What happens if you experienced an injury to your mouth at work and now you need dental attention? If any of the dental work would be cosmetic only, your workers compensation insurance carrier may deny this portion of the claim. There also can be complicating factors if you want a more expensive treatment, as the insurance company may determine this is unreasonable. In addition, different states have varying guidelines in regard to workers comp.
Dental Implants vs. Bridges or Dentures
If you had teeth knocked out or any that needed extraction because of your accident, a workers comp representative may tell you that coverage will pay for a bridge or a set of dentures, but not for the more expensive implants.
Even if the insurance carrier is willing to pay for implants, underwriting may decide that the quoted cost is too high if you need preparatory bone grafting to strengthen your jawbone in the area where the implants will be placed.
A dentist will advocate for you in this matter. Dentists highly recommend implants over conventional false teeth, not only because they tend to look better cosmetically, but because they serve important functional purposes.
Implants help maintain the integrity of the jawbone just as normal teeth roots do, which prevents the bone from deteriorating. Implants also feel entirely natural, without the discomfort that many denture wearers endure. Another advantage is a more stable chewing surface.
Not all dentists install implants, but one who provides advanced cosmetic services is likely to be skilled in this area.
Injured Teeth, Root Canals and Crowns
Workers comp may not pay to cap a chipped tooth. However, if a fairly large portion of the tooth has broken off, a dentist may verify that placing a crown on it is medically necessary to prevent further problems, such as additional fracturing.
The dentist will wait to determine whether the nerve remains healthy or not. If the nerve dies, the tooth needs a root canal to prevent infection. Nerve death darkens the tooth; if this occurs in the front of the mouth, it can be disfiguring. It is not as noticeable in a back tooth.
The bottom line is that workers comp will pay for a root canal but may not pay for a cosmetic crown. Ironically, the program will probably pay for a crown in back without dispute because teeth become more fragile after a root canal, and back teeth are used for more heavy-duty chewing.
Disfigurement and Loss Compensation
Depending on the workers comp laws in your state, you should receive a specific amount if you actually lost teeth, even if you have them replaced. Consider that a person who has a finger cut off by machinery at work receives a lump sum for this loss. The same may be true in your state for loss of teeth due to a work injury.
If not, you may be able to claim payment for cosmetic dentistry under disfigurement guidelines. In Illinois, for instance, workers comp pays for replacement and the injured person also receives a disability settlement for disfigurement. You must learn the relevant guidelines in your state.
Seek out a dentist from a place like Park Ridge Dental Associates who does advanced cosmetic treatment and takes workers compensation cases. He or she will know what you can expect workers comp to cover and what you may need to pay out of pocket. Ask whether the dentist requires you to get any cavities filled or other medically necessary dental work done before the cosmetic treatment. Soon you will have your problem resolved and will feel much better about your teeth in regard to both functional and cosmetic aspects.