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On behalf of Koszdin, Fields & Sherry posted in Medical Benefits on Monday, June 19, 2017.

One of the purposes of California’s workers’ compensation insurance requirement is to ensure that you receive the medical care you need after a workplace injury. Your employer could purchase a policy through a company, or it could be self-insured, but going without and failing to provide you with resources for treatment is against the law. The legal team at Koszdin, Fields & Sherry understands the medical benefits workers are entitled to, and how to ensure that these are not denied.

According to the California Department of Industrial Relations, state laws are specific about the type of care you should receive, and they also refer to medical treatment guidelines. There are both published and unpublished guidelines, but those that are not in the Division of Workers’ Compensation’s medical treatment utilization schedule have certain requirements. They must be recommended by your doctor, and they must follow scientifically based guidelines, as well.

The care you receive should be authorized by the insurance claims administrator as long as it is reasonably necessary to cure, or at least relieve, the effects that your injury has caused you. Medical attention should be given immediately if you are in an emergency situation, or within a work day of your filing if you are not. You should not be denied treatment while your claim is being investigated, but the authorization may only cover up to $10,000. If claims administrator will not issue authorization, your health insurance company or the medical provider may agree to seek reimbursement so you can receive the care you need without out-of-pocket expenses.

More information about access to medical treatment and workers compensation coverage is available on our webpage.

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