Let me start off by saying that I treat a lot of injured workers. It’s over 60 percent of the people I see every day, I have to tell you that the Worker’s Compensation system in California has been broken for 20 years, and severely slanted in favor of insurance companies. If you’ve been hurt on the job, it’s going to be an uphill slog to get the care you need, and you’re going to need a team on your side.
That’s where Doctors of Chiropractic (DC’s) come in. Most applicant attorneys (the attorneys who represent injured workers) typically refer their clients to D.C’s as their Primary Treating Physician. Why? Because chiropractors make the ideal quarterback for their cases. We’re not surgeons, we’re not pain management doctors and we don’t do drugs, but we understand the skills, roles and expertise of all the specialists who treat injured workers, and accordingly are well-positioned to refer them to the correct specialists. And research shows clearly that if you go to a DC first, there is a far lower likelihood of ever having to take opioids, injections, or have surgery, and lower eventual disability. Who you go to first matters! I recently co-authored a paper on this issue, which demonstrated the system could save millions of dollars if patients went chiropractors first, but that is clearly not what happens.
Farabaugh R, Hawk C, Taylor D, Daniels C, Noll C, Schneider M, McGowan J, Whalen W, Wilcox R, Sarnat R, Suiter L, Whedon J. Cost of chiropractic versus medical management of adults with spine-related musculoskeletal pain: a systematic review. Chiropr Man Therap. 2024 Mar 6;32(1):8. doi: 10.1186/s12998-024-00533-4. PMID: 38448998; PMCID: PMC10918856.
Once upon a time, 20 years ago, it wasn’t difficult for patients to get appropriate treatment quickly and fairly easily. That has all changed. Doctors can’t provide you a Band-Aid, aspirin or any other treatment without first requesting authorization from the insurance carrier. The insurance carrier then sends that request to a Utilization Review doctor who reviews the requests, and in my experience, more often than not denies it. Sadly, I tell all my work on patients that however long you think something should take, triple that, and you will be in the ballpark.
Those of us who do this kind of work every day have learned how to mostly get around these barriers, and get you to providers who can actually help you, whether it’s pain management, therapy, injections, psychologists or surgery. Unfortunately, Worker’s Compensation is often a factory for chronic pain, and you need doctors and attorneys in your corner who will fight to get you the care you need. I have been around long enough to see the California Legislature “fix” the Worker’s Compensation system “once and for all” three times in my career, and we are 20 years overdue for a new fix.
When I speak with senior claims examiners, I always ask them the same question: “If you got hurt on the job, would you report it?
Not one of them has ever said yes. That should tell you something.
I suggest you contact your legislators, because unless enough people complain, they are not going to change the laws that operate against you in favor of the insurance companies. They do not know there is a problem, and won’t do anything to fix it until enough people tell them there is.