If you’re injured on the job in California, you’re entitled to timely medical treatment under the state’s workers’ compensation system. But what happens when that care is delayed—when your surgery is postponed, your MRI is denied, or your pain meds are stuck in a Utilization Review (UR) black hole?
At Employees First Labor Law, we’ve seen how delayed treatment can devastate a recovery. The law says you’re entitled to care—but insurance companies don’t always play fair.
Here’s what you need to know about your rights, the dangers of delay, and what to do when workers’ comp drags its feet.
Is the Insurance Company Delaying Your Treatment?
Delays in care often happen because the employer’s insurance company must approve every step of your treatment plan—including doctor visits, diagnostic testing, surgery, and therapy. This process, called utilization review (UR), allows insurers to deny or delay care by claiming it’s not “medically necessary.”
Common causes of treatment delay include:
- Refusal to authorize referrals or specialist visits
- Denials of MRIs, X-rays, or CT scans
- Repeated “under review” status without decision
- Failure to approve physical therapy or pain management
- Ignoring or delaying prescription approvals
These tactics are not just frustrating—they can worsen your injury and prolong your recovery.
Your Rights Under California Law
Under California Labor Code § 4600, employers must provide all treatment “reasonably required to cure or relieve” the effects of a work-related injury. If care is delayed, they are violating this legal obligation.
You have powerful protections under California Labor Code:
- Labor Code § 4600: Employers must provide prompt care to cure or relieve work injuries.
- Labor Code § 5814: If your medical care is unreasonably delayed, you may be entitled to 25% additional compensation (or up to $10,000 in penalties).
- Labor Code § 5402(c): You’re entitled to up to $10,000 in medical treatment while your claim is being investigated—even before it’s accepted.
You don’t need to suffer in silence. The law is on your side.
Additionally:
- Medical treatment must be authorized within 5 working days of a request unless it’s denied through UR.
- Workers may request an Independent Medical Review (IMR) if care is denied.
- Delays in care may entitle you to additional benefits or support a claim for penalties.
Signs You’re Facing an Improper Delay
You may be experiencing an unlawful delay if:
- You haven’t seen a doctor days or weeks after reporting your injury
- A doctor ordered treatment that hasn’t been scheduled or approved
- You’re told to “wait for approval” with no timeline
- The claims adjuster is unresponsive or evasive
How Delayed Care Affects Your Claim
Beyond the obvious medical risks, delayed treatment can also hurt your workers’ compensation case. If there’s a large gap in care, the insurance company might argue:
- Your injury isn’t serious
- You’ve recovered and don’t need more benefits
- Your disability is no longer work-related
This can reduce or eliminate your Temporary Disability (TD) or Permanent Disability (PD) payments—even if you’re still in pain.
What You Can Do If Your Treatment Is Delayed
You don’t have to accept the delay. Here’s what you can do:
1. Document Everything
Keep a timeline of delays, who you spoke to, and what was said. Save letters, emails, and text messages from doctors or the claims administrator.
2. Push Back with Legal Support
If the delay is unreasonable, your attorney can:
- File a penalty petition under Labor Code § 5814
- Demand a QME (Qualified Medical Evaluation) if you’re stuck in UR denials
- Request a change of physician or MPN transfer
- Seek an expedited hearing before a Workers’ Comp Judge
3. Use the $10,000 Pre-Acceptance Rule
Even before your claim is officially accepted, you’re entitled to $10,000 in medical treatment immediately. Don’t let the insurance company pretend otherwise.
4. File a DWC Complaint
California’s Division of Workers’ Compensation has procedures to report abuse or repeated delay tactics.
How EFLL Helps Injured Workers Get the Care They Deserve
At Employees First Labor Law, we don’t tolerate delays in care. Our legal team fights back against insurance company games and employer negligence. We:
- Demand immediate authorization of medically necessary treatment
- File for penalties and sanctions if care is unreasonably delayed
- Represent you in hearings before the Workers’ Compensation Appeals Board (WCAB)
- Coordinate with your doctors to support your recovery and protect your case
We Put Injured Workers First—Always
If you’re tired of waiting for medical care or being ignored by the insurance company, don’t go it alone. Contact EFLL today. We’ll fight to get you the care you need and the compensation you’re owed.
📞 Call now or visit our Workers’ Compensation page to schedule a free consultation.
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