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Disability Law Offices of Tony Adderley

When Approved Benefits Are Cut Off

  • By: Tony Adderley
  • Published: July 3, 2015
Beyond Workers’ Comp

A bill that would keep insurance companies from reopening the cases of injured workers to deny them their previously-approved workers’ compensation benefits is working its way through the California Legislature. Late in April, the bill passed an important California Senate committee. The proposal is a response to a workers’ compensation law passed in 2012 that has been used to cut off vital medical care to victims who sustained injuries at their jobs. If you’re injured at work in southern California, discuss your case immediately with an experienced Los Angeles workers’ compensation attorney.

The 2012 legislation established a process that was intended to resolve workers’ comp medical disputes quickly by having doctors rather than judges decide. But the result is that insurance companies now seek second opinions for care that has already been approved, and they have cut off benefits on the basis of those second opinions. This year’s proposal, sponsored by State Senator Richard Pan (D-Sacramento), would prevent insurers from reviewing medical treatments that have already been agreed upon or approved by a judge. Exceptions would be permitted only when there is a change in the worker’s medical condition or the treatment is itself considered unsafe.

The bill is supported by the California Medical Association, which represents physicians and surgeons. Two-thirds of physicians who responded to a California Medical Association survey admitted to having trouble obtaining authorizations for needed medical treatments; more than half said that the biggest problem in the workers’ compensation system is inappropriate denials of medically necessary care.

Don’t take chances with your health or your future. If you are injured at your job in the Los Angeles area, speak right away with an attorney who will fight aggressively on your behalf for the medical treatment and worker’s comp benefits you need and deserve. After any on-the-job injury, speak at once with an experienced Los Angeles workers’ compensation attorney.

About the Author Tony Adderley has been working as a professional advocate for
individuals entitled to Social Security Disability (SSD) and worker’s
compensation benefits for more than 20 years.