Future medical care refers to medical treatment that an injured worker may need after the initial stages of a workers’ compensation claim. In California, if a work-related injury causes lasting health problems, the worker may be entitled to ongoing treatment to manage the condition.
These benefits are intended to ensure that the injured worker continues to receive necessary care even after temporary disability ends or a permanent disability rating is assigned.
What Does Future Medical Care Include?
Future medical care may include a wide range of treatments needed to relieve the effects of a work-related injury. Depending on the condition, this may include:
- Doctor visits and follow-up examinations
- Prescription medications
- Physical therapy or rehabilitation services
- Diagnostic testing such as X-rays or MRIs
- Medical equipment or assistive devices
- Surgery or other specialized treatment if medically necessary
All treatment must be related to the original work injury and considered reasonable and necessary under California workers’ compensation guidelines.
How Is Future Medical Care Determined?
A physician determines whether future medical care is necessary. This determination usually occurs when the injured worker reaches maximum medical improvement. At that stage, the doctor may indicate that ongoing treatment will be required to maintain the worker’s condition or prevent further deterioration.
Medical reports describing the need for ongoing care become an important part of the case and may affect both benefits and settlement negotiations.
How Future Medical Care Affects Settlements
Future medical care plays a significant role when resolving a workers’ compensation case. There are generally two ways a case may be resolved:
- A stipulated award, where the injured worker continues to receive future medical treatment paid by the insurance company
- A compromise and release settlement, where the worker receives a lump-sum payment and gives up the right to future medical care through workers’ compensation
Choosing between these options can have long-term financial and medical consequences.
Limits on Future Medical Treatment
Even when future medical care is awarded, treatment requests must still go through the workers’ compensation medical review process. Insurance companies may review requests to determine whether the treatment is medically necessary and consistent with state guidelines.
Disputes over treatment can occur and may require review by independent medical evaluators or a workers’ compensation judge.
Get Help Understanding Future Medical Benefits
Future medical care can be one of the most valuable parts of a workers’ compensation claim, especially when an injury causes long-term health issues. Understanding how these benefits work can help protect your access to necessary treatment.
The Law Offices of Norman J. Homen assists injured workers throughout California with workers’ compensation claims, settlements, and disputes involving future medical care. Contact us today for a free consultation.
Norman J. Homen
Norman Homen is a California attorney with over 30 years of experience representing clients in workers’ compensation and Social Security disability matters.
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