Workers Compensation

The State of California makes it mandatory for your employer to have workers compensation insurance coverage in case you are injured at work.  Treatment may not only be by an occupational medical center or therapy clinic. It can also be by a pain management specialist or sports medical doctor. In addition there are provisions in the workers compensation system to have chiropractic care as part of injury management and treatment. Any of the above facilities can get authorization for chiropractic care, as a concurrent treating “physician” under the work related injury compensation systemif you do not designate a treating chiropractor.

Dr. Sabato has been familiar with work injuryed patients perfoming Independent Medical Exam(s) (IME) and Qualified Medical Evaluations (QME) on injured workers’ in the occupational health field since the mid 1980's serving the Citrus Heights, Anelope, Orangevale, Fair Oaks, Gold River, Roseville, surrounding Foothills communities as well as Sacramento region.  He still is taking the Worker's Comp. patients.  

Majority the times there is the need for authorization for treatment, but not always.

The ways in which patient can access Worker's Comp. care is either through direct access from the employer, through MPN (Medical Provider Network), from attorneys, and by patient, friends or family referral.

Medical Provider Networks were established under SB 899 under (Section 9767.1) of the California labor code.

The employer or the insurer has the exclusive right to determine who they want to include and their Medical Provider Network.

If an employer fails to provide appropriate notification of A Medical Provider Network, the employee can go outside the MPN.  This is by at the Knight versus United Parcel Service (2006) which is listed below:

Knight v. United Parcel Service (2006) 71 CCC

1423, Appeals Board En Banc Decision.

 

• The Injured worker (IW) treated by occupational medical center & their Roth, none of whom were in the MPN

• The IW obtained counsel and requested new PTP; applicant attorney unable to get list of Medical Provider Network (MPN) doctors, carrier failed to provide notices, rights or options

• An employer or insurer’s failure to provide required notice to an employee of rights under the MPN that results in a neglect or refusal to provide reasonable medical treatment renders the employer or insurer liable for reasonable medical treatment self-procured by the employee.

 

There is a 24 visit on chiropractic treatment, also physical therapy and osteopathic care.  However, exceptions to this rule can occur can occur.  Treatment is usually approved in small increments, for example 6-8.   

The following link is to the California State Division of Workers Comp (DWC). It is there for your reference.

http://www.dir.ca.gov/dwc/InjuredWorker.htm

If you do not know your rights then you can go to the following link on the California State Division of Workers Comp. There you can fine a link to the “Information and Assistance” officer in your area.

 

 

 

 

Disclaimer

Any person who makes or causes to be made any knowingly false or fraudulent mateal statement or material representation for the purpose of obtaining or denying workers' compensation benefits or payments is guilty of a felony.