Work Comp Carrier Denied My Medical Treatment! A Work Injury Lawyer in Santa Rosa Can Help


At the Law Offices of Marc Francis, specializing in representing injured workers throughout Santa Rosa, Sonoma, Napa, Mendocino, and Marin Counties, we often hear from callers seeking help with their workers’ compensation claims that they have been denied medical treatment for various reasons. This article discusses some of those common denial stories and what you can do to get help from a workers compensation attorney in Santa Rosa now.

Treatment denied because the worker ‘had a prior injury’. This is not a proper basis to deny medical treatment in a workers compensation case. Under California workers’ compensation law, if the work injury contributes in any medically significant way to the need for medical treatment the treatment must be paid for by the employer and their workers compensation insurance carrier. This is known as the “1% rule” which is based on the legal principle that medical care is not apportionable to other causes as long as there is at least 1% of the need for treatment attributable to the current injury, even if there are prior injuries to the same part of the body. So, for example, if there as a prior back injury with a previous employer and then a new injury with new employer, that new employer and their insurance carrier will be required to provide medical treatment if the new injury contributed in any medically significant way to the need for treatment.

Treatment denied because the ‘company clinic attendant made me wait for two hours, didn’t listen to my complaints, didn’t examine me, then said I didn’t need any treatment, even though I have swelling and pain where I was injured.’ Often we interview injured workers who come to our offices with ‘medical reports’ from the employer’s industrial clinic, and those ‘check-the box’ reports fail to correctly describe how the injury happened, what body parts were injured, and what complaints the patent made at the clinic, where they are often released with no medical care provided. We can help you get another medical opinion to show that treatment is needed.

Treatment denied because ‘my supervisor refused to report the injury to the employer.’ Sometimes we hear from injured workers that their supervisor told them there was no need to report a work injury and that doing so might jeopardize the injured workers’ job. Conduct like this on the part of an employer or supervisor is plainly illegal and we can help.

Treatment denied because ‘my employer said I must have been hurt off the job.’ A woman who keeps horses at her Sonoma County home called our office and reported that her supervisor refused to give her a claim form to report her work injury, stating that “everybody knows you have horses so you must have injured yourself there, not at work.” In that case, the resulting delay in reporting the injury caused delay in obtaining needed medical treatment and other workers’ compensation benefits, but we were able to correct the situation through investigation and development of the legal case.

In all of these situations the Law Offices of Marc Francis can help! We conduct detailed interviews and take all necessary legal steps, including depositions, subpoena of witnesses and documents, and trials before a workers compensation judge in order to secure your needed medical treatment so that you can recover and return to work as soon as possible. Call today for a free consultation with a workers compensation attorney in Santa Rosa if you have been injured and need medical treatment in the greater Santa Rosa area or anywhere in Sonoma, Napa, Mendocino, or Marin Counties. Get the legal help you need now!

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