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Workers' Comp Rates for Outpatient Surgery Vary Significantly

Workers' Comp Rates for Outpatient Surgery Vary Significantly

If you break your wrist and require outpatient procedures to set it, how much coverage you collect will vary greatly depending on your state, and your coverage type, a recent report has found. The Workers’ Compensation Research Institute (WCRI) examined workers’ compensation benefits paid out in 33 different states; the sample size contributed to 87% of all workers’ comp benefits paid in the country during the study’s timeframe.

It concluded that most people who used Medicare would collect significantly less in coverage and benefits than if they had used workers’ compensation benefits. Only three states in the study, which examined 2005 to 2014 data sets, typically provided more through Medicare than through workers’ compensation payments: New York, Nevada, and Maine. All other states generally gave more benefits to a person for the same procedure if they used a workers’ compensation payment instead of a Medicare rate.

On the opposite end of the spectrum, Louisiana usually provided 430% the coverage through workers’ compensation when compared to Medicare. To put it into perspective, imagine a medical outpatient procedure that cost $1,000 to complete. In Louisiana, a patient might be able to collect $4,300 worth of coverage through workers’ compensation payments, allowing them to get all the medical attention they need; if that same person had relied on Medicare, they likely would have only been afforded the bare minimum or, in some cases, even less and have to pay out of their own pocket.

The results of the study indicate that government spending on Medicare may be largely insufficient when compared to other avenues of gaining benefits or compensation. If a person is injured on-the-job and workers’ compensation is an option, it is, in most scenarios, the right avenue to pursue, as it has the potential for the higher payout.

For a complete article on the report, you can click here to visit Insurance Journal. If you live in New Mexico and were unfairly denied workers’ comp benefits, Albuquerque workers’ compensation lawyer Michael J. Doyle can help you create a lawsuit. Contact his firm today to learn how you can fight for the coverage you deserve.


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