Secure Your Off-Label Medication Coverage With Our Experienced Ohio Workers' Compensation Lawyer
If you’re injured on the job, you’re eligible to file a workers' compensation claim to receive benefits, including coverage for necessary medical treatments such as medication. However, getting approval for certain treatments, especially those involving off-label medication use, can be a challenging process.
At Monast Law Office, we understand the restrictions and requirements regarding workers' compensation, prescription drug coverage, and off-label medication. We’ll detail what you’re entitled to as part of your claim so you get the treatment to recover from your work-related injury.
Using Off-Label Medications ![graphic-reading-off-label-use]()
"Off-label" refers to using a medication for a purpose other than what the U.S. Food and Drug Administration (FDA) originally approved for its use.
While this practice is legal and often medically appropriate, it can complicate workers' compensation claims.
Doctors may prescribe medications off-label when they believe it will help the patient's condition, but such prescriptions may not always align with Ohio Bureau of Workers Compensation (BWC) guidelines.
BWC Guidelines and Policies
The BWC has established guidelines and criteria for approving medical treatments and prescriptions for injured workers. These guidelines are designed to make sure treatments are safe, effective, and cost-efficient. However, they’re not exhaustive and don’t cover every potential medical scenario. When a doctor prescribes an off-label medication, the BWC may deny coverage based on its policies.
The Role of the Industrial Commission
The Industrial Commission of Ohio (IC) is a separate entity from the BWC and plays a critical role in resolving disputes related to workers' compensation claims. The IC isn’t strictly bound by BWC guidelines. This means that if a doctor recommends an off-label medication and supports the request with evidence, the IC can approve the treatment even if the BWC first denies it.
Navigating the Off-Label Medication Appeal Process
If the BWC denies a request for an off-label medication prescribed as part of your treatment, you have a right to appeal the decision to the Industrial Commission. The IC appeal process involves several steps and having our workers’ compensation knowledge on your side will help with this process.
The Importance of Medical Evidence
Throughout the appeal process, the strength of the medical evidence is important. A doctor’s detailed explanation of why the off-label medication is necessary and beneficial for your medical condition makes a significant difference. This may include:
- Peer-reviewed studies supporting the off-label use
- Clinical guidelines from medical organizations
- Case studies or examples of successful off-label use in similar cases
- Testimony from medical experts
Monast Law Office Provides Essential Legal Support and Advocacy
If you’re an injured employee and your doctors believe treatment with off-label medications is the right course of action, don’t take no for an answer from the BWC. At Monast Law Office, we’ll build a strong case and:
- Obtain evidence. We act quickly to gather and present compelling medical evidence to strengthen the claim for off-label medication.
- Provide guidance. We explain every step of the appeal process and offer thorough detail along the way so you feel confident in your decisions.
- Advocate for your rights. We’re your voice fighting for your rights at all hearings.
Having strong legal support when dealing with a workers’ compensation claim for a treatment or medication is important. Our client, Margaret, noted, “Mr. Monast has been at every hearing I have had with BWC. He talks to me about my case and what he will be doing in the hearing room to win. He is confident and always prepared. I really appreciate Mr. Monast understanding the difficulties I have and how important it is for me to receive my treatments so that I can function better on a daily basis. Thanks for all you do.”
Our client, Kyle, could not get the treatment he needed to recover from his work-related injury. He enlisted the help of Monast Law Office and said, "Three years ago, I hurt my back in a work accident. I was stuck in a red tape nightmare. I was unable to get the treatment I needed or to support my family. I was referred to Monast Law and it changed everything. Jim Monast and his staff are truly caring, compassionate people. Not only did they help me navigate the BWC red tape but were able to help me find a doctor that has been very proactive in getting me treatment. I highly recommend this law firm because they believe in helping the individual. You are treated as a friend."
Read more of our testimonials and case results to learn how far we go to help our clients and how we’ll do the same for you.
