When you’ve suffered a workplace injury, you may not know what to do next. Do you try to work through the pain? Are you worried that your employer will blame you? Are you concerned about the cost of medical treatment?
The workers’ compensation system should help relieve you of your concerns. It’s a no-fault system, which means you can receive benefits no matter who is to blame for the accident. Your employer cannot legally fire you for making a workers’ comp claim. Most importantly, your medical treatments should be covered through workers’ compensation.
The fastest way to get medical treatment for a workplace injury is to make a claim with your employer soon after the injury occurred. Your employer will forward the claim to the insurance company. An administrator at the insurance company will decide whether to accept or deny your claim.
However, you don’t have to sit around waiting for a decision. The administrator is required to authorize medical treatment within one working day after you’ve made a claim with your employer. Workers’ comp should still cover your initial treatment, even if your claim is ultimately denied.
In California, the treatment of work-related injuries is governed by a medical treatment utilization schedule (MTUS). The schedule contains treatment guidelines and rules for deciding the types of care that are medically necessary.
Sometimes, a course of treatment may not be covered by the MTUS. Other times, your doctor may disagree with the recommendations provided by the MTUS. In these cases, it may be possible to receive an exception for your medical care. A skilled legal professional can help explore your options to determine the best path forward for your case.