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How Prescription Drug Coverage Works on Workers' Compensation


After you suffer a work injury, you deserve to get the best care available to help you recover. In most cases, you'll be able to seek compensation through workers' compensation, which will then pay for your medical expenses. Eventually, the workers' compensation program will also help cover your lost wages.

Now, with the workers' compensation program, there is coverage in place for you to get the medications you need. So, for example, if you are prescribed Celexa for anxiety, you'll be able to get the medication and have it paid for. There is a catch, though. Because this medication has a generic version, you have to get the generic, not the name-branded item.

According to the Ohio Bureau of Workers' Compensation, you will only be reimbursed for brand name drugs when there are no generics widely available for it. In the case of Celexa, the generic citalopram would be used. The drugs are nearly identical chemically, and they work the same. However, there are some patients who don't tolerate one version well.

Unfortunately, there is no way to appeal this rule by the BWC. Even if your physician writes that the drug needs to be dispensed as written or specifically identifies a drug to be used as the branded product, the Bureau of Workers' Compensation won't cover that cost. Instead, the cost of the generic will be granted, and you'll have to make up the difference.

Accounting for issues like this should be part of your plan in a case. If you need name-branded medications, you may want to include the medical reasoning for this when you seek a settlement or continuing compensation.

Source:, "Generic Drug Requirements," accessed May. 20, 2015