Legal Question in Workers Comp in California

Make an appointment to meet with the Information & Assistance Officer , *"I&A", at the Workers Comp Board facility where your claim was heard/resolved (unless you've moved 500 miles away, then ask I&A to help you transfer Venue nearer to home). California Insurance Guarantee Association -- CIGA -- covers workers' losses/treatment for bankrupt insurance companies, so they have zero benefit to "stalling", they are just state workers requiring every treatment request carefully written and explained before paying out taxpayer money for so much as a aspirin.

I haven't any clue why a Personal Injury firm would send you one shred of paper, because Workers Compensation benefits are completely separate from Personal Injury awards/settlements.

However, you SHOULD be receiving "Utilization Review" answers from reviewing doctors. Every time a treating physician faxes a request for a form treatment for you, CIGA Adjusters send that REquest For Authorization -- RFA -- form to Utilization Review. A UR doctor checks it and tries very, very hard to find a reason to refuse the treatment. If the UR doctor "non-certifies" the treatment, CIGA adjuster sends you the INdependent Medical Review Request Form for an IMR.

80% of the IMR are denied, so odds are against you that you will get any treatment when you request the IMR.

So you are out-matched, but it's by the scheme voted in by your Assemblymen and State Senator and signed into law by Gerry Brown to guarantee insurers pay almost nothing for injured workers' care. If you're in enough pain, you'll campaign against every one of them. They're clearly 'in bed' with insurance companies while claiming to support the common worker.