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Workers’ compensation in Connecticut requires employers to pay all reasonable medical costs for a work-related injury. This article explains how to verify that your medical bills were paid by the workers’ compensation insurer.

Detailed Answer

Under Connecticut law, Conn. Gen. Stat. §31-294c mandates that employers or their insurers pay for all necessary medical and surgical services following a compensable injury. You can find the statute here: Conn. Gen. Stat. §31-294c. Once you receive treatment:

1. Obtain the Explanation of Benefits (EOB): After your provider submits a claim, the insurer issues an EOB detailing the billed amount, the insurer’s payment, and any patient responsibility.
2. Request itemized statements: Ask your health care provider for an itemized statement showing payments received from all sources. This statement should reflect payments made by the workers’ compensation insurer.
3. Compare statements: Match the EOB with the provider’s bill to confirm that the insurer’s payments cover the billed services.
4. Contact the insurer: If payments do not match or you see unpaid balances, contact the insurer’s claims adjuster. Request a copy of the claim history and confirmation of payment dates and amounts.
5. Escalate disputes: If the insurer denies or delays payment, you can submit a dispute to the Connecticut Workers’ Compensation Commission by filing Form 43 (Claim for Medical Fees) per Conn. Gen. Stat. §31-294d: Conn. Gen. Stat. §31-294d.

Disclaimer: This article provides general information under Connecticut law. It is not legal advice. For advice specific to your situation, consult a qualified attorney.

Helpful Hints

• Keep all billing statements and EOBs organized chronologically.
• Document all communications with providers and the insurer, including dates and names.
• Use certified mail or an online portal when sending requests to the insurer.
• Review the Connecticut Workers’ Compensation Commission website for forms and procedural guidance.
• Act promptly: Connecticut sets time limits for medical payment disputes.