What to Do if Workers Comp Is Not Paying Your Bills in Cincinnati

Compassionate Ohio attorneys working for you

When you are being treated for a work-related injury, you need to focus on getting better and returning to work as soon as possible. At Clements, Taylor, Butkovich & Cohen, L.P.A., Co., we understand this and do everything possible to make the workers compensation system live up to its promises and work for you. Payment of your medical bills is one of the primary benefits of workers comp. Your treatment plan and recovery may be negatively impacted if your claim has been approved, but your doctors and medical providers are not getting paid. If this happens, our experienced job injury attorneys can be of assistance. In some cases, medical providers may suggest that you need to pay these bills yourself, and then be reimbursed. But if the expenses go into the thousands of dollars – particularly in cases of hospitalization or surgical procedures – then it is simply too much of a financial burden to ask you to shoulder the expense before the Bureau of Workers Compensation reimburses you. In actuality, the BWC should be paying those bills outright, as soon as medical services are rendered.

Why aren’t my doctor bills being paid?

doctorThere may be several reasons why bills from your doctor or other medical provider are not being paid by workers compensation. We help you figure out the reason why and resolve the situation. These problems are one reason why you often need a lawyer for workers comp claims.


If your doctor or other medical provider is not being paid, here are some issues to consider:

  • Prior authorization — Did the doctor or medical provider obtain prior authorization for the services provided? Prior authorization is normally required. Most doctors and medical providers will obtain prior authorization on your behalf. Did yours? It could be the case that your medical providers obtained prior authorization, but their proof of such authorization did not go through correctly to the Bureau of Workers Compensation. Sometimes, merely providing an additional copy of relevant documentation will help a claim be approved and paid.
  • Maximum medical improvement — Have you reached the maximum medical improvement (MMI) for your condition? MMI is the stabilization of your medical condition, which means that continued treatment will not improve your physical condition further. Workers compensation may not pay for treatment once you have reached your MMI. But you may be entitled to other types of payments from workers compensation even after your MMI has been reached. Demonstrating MMI is not always a cut-and-dried step of this process. If you believe you have further to recover, and the workers’ compensation office thinks you have recovered to the fullest extent, then you may be compelled to provide evidence or documents defending your position.
  • Self-insured employer — Is your employer self-insured for workers compensation? If your employer is self-insured and not paying your bills, you or your attorney may need to contact the Ohio Bureau of Workers Compensation (BWC) for assistance. Employers may not self-insure unless they have a minimum of 500 employees in the state and demonstrate significant financial strength. But even large companies face financial troubles now and then, or make mistakes. The good news is that the BWC requires employers who are self-insured to participate in the Self-Insured Employers’ Guaranty Fund. This fund guarantees claims liabilities if the employer cannot pay them. You may need to have your doctor or medical bills paid from the Self-Insured Employers’ Guaranty Fund.

Contact one of our skilled and compassionate workers compensation attorneys in Cincinnati, OH

The world of workers compensation involves many parties, including the injured employee, employer, insurance carrier and professional medical individuals. The paper trail in a work-related injury can seem daunting at times. You can have peace of mind by placing your claim in the hands of our trustworthy and dedicated workers compensation attorneys at Clements, Taylor, Butkovich & Cohen, L.P.A., Co. We handle your claim, so you can spend your energy recovering. For a confidential and free initial consultation to discuss the details of your case, call us in Cincinnati at 513.721.6500 or contact us online.