Following a workplace injury or illness, it is important to notify your employer as soon as possible. Acting quickly helps ensure that the workers’ compensation process will proceed smoothly and you will receive much-needed benefits, including medical care and lost wages.
If you do not notify your employer about your injury within 30 days and this prevents your employer from fully investigating the injury, this may result in a denial of your claim for workers’ compensation benefits. With regard to medical treatment, you must obtain any emergency treatment that you may need. Once you have filed your claim, your employer may direct your future health care.
Under California’s workers’ compensation laws, you are entitled to medical benefits even while your claim is being investigated. In most cases, your employer selects the primary treating physician you will see for the first 30 days. If you still need treatment after 30 days, you may be able to switch to another physician within the employer’s medical provider network, or if there is no medical provider network to any physician you choose.
The workers’ compensation program and your employer also dictate the medical treatment you receive. Doctors are required to follow specified treatment guidelines for your condition, which are set forth in the medical treatment utilization schedule. The guidelines not only detail the course of treatment but also the frequency, intensity and duration.
Your primary doctor’s treatment requests may also be subject to a utilization review, during which an outside third party retained by the claims administrator determines whether your treatment is medically necessary. If you disagree with the utilization review decision, you may request an independent medical review. On the other hand, if you disagree with your primary doctor’s treatment plan, you may select a different physician within the employer’s medical provider network for a second opinion.
The workers’ compensation process can be overwhelming, particularly if you are facing serious medical issues. At the Law Offices of John E. Hill, a Professional Corporation, our dedicated and knowledgeable workers’ compensation attorneys can alleviate your stress by handling every step of the claims process.