EMERGENCY MEDICAL CARE:
Q: Is an employer liable for payment of medical care it arranges in response to a personal sudden emergency?
A: No. "An employer is not liable for the cost of care that the employer arranges in response to a sudden emergency if the employee's condition, for which care was arranged, is not related to the employment."
Be careful, however, as an aggravation of a preexisting personal condition, or damage caused by continuing to work after the onset of personal condition, such as a heart attack or stroke, may be a separate and compensable injury entitling him to payment of medical expenses under the Iowa Workers' Compensation laws. The general rule is that you take your employees as you find them, subject to their preexisting conditions, and are liable to the extent of any temporary or permanent worsening caused by work.
The line between these two to situations can be quite fine and may require expert medical evaluation. It is the subject of much litigation.
The best advice we can give is to consult an attorney or, your insurance representative before you decide to pay any medical bills in this situation.
Q: Can an employer, or their carrier, be held liable for payment for emergency medical care they did not authorize?
A: Yes. "In an emergency, the employee may choose the employee's care at the employer's expense, provided the employer or the employer's agent cannot be reached immediately."
If the employee does not try to contact the employer or their agent, the employee may end up in a situation where their bills would be denied under workers' compensation, and under any personal or group medical insurance they may have, as they usually exclude payment for care necessitated by employment injuries. This may be true despite the provision that, "If an employer denies liability ..., for payment for any medical services received or weekly compensation requested by an employee, and the employee is a beneficiary under either an individual or group plan for nonoccupational illness, injury, or disability, the nonoccupational plan shall not deny payment for the medical services received or for benefits under the plan on the basis that the employer's liability ... is unresolved." Payment would not have been denied because liability was "unresolved," but rather because the care was not authorized, either by the employer or their insurer, or under this "emergency" exception.
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