Reasons Your Pain Medication Coverage May Be Limited In An N.C. Workers Comp Claim

Suffering an injury on the job can cause severe pain to the worker, especially in jobs where labor involves working from high heights, scaling buildings, or physical labor.

Managing the resulting pain in workers is a real challenge that can require medication, but your workers’ compensation may limit what pain therapy you have access to.

Why Would Pain Medication Be Limited Under Workers’ Compensation Claims?

According to the U.S. Department of Health and Human Services, 130 people die each day in the U.S. as a result of opioids. Opioids are narcotic painkillers that work by preventing pain signals from reaching the brain. They are incredibly addictive but still are necessary for particular situations, such as after back or neck surgery.

A special law governs workers’ compensation claims requiring patients receive a referral from their primary workers’ compensation doctor so the insurance company can justify your medical expenses. If you fail to do this, you may end up paying your medical bill.

Some doctors will want to refer you to a pain specialist because your injury is so severe, so it is essential to make sure that your doctor is authorized to refer you to a pain management doctor.

North Carolina has laws governing opioid use in workers’ compensation cases. For the first 12 weeks after the injury occurs and the patient is in the acute phase, physicians may prescribe opioids. However, there cannot be more than one opioid prescription written at a time. Providers are instructed to prescribe fentanyl for pain and benzodiazepines for pain or as muscle relaxers.

Physicians are also forbidden from prescribing more than a five-day supply at once and must write the prescription for the lowest effective dose.

Once the patient enters the chronic phase, the state has a new set of guidelines governing opioids.

What Should I Do If I’ve Been Injured at Work?

If you’ve been injured on the job, seek medical attention immediately. Then, when you’re able, contact Hyland, Padilla, & Fowler for a complimentary consultation as soon as possible.

We can help you navigate the legal maze of workers’ compensation claims, help you file the claim right the first time, and negotiate with the insurance company on your behalf to ensure you receive the compensation you need to receive the pain management therapy you require.

We can help you see which doctors are covered by the workers’ compensation claim and which pain medication will be available to you.