What do I do when workers' comp isn't authorizing my treatment?

This video reviews the most common steps to take when the workers' comp insurance company isn't authorizing treatment. If you are an injured worker with a California injury, and don’t have an attorney, this video is intended to help provide an overview of workers’ compensation topics so you can better represent yourself.

The three most common scenarios when workers' comp isn't authorizing treatment are:
1. The treating doctor didn't send in the RFA yet. In this instance the doctor needs to complete and send the paperwork.
2. The RFA was sent in, and UR denied the treatment. In this instance the most common response is to file for Independent Medical Review.
3. The RFA was sent in, and there was no response. Then, follow up with the adjuster, and file a DOR to Expedited if need be.

Jeremy Lusk is a certified specialist in workers’ compensation with about two decades of experience, and previously served as a Judge at the Fresno District Office of the WCAB. He has worked out of Fresno, but appeared at numerous Boards to represent both injured workers and employers/carriers.

No attorney/client relationship is created or implied by this video. This video is not offering legal advice as to what you should, or should not, do in your workers’ compensation case, but rather offers education/information as to the California workers’ compensation system for unrepresented workers so they can better represent themselves and make more informed decisions.

[cjhiyvk]

If you go to the state doctor suggested something like back shots then insurance rejected it

[bmolale]

I am now 7 months after injury and just yesterday got a denial for treatment from the insurance company. I will file the appropriate paperwork, and have the deposition coming up (the company who fired me, their lawyer delayed the first deposition the day of months ago) and saw a QME doctor over a month ago and have yet to get that report. This to me seems to be taking longer than normal, and my pain has increased in the meantime. I feel like my lawyer has lied to me. Suggestions?

[bobcrina-psmm]

You have not adressed the situation when IMR overturns Ur and insurance still does not take action

[jocelyngutierrez]

Great video, , denied claim in March cumulative claim I applied for adjudication and and its almost 5 month that I have not receive anything is it normal? when its time to applied for a hearing??Also in those month I feel my injury its getting worst should just go to emergency and worry about the bills.

[Merzouga]

Hi I enjoy your videos alot, and I will appreciate your input in my case (Oregon) : my workers comp got accepted for strained back and foot, ( MVA), got treatment for 5 months, pain still there, MRi done, herniated disk, tendinitis in foot ( bus driver here), after back injection, foot injection, the insurance sent me to an IME, received a notice of closure wit no ppd 2 months later, thy said I should have returned to wrk 2 month ago, but my doctor gave me work status that still active. What you think Of this