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The Role of Medical Treatment in California Workers’ Compensation Claims

The California workers’ compensation program provides medical care and wage-replacement benefits to workers who incur injuries or illnesses arising from or during employment.

At Ghitterman, Ghitterman & Feld, our Santa Barbara workers’ compensation attorneys

have protected the rights of California workers since 1956. Our experience supports that while workers’ compensation is designed to benefit injured employees, it does not always apply as it should. Many employees must fight for the benefits they are entitled to, even when their medical records and documentation support their claims. That is why we are here.

The more California workers understand the role of medical treatment and how it applies to their potential benefits, the more they can make informed decisions about the direction of their claims.

Here is what injured workers need to know.

How Does Medical Care Impact My Eligibility for California Workers’ Compensation Benefits?

California workers’ compensation guidelines require employers to pay for medical care reasonably required to cure or relieve the effects of an injury. This includes care that follows a scientifically based medical treatment utilization schedule (MTUS).

For employees, pursuing and maintaining medical treatment is paramount during a workers’ compensation claim in California for several key reasons, including:

  • To Produce a Thorough Diagnostic Evaluation

Medical treatment involves thoroughly evaluating the injury or illness by healthcare professionals. This evaluation helps diagnose the condition accurately, which is crucial for determining the appropriate course of treatment and any necessary work restrictions or accommodations.

  • To Provide the Necessary Supporting Claim Documentation

Medical records serve as critical evidence in a workers’ compensation claim. Detailed and well-documented medical records record the injury, its severity, treatment received, and any ongoing symptoms or disabilities.

This documentation is vital when pursuing a claim, as it supports the injured worker’s case for benefits by confirming that the injury or illness is indeed work-related.

  • To Help Successfully Navigate the Workers’ Compensation Claims Process

Medical treatment is often the first step in the workers’ compensation claims process. It establishes the basis for the claim, including the nature and extent of the injury, which is necessary for determining eligibility for benefits like medical coverage, temporary disability payments, and vocational rehabilitation.

  • To Help California Workers Recover from Their Injuries

The primary purpose of medical treatment is to address and treat work-related injuries or illnesses and provide timely and appropriate medical care essential for an injured worker’s physical recovery and overall well-being.

Physicians develop treatment plans, including surgeries, medications, physical therapy, and rehabilitation services, to facilitate the injured worker’s recovery and return to work.

Injured workers often receive coordinated care from various healthcare providers, including primary care physicians, specialists, and therapists. This collaborative approach ensures that the worker gets comprehensive and effective treatment.

Without proper treatment, injuries may worsen, leading to more severe health complications.

  • To Help Provide Legal Protection When Filing a California Workers’ Compensation Claim

Injured workers who seek prompt and appropriate medical treatment are more likely to protect their legal rights, which can be essential if there are disputes or delays in the claims process.

Medical treatment is crucial during a workers' compensation claim in California because it facilitates the injured worker's recovery and is the foundation for the entire claims process.

If you have sought the appropriate medical care and are still facing resistance from your employer’s workers’ compensation insurance provider in the form of benefits delays or undervalued or denied claims, contact our dedicated California workers’ compensation attorneys today for help.

We have six physical offices in Bakersfield, Fresno, Santa Barbara, Santa Maria, Ventura, and Visalia, and our top-tier technologies provide a virtual reach to serve clients throughout California. We offer free in-person, telephone, and virtual consultations to offer straightforward legal advice for your unique needs.

Contact us today to learn more about your legal rights and options. 

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