Legal Question in Workers Comp in California
Is it legal for an UrgentCare facility to refuse to treat a patient because they were injured on-the-job and have an open work comp claim? The patient was seeking medication for pain control because the insurance carrier was dragging their feet with referral authorization, and he was in severe pain.
2 Answers from Attorneys
It probably is, as what they did was refusing to take future possible WC payments as payment for the treatment, much as a medical facility refusing to take any particular medical insurance company they do not have a contract with. Since the person was having trouble in getting the WC carrier to agree to some type of treatment, it was not clear to the Urgent Care facility that it would be paid.
Yeah, its a private business. \Urgent Care won't get paid. it doesnt have to work for free.
Only the County Emergency Room has to work for free.
The solution is to use RoncoDrug or BuenaVista pharmacy which uses liens to fill injured workers' prescriptions for free...
....AND TO HAVE AN ATTORNEY who can get the Expedited Hearing on calendar to show the judge the adjuster is not authorizing treatment timely (when properly requested in writing and that writing is properly delivered to that adjuster....which I'm presuming you made certain was completed).
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