Text of Labor Code §4062:
If either the employer or employee objects to a medical determination made by the treating physician concerning any medical issues not covered by Sections 4060 and 4061, including the necessity or scope of medical treatment, a written objection must be made, and the parties must seek a Qualified Medical Evaluator (QME) or Agreed Medical Evaluator (AME) to resolve the dispute.
What Is Labor Code §4062?
California Labor Code §4062 gives both injured workers and employers the right to dispute medical determinations that do not fall under claim denial (§4060) or permanent disability rating (§4061). This includes decisions regarding:
- The necessity or appropriateness of medical treatment
- The timing or conclusion of treatment
- Whether an employee has reached Maximum Medical Improvement (MMI)
- Any other unresolved medical issue affecting benefits
The objection must be made in writing within strict deadlines—typically within 20 days (represented workers) or 30 days (unrepresented workers) of receiving the medical report.
What Kinds of Medical Issues Can Be Disputed?
Common disputes that fall under §4062 include:
- Is the doctor recommending enough treatment (e.g., surgery, pain management)?
- Is the insurer refusing to authorize physical therapy or diagnostics?
- Has the doctor prematurely declared MMI?
- Is the insurer’s doctor downplaying the severity of the injury?
These disagreements are not uncommon—and they are often where insurance companies attempt to reduce costs at your expense.
How Do You Challenge a Medical Opinion Under §4062?
If you’re represented by an attorney, your lawyer must file a written objection and initiate the Panel QME process through the Division of Workers’ Compensation (DWC). You and the insurance company will choose from a list of neutral medical examiners.
If you’re not represented, you still have rights—but the process differs slightly. The DWC Medical Unit will guide you through selecting a QME on your own, or you can hire an attorney to ensure you get proper guidance and protection.
Timing Is Everything
Deadlines are strict and missing them can result in losing your right to dispute a bad medical report. This is why it’s crucial to act quickly if you disagree with a treating physician’s findings.
Common Insurance Tactics
Insurance carriers often:
- Use Utilization Review (UR) to deny treatment
- Claim the worker reached MMI prematurely
- Use hand-picked QMEs with a track record of downplaying injuries
Don’t let this limit your care or your case value. If you’re facing a §4062 dispute, legal representation can make all the difference.
How EFLL Helps with §4062 Disputes
At Employees First Labor Law, we:
- Identify flawed or biased medical determinations
- Draft formal objections under §4062
- Secure panel QMEs or negotiate for an AME
- Prepare clients for QME evaluations
- Challenge lowball reports through deposition or rebuttal
We’ve successfully overturned unjust treatment denials and helped clients obtain life-changing surgeries, therapy, and accurate disability ratings.
Learn More About Key Labor Codes
Want to see how §4062 fits into the broader workers’ comp system?
👉 Explore the Top 25 California Labor Codes for Workers’ Compensation
Final Thoughts
Labor Code §4062 is your safeguard against unfair medical decisions. If you disagree with a treating physician’s opinion—or your treatment is being cut off—don’t delay. The clock is ticking.
Contact Employees First Labor Law to make sure your medical rights are protected and your recovery isn’t compromised.
