Most everyone is familiar with workers’ compensation and its purpose. After an injury, an employer is required to pay for medical care and treatment if it is work related. Once it is determined the injury is work related, the process of receiving workers’ compensation benefits should be relatively simple and straightforward. Medical treatment or care after a workplace injury is required to begin immediately, or within 1 working day for non-emergency injuries.
When it comes to what type of medical care or treatment is covered by the workers’ compensation benefits, the process may become more complicated. After an employee suffers a work-related injury, California law mandates that employers pay for medical care that is reasonably required to cure or relieve the effects of the injury, based on scientific medical treatment guidelines.
In California, these guidelines are published by the Division of Workers Compensation. Doctors following these guidelines should provide advice to the employee on how to treat the injury while remaining active and guiding them through the process to get back to work. Doctors should also be communicating with employers, letting them know what steps they can take for the injured worker upon return.
What about other treatments?
Sometimes medical treatment outside of the published guidelines may become necessary. If this is the case, if the treatment follows scientifically based guidelines that the national medical community generally recognizes, the insurance claims administrator is legally required to cover the treatment.
There are several things that can be done to keep the process moving smoothly and reduce the possibility of problems with getting the required medical care. Get copies of all reports related to your injury or illness and ask your doctor to clarify anything in them that is incorrect or that you don’t understand. You are entitled to a copy of all reports from your doctor or insurance claims administrator.
Workers who have sustained an injury or illness in the workplace are likely to have many questions. Getting the proper medical treatment is vitally important and professionals are available to help.
