelated to work, including pre-existing conditions except where work has demonstrably worsened them
- Pain and suffering, which is a feature of personal injury claims rather than workers’ comp
- Injuries occurring during a normal commute, in most states
- Injuries caused by intoxication or by deliberately violating safety rules, in many states
- Treatment not authorized or not considered reasonable and necessary for the accepted injury
What happens after a settlement
This is the question people most often get wrong. Whether your medical treatment and prescriptions continue after a settlement depends entirely on how the settlement was structured: some leave future medical care open, others close it out in exchange for a larger payment. If you are considering a settlement and you expect to need ongoing medication, that is a specific question to raise with your attorney before signing, because the pharmacy coverage follows the settlement terms.
FAQ
Does workers’ comp cover prescriptions?
Yes, in full, for medication related to the accepted injury, with no copay or out-of-pocket cost to you.
Does workers’ comp cover braces and medical equipment?
Generally yes, where prescribed for the accepted injury. We dispense and deliver supplies alongside medication.
Does workers’ comp pay for travel to the pharmacy?
Many states reimburse travel for medical appointments and in some cases pharmacy trips. Rules vary, so check with your adjuster. Home delivery removes the issue entirely.
Will my prescriptions still be covered after a settlement?
It depends on whether future medical care was left open or closed out in the settlement. Raise it with your attorney before signing if you expect ongoing medication.
The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.
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Our location
Patient Direct Pharmacy 3350 N. High School Rd. Ste. JIndianapolis, IN 46224
(317) 676-5752