Q: What sort of medical treatment am I entitled to in my California workers’ compensation claim, and will all my medical expenses be covered?
According to California workers’ compensation law, you have a right to be compensated for “all medical treatment necessary to cure or relieve the effects of your industrial injury.” (Labor Code, sections 4600-4600.3)
That means workers’ comp must cover the cost of:
- Doctor’s bills
- Prescription and over-the-counter medications
- Hospital stays
- Lab tests, X-ray, MRI, and other diagnostic tests
- Any treatment-related mileage
As anyone who has been dealing with a Tehama worker’s compensation claim for any amount of time could tell you, the letter of the law and the realities of the system are two very different things. That’s because insurance companies have also been given several “cost saving” opportunities by California legislature, such as:
- Independent Medical Review – This allows the insurance company to resolve any disputes about your claim through consultation with a physician you’ve never met.
- Multiple Provider Networks (MPN) – In an MPN, the insurance company is paying all of the physicians you may use.
- Utilization Review – This means any approved treatments must be listed as ‘evidence based’ in a set of guidelines notoriously limited in what they will allow – often, anything very costly will be denied.
You can still obtain the medical treatment you need – it’s just a lot more tricky than it used to be. Because of that, it may be in your best interests to review your case with a Tehama workers' compensation attorney as soon as you are able. Call the Ledgerwood Law Group today at 888-761-7383 or fill out the online form. Don’t miss out on our free book, The California Workers’ Compensation Survival Manual.