Managing Employee Injuries and Disability and Occupational Safety

The employee may predesignate his or her personal physician if the employer provides non- occupational group health coverage, the physician has previously directed medical care and the physician agrees to be predesignate.

5. R EIMBURSEMENT FOR M EDICAL E XAMINATION E XPENSES If the employee submits to examination by a physician at the request of the employer or insurer, or the workers’ compensation administrator, the employee is entitled to the reasonable expenses of transportation, meals and lodging, and one day of disability indemnity for each day of wages lost. Labor Code Section 4600. 6. R EASONABLE AND N ECESSARY T REATMENT The employer must reasonably offer treatment which is designed to cure and relieve the employee from the effects of the industrial injury. Treatment includes medical care for secondary conditions that may arise due to the original industrial injury. For example, if an employee contracts an infection, or pneumonia secondary to his treatment, treatment for those conditions is the employer’s responsibility. 38 The American College of Occupational and Environmental Medicine protocols for treatment are rebuttedly presumed to be correct and treatment outside of those protocols is not allowed unless it is supported by scientific principals. Labor Code Section 4600. On and after January 1, 2004 until January 1, 2008, chiropractic and/or physical therapy treatments are limited to twenty-four per injury. After January 1, 2008, additional such treatment is available after surgery, subject to Utilization Review. Labor Code Section 4604.5. a. Unlimited Time and Amount There is no monetary limit to the amount of treatment to be furnished. If needed, an employee may be entitled to such benefits for life, except for chiropractic and physical therapy treatment. b. Spousal Nursing Care Private nursing care provided by an injured employee’s spouse or other relative is within the definition of medical treatment, and if the employer has knowledge of the need and the fact that such services are rendered by the spouse, the spouse may be entitled to payment for services rendered. c. Self-Procured Medical Treatment If an employee obtains medical treatment at a time when the employer or its insurance carrier has not been afforded the opportunity to provide it due to lack of notice, the cost of such treatment may not be the employer’s responsibility. However, such self-procured medical treatment may nonetheless be chargeable to the employer under one of four conditions. These four conditions are: 1) emergency treatment was required; 2) the employee was not aware that his injury or disability was industrial; 3) reasonable medical care was not being provided by the employer, or notice would be futile because the employer or insurance carrier has repeatedly refused to

Managing Employee Injuries, Disability and Occupational Safety ©2019 (s) Liebert Cassidy Whitmore 33