Rehab

California court upholds therapy cap for workers' comp

Rehab Regs, June 6, 2008

The California Court of Appeal upheld the state’s right to limit the number of PT, OT, or chiropractic sessions workers may receive under workers’ compensation rules, Insurance Journal reported Thursday.

Injured worker Jose Facundo-Guerrero challenged the cap after a CA Workers’ Compensation Appeals Board determined Facundo-Guerrero was only entitled to benefits to cover 24 chiropractic visits, the maximum allowed under state rules, according to Insurance Journal. Facundo-Guerrero argued the ruling violated the state’s mandate to implement “a complete system of workers’ compensation,” including “full provision for such medical, surgical, hospital, and other remedial treatment as is requisite to cure and relieve from the effects of such injury.”

The Court of Appeal rejected Facundo-Guerrero’s challenge, stating the state law neither gives injured workers the right to unlimited treatment nor restricts the legislature’s ability to limit the number of treatments provided under workers’ compensation rules.

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