Legal Question in Workers Comp in California

I have a workers compensation case that is ready to settle but I am hesitant to settle. What is an award of lifetime future medical treatment really mean? Box #4 is checked a need for medical treatment to cure or relieve from the effects of said injury (ies). I am being told that is lifetime award (questionable since it is not spelled out). I have been approved 4 times for PRP injections for all of my finger joints. Can't the specific treatment be included as a stipulation? My biggest issue is that the Orthopedic was never properly paid so he will not perform any other injections. Also, the county is now denying the PRP injections. Should I ask this to go to trial and does the Judge have any authority on the medical procedures such as PRP?

Asked on 5/06/19, 12:33 pm

1 Answer from Attorneys

Nancy Wallace Nancy Wallace Atty at Law

There "IS" need for future medical treatment (paragraph 4) means that you may demand and eventually see one treating doctor on the Medical Provider Network for that insurer... THAT IS ALL, and only for the accepted body part. If you are trying to get a treatment visit on a new body part that started hurting from this injury, you don't get that'd have to re-open and prove a new body part was injured first. IF this doc on the MPN requests any procedure, it can be denied in 5 business days by a chiropractor who will never see you, then the code says you get an Independent Medical Review. IMRs are denied about 90 percent of the time, and you don't get to know who denied the treatment or what they looked at...all you get is to appeal that IMR denial over and over and over, endlessly (the supreme court said that is your right of redress). You can refuse to sign the Stipulations until and unless approval for injections to your fingers are approved in that document, but generally the insurer refuses. and then there is no settlement. If the county denied the injections late, you need an Expedited Trial on the injections, not a settlement.

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Answered on 5/15/19, 2:50 pm

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