In the state of California, doctors, or other health care providers, are required to provide evidence-based medical treatment. This simply means that they must provide treatments and procedures that the employee’s work-related injury or illness requires. For these doctors and health care providers, there are certain guidelines that provide the necessary information on which treatments are most effective for specific injuries, how frequently treatment should be given, the extent of the medical treatment, and how long treatment should last.
In California, doctors should adhere to the medical treatment utilization schedule (MTUS). These guidelines provide specific information on various medical treatments and also includes information regarding acupuncture, chronic pain, and therapy after any surgery.
When it comes to receiving the proper medical treatments, the claims administrator must authorize the proper medical treatments within one (1) day of receiving the claim from your employers—even if your claim is being reviewed. However, during the period in which you claim is being investigated, the total cost of medical treatment is limited to $10,000. If you do not receive the proper authorization from the claim’s administrator within one day, then you should tell your employer or supervisor. As an employee with a work-related injury, you do have the right to medical treatment even during the investigational phase of your claim.
Overall, if you have sustained an injury or illness due to your employment, you should receive the proper medical treatments to help relieve, heal, or help. Under workers’ compensation, you should receive any and all medical treatments necessary, and they should be provided by your employer’s workers’ compensation insurance.
