Seeking Medical Treatment after a Work Injury

If a work injury is severe or life-threatening, do not hesitate to call 911 and/or seek emergency medical treatment.  Let the emergency room know that the injury occurred at work to avoid surprise medical bills.

For most workplace accidents or repetitive motion injuries, the first step to take is to report the situation to a supervisor or manager.  You should do so as soon as possible because you cannot receive the medical treatment benefit of workers’ compensation insurance until the injury is reported.  Most workplaces have different reporting procedures, but all injured workers need to complete a Workers’ Compensation Claim Form (DWC-1) and submit it to their employer.  After your report the injury, your employer will need to complete the rest of the DWC-1 form and authorize medical treatment for up to $10,000 within one day of receiving your while your workers’ compensation claim is pending.

What are My Medical Treatment Options?

In workers’ compensation claims, injured workers may be surprised to hear just how limited their treatment options really are.  Most of the decisions regarding medical treatment under workers’ compensation are made for you.  California law regulates what type and how much treatment is allowed, employers decide which doctors you see, and insurance companies decide whether or not your injuries are even allowed to be treated.

Yes, you can see your preferred doctor, but only immediately after your injury or  if you told your employer your doctor preference (and filed the appropriate paperwork) before your injury.  Yes, you can choose a new doctor if you don’t like the doctor you’re assigned to, but you’re limited to certain doctors in a “medical provider network (MPN)” selected by your employer.  Yes, you can receive treatment until you’re healthy, but you’re limited to 24 visits to a chiropractor, physical therapist, and occupational therapist.  Yes, you can receive the necessary treatment, but only if it’s approved by the insurance company.

I’m No Longer Allowed To Receive Medical Treatment?

Your doctor has likely designated you as permanent and stationary (P&S).  This means that your doctor does not believe that any additional treatment for your work injury will aid in your recovery.  If you’re still suffering effects of your injury after being declared P&S, you are considered permanently disabled and will be assigned a disability rating.  This disability rating, and a complicated mathematical formula, will determine your permanent disability benefits.  If you believe that additional treatment will help, you are allowed to seek a second opinion from a different eligible doctor.