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How Delayed Medical Treatment Can Impact Your California Workers’ Compensation Case
As a California workers’ compensation attorney, I’ve worked with many injured workers who were unsure of what to do after getting hurt on the job. Some wait days or even weeks before seeing a doctor, thinking their injury will heal on its own. Others delay treatment because they’re worried about retaliation or don’t know their rights. Unfortunately, delaying medical treatment after a work-related injury can create significant problems in a workers’ compensation case. Your health and potential legal claim are both on the line, and how quickly you seek care can affect whether you receive full benefits under California law.
California’s workers’ compensation system is designed to provide medical treatment, wage replacement, and disability benefits for injured employees. These benefits are your legal right under the California Labor Code, but they are not automatic. Insurance companies often look for ways to deny or reduce claims, and delayed medical care can give them an excuse to question whether your injury was work-related or serious enough to require benefits. That’s why I encourage every injured worker to report their injury and seek medical attention as soon as possible.
Why Prompt Medical Care Is So Important In Workers’ Compensation Cases
One of the first things the insurance company looks at when evaluating your claim is the timing of your medical treatment. Under Labor Code § 4600, injured workers are entitled to receive all medical care that is “reasonably required to cure or relieve” the effects of a work-related injury. But if you wait too long, the insurance adjuster may argue that your injury didn’t happen at work or that it wasn’t serious enough to require treatment.
When you delay care, it also becomes harder to establish a clear connection between your injury and your job. This connection, called “causation,” is essential in any workers’ compensation case. Without medical documentation that shows you were hurt on the job, your claim could be denied or significantly delayed. As your attorney, I work to present the strongest possible evidence, but even the best legal arguments can’t make up for a lack of timely medical records.
How Delays Can Affect Your Right To Temporary Disability Benefits
Under Labor Code § 4650, if you are unable to work due to your injury, you may be entitled to temporary disability benefits to replace part of your lost wages. But to qualify for those benefits, a doctor must verify that you are medically unable to perform your job. If you delay treatment, there may be no medical evidence to support your claim for temporary disability, and you could miss out on weeks or even months of income.
Additionally, if your doctor eventually confirms your injury but there’s a gap in treatment, the insurance company may dispute when your disability began. They may argue that your inability to work started later than it actually did. That delay can reduce the amount of compensation you receive, and in some cases, prevent you from receiving any benefits at all during the early stages of your recovery.
Delays Can Lead To Denials Of Care Or Use Of Non-Network Providers
California law requires that injured workers receive treatment through their employer’s Medical Provider Network (MPN), which is a group of approved doctors under the workers’ compensation system. If you delay treatment and decide to seek care on your own, you may unknowingly go outside of the MPN. This can result in the insurance company refusing to pay for your treatment, even if your injury is clearly work-related.
You also run the risk of not getting pre-authorization for certain procedures. Under Labor Code § 4610, most non-emergency treatments must be approved in advance through a utilization review process. When there’s a delay or if you try to manage care on your own, your claim can become complicated and harder to support with proper documentation.
How Insurance Companies Use Delayed Treatment Against You
Insurance adjusters often treat delayed medical care as a red flag. If you didn’t seek treatment right away, they may argue:
- The injury wasn’t serious.
- You were injured somewhere else, at home or outside of work.
- You’re exaggerating the injury.
- You didn’t follow the required reporting or treatment protocols.
They use these arguments to limit or deny your benefits. I’ve seen insurance companies comb through medical records to find any gap or inconsistency they can use to cast doubt on a claim. That’s why it’s critical to get care immediately and follow your doctor’s orders every step of the way.
What To Do If You’ve Already Delayed Treatment
If you didn’t get medical attention right away, that doesn’t mean your case is hopeless. I’ve helped many clients who delayed treatment still receive benefits, but it requires careful documentation and a clear legal strategy. Here’s information I usually provide:
- Seek medical attention immediately, even if some time has passed.
- Explain to your doctor when and how the injury occurred and why you delayed treatment.
- Notify your employer in writing if you haven’t already (required under Labor Code § 5400).
- Consult with a workers’ compensation attorney to build a record of your injury and pursue benefits.
Time is important, but so is the quality of the evidence. I work with doctors, specialists, and medical experts to support a claim and counter the insurance company’s arguments.
FAQs About Delayed Medical Treatment In California Workers’ Compensation Cases
Can I Still File A Workers’ Compensation Claim If I Didn’t Get Medical Treatment Right Away?
Yes. While prompt treatment strengthens your case, California law does not automatically disqualify you for delaying care. However, the longer you wait, the harder it may be to prove your injury was work-related. The insurance company will question the delay, so it’s important to get treated as soon as possible and explain the reason for waiting.
What If I Thought My Injury Was Minor And Got Worse Later?
This is very common. Some injuries, especially strains or repetitive stress injuries, start small and gradually become serious. As long as the injury is reported and connected to your work duties, you may still have a valid claim. You should inform your employer and seek treatment as soon as you notice worsening symptoms.
Will My Benefits Be Reduced If I Waited To See A Doctor?
Possibly. If there’s a gap in your medical records, the insurance company may try to limit the duration or amount of your benefits. For example, they might only approve temporary disability starting from your first doctor visit, not from the date your injury actually began affecting your work.
Can I Choose My Own Doctor If I Delayed Treatment?
In most cases, you must use a physician within the employer’s Medical Provider Network. However, if your employer failed to give you information about the MPN or did not authorize treatment within a reasonable time, you may have the right to choose your own doctor. I can help determine if that applies to your case.
What If My Employer Says It’s Too Late To Report The Injury?
California law requires workers to notify their employer within 30 days of the injury under Labor Code § 5400. But there are exceptions, especially in cases of cumulative trauma or delayed-onset injuries. If you’re facing a late-reporting issue, I can evaluate whether your claim may still be valid and take the appropriate legal steps.
How Can An Attorney Help If I Delayed Treatment?
I can gather evidence, work with your treating physician to support your claim, and push back against insurance arguments that try to use the delay against you. Even with late treatment, I can help clients file a claim, request benefits, and represent clients at hearings if the case becomes disputed.
Call Law Office Of Joseph Richards, P.C. To Protect Workers’ Compensation Rights
If you’ve suffered a workplace injury and waited to get treatment, you’re not alone—but you still have rights under California law. At Law Office of Joseph Richards, P.C., I help workers across California fight for the medical care and wage benefits they deserve, even when their claim faces challenges due to delays or insurance denials.
To speak directly with a California workers’ compensation attorney, call us today at (888) 883-6588 to receive your free consultation. We represent injured workers throughout the state of California and are ready to help you take the next step toward recovery and justice.