Does Workman's Comp Pay for Physical Therapy?
Workers’ compensation, or workman’s comp, is a mandatory insurance program that is designed to ensure that workers who experience on-the-job injuries or job-related illnesses are compensated for medical care, lost wages, and any type of long-term disability resulting from these incidents.
So is physical therapy medical care? Does workman's comp pay for physical therapy? It certainly does under some circumstances, and here we’ll go over the basics of what you may be entitled to if you need physical therapy to help you recover and/or rehabilitate from a workers’ comp injury or illness.
Under workman’s comp, employers (or their workers’ comp insurance carriers) are responsible for paying for reasonably necessary medical treatment associated with a workplace injury. That means that if the treating physician (the doctor, selected by the employer/insurance carrier, who is primarily responsible for overseeing the injured worker’s care) recommends particular treatments, therapies, specialists or medical devices, for instance, as necessary to the worker’s treatment and recovery, workers’ comp must pay for them – within the limits/guidelines of the workers’ comp program.
Physical therapy is often recommended by treating physicians as reasonably necessary treatment, and therefore is often paid for by workman’s comp. This may include physical therapy treatment immediately after an injury to aid in recovery and/or rehabilitation, with workers’ comp footing the bills for short-term rehabilitation services deemed reasonably necessary to help the injured worker regain function and return to work.
Rehabilitative therapy after a surgical procedure related to a workplace injury is also often covered. In some cases, workers’ comp may also cover ongoing physical therapy (which is usually geared towards achieving the best possible level of functional improvement and recovery) for a certain period of time when long term disability is caused by a workplace injury.
So, what this means for you, as an injured worker, is that in order to get your physical therapy paid for by workman’s comp, your therapy must be ordered by an authorized treating physician as a medically necessary component of your overall injury treatment.
Generally, physical therapy will only be covered while that treating physician feels that you can benefit from therapy and are making progress with your recovery aided by that therapy. Once your doctor feels that you have reached your best level of recovery and rehabilitation – or, as it is expressed for workers’ compensation purposes, have reached maximum medical improvement (MMI) – coverage for physical therapy treatment is typically withdrawn, meaning that workers’ comp will no longer pay for any physical therapy services in your case.
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