California workers’ compensation law requires claims administrators to authorize and pay for medical care that is reasonably required to cure or relieve the effects of the injury. Under laws enacted in 2003 and 2004, this means care that follows scientifically based medical treatment guidelines. It is illegal for a physician or medical facility to bill a worker if they know the injury is or may be work related.
You are entitled to reasonable medical treatment to cure or relieve work-related injuries and illnesses. The doctors who treat you must follow treatment guidelines referred to as the medical treatment utilization schedule (MTUS). Only the treatment that meets the guidelines must be approved.
All employers or claims administrators handling their workers’ compensation claims are required by law to have a program called utilization review (UR). This program is used to decide whether or not to approve medical treatment recommended by your doctor.