Prescription Medications

Prescription medications

L&I or your self-insured employer only pays for prescription medications necessary for treatment of accepted conditions resulting from industrial injuries and occupational diseases on open and allowed workers' compensation claims.

Limitations on reimbursement for prescription medications

Prescription medications are covered only for conditions accepted under open claims or, in rare instances, in claims with treatment orders that authorize payment for specific medications for life-threatening conditions.

Prescription medications for treatment of unrelated conditions and/or conditions not accepted under a claim must be paid for by the worker or billed to their private health insurance.

Medications prescribed for workers who are outpatient (not confined in a hospital) are listed on the L&I's Outpatient Drug Formulary (150 KB PDF). Drugs and/or therapeutic classes listed on the formulary do not guarantee coverage and are subject to L&I's policy and decisions regarding appropriateness for the accepted conditions.

Drug coverage

Review a list of drugs that may or may not be covered by L&I.

Billing and payment

Submit the Statement for Pharmacy Services (F245‑100‑000) form to request reimbursement for out-of-pocket costs for prescriptions that are accepted under your claim. For self-insured claims, send your receipts directly to your employer or their claims representative.

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