Legal Question in Workers Comp in California

Re: Sequela injuries now

Th relationship between the knee injury and the hip injury is purely a medical determination. If the physician you have is the one that has been treating you throughout and is considered the "treating"physician then his determination that the hip injury and knee injury are related with the hip injury being a consequence of the knee injury will carry the legal presumption and it will similarily be very difficult therefore for the insurance company to defeat this opinion. The physician is considered the treating physician if this is an admitted or also referred to as an "accepted" claim (which it appears to be based on your message) and you were not released from treatment by a previous physician for your work injury prior to becoming a patient of this current physician. The fact that they are disputing it is not the end all on this and you shouldn't perceive it as such. They will be entitled to a medical opinion and evaluation but again your own physician's determination will carry the most weight at the WCAB. If your physician, and again if he is the treating physician, has made the determination that this is related then you need to file an amended claim form to now include this injury and follow all procedures to add this to the claim with the claim form being the first step. If the insurance company refuses to authorize treatment for this new injury then you should proceed immediately to the WCAB for an "expedited hearing" which will resolve this issue and get the WCAB to order a determination on the issue that the hip injury relates to the knee injury therefore industrial and compensable and that treatment is necessary based on an industrial injury. Good luck and don't give up the fight!