When San Francisco workers are hurt on the job, the law requires their employer to cover part of their lost wages and medical treatment. California’s workers’ compensation laws are important to help injured workers recover from their injuries and avoid costly medical bills.
San Francisco workers need to understand there are limitations and restrictions on these benefits and employers and their powerful workers’ compensation insurance providers may exploit these provisions. Hiring an experienced and dedicated workers’ compensation attorney from the onset of a claim should be a top consideration for injured workers.
Limits on medical treatment
For the most part, the length of medical treatment ultimately comes down to what the treating physician recommends. However, California does have limits on some types of medical treatment injured workers may be entitled to receive.
As of 2004, injured workers may only receive a maximum of:
- 24 chiropractic visits
- 24 acupuncture visits
- 24 occupational therapy visits
Claims administrators may recommend more than the allotted 24 visits for chiropractic, acupuncture, and occupational therapy. Treatment may also be extended following surgery. Having the right workers’ compensation attorney to advocate for injured San Francisco workers may be crucial to getting all the necessary treatment workplace injury victims need.
Medical Treatment Utilization Schedule
California’s Medical Treatment Utilization Schedule (MTUS) outlines recommendations treating physicians should follow when prescribing medical treatment. While these are only guidelines, treating physicians and insurance claims adjusters will generally adhere to these guidelines and approve medical benefits accordingly.
- Acupuncture – Treatment that involves pricking the patient’s skin with needles with the goals of alleviating pain. This type of treatment may be authorized when when pain medication is reduced or not tolerated. Functional improvement should be seen within three to six treatments. This may have a duration of one to three treatments per week over one to two months.
- Chronic pain – Any pain that persists beyond the anticipated time of healing. Treatment may include opioids, injection therapy, or massage therapy. Treatment plans are prescribed on a case by case basis
- Post surgical – Treatments following surgical procedures. The type of injury determines the duration and frequency of visits.
How do I get workers’ compensation medical benefits?
Following a workplace accident, injured workers must immediately report the accident to their employer. Workplace injury claims must be filed within 30 days of the accident or the claim may be denied and no medical benefits may be provided.
Workers will be given a claims form to document their injuries by the employer who will in turn forward the paperwork on to their workers’ compensation insurance provider. Claims adjusters will then review the incident and decide if it warrants benefits. While the claim is under review, adjusters must provide up to $10,000 of necessary medical treatment.
San Francisco workers’ compensation attorneys
Workers’ compensation claims adjusters are entitled to a utilization review (UR) of the physician’s recommendations and may decide whether or not to approve treatment. Injured San Francisco workers whose claims were denied may need to hire an attorney to ensure they get the appropriate treatment. If you or a loved one was hurt in a workplace accident, you should strongly consider hiring a San Francisco workers’ compensation attorney from the onset of your claim and let insurance companies know you are serious about getting all the benefits you deserve.