Workers’ compensation benefits should provide coverage for all medical care that workers in Coventry, Warwick, and Providence need in order to try to recover from injuries. When a worker has sustained serious and permanent injuries, the benefits should ensure that the worker gets the adaptive devices and assisted care he needs to try to maximize his quality of life despite the harm he has experienced.

A workers’ compensation lawyer knows that sometimes insurers try not to pay benefits that a worker legitimately should receive. In other instances, a legitimate dispute occurs over whether a particular type of benefit should be covered. One recent case, for example, involved a dispute regarding whether an injured workers’ wife should receive counseling as a caregiver that was recommended by the workers’ doctor.

Should Workers’ Compensation Benefits Cover Counseling for a Caregiver?

Safety News Alert reported on the case of a worker who sustained serious injuries on-the-job. He suffered multiple bone fractures, including thoracic fractures and several fractured ribs. He sustained trauma to the arm necessitating a shoulder amputation, and he also suffered a bruised spleen. In addition to physical issues, the injury left him with mental issues including post-traumatic stress disorder, dementia, and a depressive disorder.

The injuries he sustained not only changed his life, but the life of his family. His wife was to become his full time caregiver and the worker’s doctor believed that it was very important that the wife undergo counseling in order to get help coping with the impact of the injuries and the lasting impact on her life. The doctor believed that she would need this type of counseling in order to make her an effective caregiver, which was essential to the well-being of the injured worker. He prescribed the counseling and a claim was made to workers’ compensation to cover it.

Workers’ compensation benefits have provided coverage for joint counseling attended by both the injured employee and his or her spouse. However, the workers’ compensation insurer denied the coverage for the counseling that was to be provided exclusively to the spousal caregiver.

After the counseling was denied, a request was made to the worker’s compensation board to receive alternative care. The board, however, decided that the denial of the counseling was appropriate. The case was also appealed to the state court, but the state court affirmed the prior denials of the counseling. The court made clear that although it could benefit the injured worker for the caregiver to receive counseling, the plain language of the workers’ compensation laws did not require a workers’ compensation insurer to provide coverage for any medical care to anyone other than the employee who had been injured.

Every state has sight variations on their own workers’ compensation laws, and this does not necessarily mean this would be the outcome in all situations. There is certainly an argument to be made that it would be a significant benefit for an injured employee to have a caregiver who received necessary support to provide the best quality ongoing care.

Contact a Providence accident lawyer at the Law Offices of Deborah G. Kohl at 508-677-4900 or visit http://www.dgklaw.com to schedule your free consultation. Serving Coventry, Warwick, Providence and surrounding areas.