Any San Rafael Workers’ Compensation Attorney will tell you that seeking medical attention should be your first priority after sustaining a work-related injury. But unfortunately, many workers are not sure of what steps they need to take in order to receive medical treatment for their work-related injuries. 

If you are a worker in California, it’s important to understand what rights you have regarding medical care immediately following a workplace injury.

WHAT SHOULD YOU DO AFTER SUFFERING A WORK-RELATED INJURY?

If it’s an emergency, call 9-1-1 and seek emergency medical treatment for your injuries. If it’s not an emergency, report your injury to your supervisor as soon as possible. You have 30 days to notify your employer of work-related injuries, but it’s best to do it right away to speed up the process of obtaining benefits.

WHEN SHOULD YOU RECEIVE MEDICAL TREATMENT AFTER A WORKPLACE INJURY?

Some workplace injuries require immediate medical attention, whereas others will not. If you are in need of emergency medical assistance, your employer is legally required to provide it right away. If you are in need of non-emergency medical care, the claims administrator with your employer’s workers’ compensation insurance company will need to authorize treatment first.

The claims administrator must authorize treatment within one day of receiving the claim form from your employer. This is why it is so important to notify your employer of your injury as soon as possible. The sooner you notify your employer, the sooner this claim form can be sent to the claims administrator for authorization.

The claims administrator can continue to investigate your claim after authorizing non-emergency medical care. However, the clams administrator must authorize up to $10,000 in necessary treatment while they complete their investigation.

WHAT HAPPENS IF TREATMENT IS NOT AUTHORIZED RIGHT AWAY?

Non-emergency medical care authorizations must be made within one day of receiving the claim form. But what happens if the claims administrator misses this deadline? If this happens to you, contact a workers’ compensation attorney right away. Your attorney can communicate with your employer and their insurance company to make sure that your right to immediate medical care is not violated.

WHERE WILL I RECEIVE TREATMENT AFTER A WORK-RELATED INJURY?

Every worker in California should know where they will receive treatment if they suffer a work-related injury. The answer to this question will depend on several factors.

First, it’s important to determine whether your employer has a contract with a health care organization (HCO). If there is a contract, the HCO will most likely provide non-emergency medical care.

Some employers have a medical provider network (MPN) rather than a HCO. If your employer has a MPN, you will most likely receive treatment in this network immediately after sustaining an injury.

If your employer does not have a MPN or HCO, the claims administrator will typically choose which doctor treats you following a work-related injury.

CAN I SEE MY REGULAR PHYSICIAN AFTER A WORK-RELATED INJURY?

Many people want to be treated by their regular physician following a work-related injury. In some cases, it is possible to see your regular physician for non-emergency medical care. However, this is only an option for workers who have provided the name and address of their physician to their employer in writing. This information must have been provided to your employer prior to your injury. This is called “predesignating” because you are choosing which physician will treat you in the event you are injured at work.

You are only allowed to predesignate a doctor of medicine (MD) or doctor of osteopathy (DO) who has treated you at least once and has access to your medical records. The physician that you predesignate must be an internist, family practitioner, general practitioner, pediatrician, or OBGYN. You cannot predesignate a chiropractor or acupuncturist. Furthermore, the physician that you choose to predesignate must agree in advance to treat you for work-related injuries. If the physician does not agree to this, you cannot predesignate them.

All workers are not eligible for predesignating. You are only eligible if you have medical coverage for conditions that are unrelated to your work. If you do not have health insurance for non-work-related medical conditions, you cannot predesignate.

SEEK LEGAL REPRESENTATION FOR MEDICAL TREATMENT ISSUES

The workers’ compensation system in California gives you the right to obtain medical treatment immediately after sustaining a work-related injury. If your rights are violated, or you are being denied treatment, it’s in your best interest to seek legal representation from an experienced workers’ compensation attorney. Your attorney will aggressively pursue the workers’ compensation benefits–and medical care–you are entitled to by law.