Who Pays for the Treatment of Non-work Related Treatment that is Required to Treat the Work Injury?

Employers in California have more than a legal responsibility to support the timely recovery and return to work of all injured employees. Note that this is regardless of whether the injury is work-related or non work-related.

You probably know that your California employer has a responsibility to provide you with a safe workplace. And as safety is one of the top priorities in every organization, note that a workplace injury does not bode well for employers because it happened on their watch. There is a common misconception that only because an injury isn’t specifically work-related, your employer does not have responsibility after the injury. There is no doubt that legally there are more ramifications for your California employer if you sustain an injury on the job. However, keep in mind that your employer is not fully off the hook for your non-work injuries.

Can your Employer be Held Responsible for the Treatment of Non-work Related Injuries?

 NSC Injury Facts revealed that there were more than 3 times as many non-work-related injuries that needed medical attention as work-related injuries in 2015. And this means that workers were missing time from work because of injuries that inevitably has a considerable impact on the organization’s bottom line.

Note that your employer might have to pay for the treatment of a non-work related injury or condition. For example, your employer will be liable if treatment of the non-work related injury is reasonably needed to cure your workplace injury or minimize its effects.

Another example, if you have a medical need for weight loss in order to get rid of non-industrial fat and this is a precondition to your industrial surgery, then your employer has to pay for your gym membership. Your employer may also have to pay for bariatric surgery and any other weight loss plans to ensure a speedy recovery.

However, it is worth noting that in most cases your employer will not pay for all non-work related medical expenses. This is true even if those medical conditions or injuries complicate, aggravate or delay the treatment of your work injury. For instance, if you are pregnant and have carpal tunnel syndrome, your employer will not pay for your obstetrician’s bill, even if your pregnancy complicated or delayed your carpal tunnel syndrome treatment!

<h3style=”text-align: left;” align=”justify”>How to Determine if Your Employer is Responsible for the Treatment of Your Non-work Related Injury?

We can get some guidance from Doke vs. WCAB (2004) to figure out if your employer can be held liable for your non-work related injuries. After sustaining a work injury that affected his back as well as lower extremities, the employee developed a heroin addiction.

Because of his addiction, the employee developed hepatitis C. Due to this condition he had to undergo surgery requiring a liver transplant. The applicant claimed that his employer had to compensate him for his liver disease since the disease was a direct consequence of his orthopedic injuries. He claimed that he started using heroin in order to relieve the pain.

However, the WCJ concluded that hepatitis C was not a compensable result of the work-related injury that the employee had sustained. The WCAB outlined that the employee’s use of heroin to treat chronic pain was not an acceptable response. Hence, the board decided that the employee’s secondary injury, which was mainly caused by heroin use, was not compensable. This was because it did not meet all the statutory and legal conditions of compensation under various codes. Some of them are:

  • Under Labor Code 3600(a)(4) any injury caused because of the illegal use of a controlled substance, such as heroine, is non-compensable

  • Under Labor Code 3600(a)(5) any intentionally self-inflicted injury is also not compensable

  • Under Labor Code 3600(a) (7) any injury caused by committing a felony is not compensable

Nonetheless, it is worth noting that the WCJ ordered the employer to pay for the treatment of the liver disease. This was because the treatment was an important prerequisite to facilitate orthopedic care, which the employee needed but could not receive until liver transplant surgery was performed.  It was further decided that when the treatment for a non-work related condition or injury is needed to treat a work injury, then the employer is responsible for the treatment of both conditions.

Note that the WCAB agreed that the employee needed further medical treatment that was reasonably required to cure his industrial injury or relieve its effects. However, he was not entitled to receive payment for the treatment for the liver disease.

Document all the Details

In life, like in any situation, the best offense is a good defense. Keep in mind that during your worker’s compensation claim in California, documentation is one of your strongest defenses. And there is nothing wrong with keeping accurate and detailed records of your injury or accident and what happens during the course of the worker’s comp claim. The best thing about keeping records is that you can provide all this information to your doctor in order to give them additional and useful context for your injury or illness and how your work caused it.

Follow Your Doctor’s Orders and Instructions

If you receive any medical directions from your doctor, you should follow them very closely. You should ask your doctor to give you a complete list of all work-related activities that they advise against you performing until you have fully recovered from your injuries.

When you get the list, keep one copy for yourself and provide one copy to your manager or supervisor so that they are aware of the type of restrictions and limitations that have been placed on your work in order to protect your health.

Get Help from an Experienced Workers’ Compensation Attorney

Workers’ compensation claims in California can be difficult and complex to navigate, particularly if your California employer is fighting any portion of your claim. Hiring an experienced and competent workers’ compensation attorney is invaluable in making sure that you are fully compensated for your loss.  Getting help from a competent West Coast WC Attorney can help you make sure that you receive all of the benefits you are entitled. Contact Brittany Huynh today to learn about your rights.