Out-of-state doctors deciding treatment for injured California workers?
In California, when someone is injured on the job, that individual will be eligible to receive workers’ compensation benefits while he or she is unable to work. Employers will be required to pay for the individual’s medical care, but there are specific procedures in place that may limit an employee’s ability to seek the treatment that is needed to help recover from these injuries.
Under workers’ compensation laws, the employee is required to seek treatment from doctors that are provided by the employer or the employer’s insurance company. These physicians will consult guidelines that specify the type of treatment that should be administered, and also the time it will take for the individual to recover from the injury or illness.
Claims administrators will conduct utilization reviews (URs), which will attempt to determine if the treatment being prescribed is medically necessary. These companies often have offices across the United States, and may use doctors outside of California to perform the UR. These individuals, who are unlicensed in California, will then decide if the treatment plan is acceptable.
This has led to some concern regarding the use of these out-of-state doctors. Anyone who practices medicine within the state must be licensed by the Medical Board of California, which has very strict procedures and requirements in place. These out-of-state doctors are not necessarily being held to the same standards by the licensing boards in other states, which could lead some differences in opinion about the care that the injured worker should receive.
In many cases, the doctors reviewing the treatment plans may raise objections to the amount of time it may take for a worker’s injury to heal. They may believe that the individual should be able to return to worker sooner, and some of the decisions being made by the treating physician are unnecessarily prolonging the worker’s absence. This could lead to disputes concerning which treatment will be covered by the employer, and could make it difficult for the worker to receive the care that he or she needs.
If you have been injured in a workplace accident, it is important that you understand how to protect yourself at this time. Speak to an experienced workers’ compensation attorney to learn more about what you need to do to be able to receive treatment for your injuries, as well as the benefits you will need while you are out of work.
Employers will have specific procedures that they must follow, and you need someone on your side that is able to protect your interests throughout the process. An attorney can ensure that you receive the care necessary for you to return to work in a timely manner.