Managing Employee Injuries and Disability and Occupational Safety

B. M EDICAL B ENEFITS The California Workers’ Compensation law provides coverage of full medical benefits for work -related injury or illness. Labor Code Section 4600. The Code specifically requires payment of all treatment necessary to relieve the effects of an industrial injury, including: medical, surgical, chiropractic, and hospital treatment; nursing, medicines, medical and surgical supplies; crutches, mileage reimbursement, and reimbursement for expenses incurred and not seasonably provided by the employer. 1. N OTICE OF I NJURY An employee or someone acting in the employee’s behalf must give written and signed notice of the injury to the employer within thirty days of the injury. Labor Code Section 5400-5401. The notice must include the injured workers name and address, the time and place of the injury and the nature of the injury. If the employer has knowledge of the injury from any source which is sufficient to enable the employer to investigate the facts, the notice requirement of Section 5400 will be deemed to have been met. Labor Code Section 5402. 2. E MPLOYER ’ S R ESPONSIBILITY The primary obligation of the employer upon receiving notice of injury is to arrange for prompt and adequate medical treatment. In addition, the employer must inform the employee of the availability of benefits under the law, and provide the employee with the claim form within twenty four hours, either personally or by first class mail. 3. C ONTROL OF M EDICAL T REATMENT – U NTIL J ANUARY 1, 2005 An employee may designate a treating physician to treat his industrial injury. In order to designate the physician, the employee must have made a pre-injury designation of treating physician. If an employee has notified his employer, in writing, prior to the date of injury that he or she has a personal physician, the employee shall have the right to be treated by such physician from the date of injury. In order to qualify as the employee’s “personal physician”, the medical care provider must be a licensed physician and surgeon who is the employee’s regular physician and has previously directed the medical treatment of the employee, and who retains the employee’s medical records, including his or her medical history. Labor Code Section 4600. If an employee has properly pre-designated his or her personal physician the network does not apply. Title 8 Cal. Code of Regs. Rule 9780.1(c)(d). When the employee has not made a pre-injury selection of physician, initial control of medical treatment rests with the employer or its insurance carrier. After 30 days have lapsed from the date of employer knowledge of the injury, the employee has the right to make one change of physician. The employer is obligated to For injuries on or after April 19, 2004, the employer must immediately provide medical care, even in disputed claims, up to $10,000 during the disputed period.

Managing Employee Injuries, Disability and Occupational Safety ©2019 (s) Liebert Cassidy Whitmore 31