Employers may limit the number of chiropractic visits for workers' compensation cases to 25, according to Labor Code section 4604.5(d).
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WORKERS’ COMPENSATION UPDATE
Court Upholds Employer’s Right
To Limit Workers’ Comp
Chiropractor Visits
By Christopher W. Olmsted
Labor Code section 4604.5, subdivision (d) was enacted in 2003, and provided that, unless approved by an injured employee’s employer, benefits for chiropractic treatments and physical therapy sessions were limited to no more than 24 visits per industrial injury.
The statute was amended the following year as part of Senate Bill No. 899 (SB 899), a comprehensive reform of this state’s workers’ compensation system. As pertinent to section 4604.5(d), SB 899 left in place the cap on chiropractic and physical therapy visits, but added a limit of 24 occupational therapy visits per industrial injury as well.
Jose Facundo-Guerrero received 76 chiropractic treatments following an industrial injury he sustained while working for Nurserymen’s Exchange. After a Workers’ Compensation Appeals Board (WCAB) decision determined that he was entitled to benefits covering only 24 chiropractic treatments, as specified by section 4604.5(d) Guerrero filed an appeal to state court.
The worker argued that section 4604.5(d) violates the California Constitution’s mandate to the state Legislature, that it 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.” (Cal. Const., art. XIV, § 4.) He also argued that giving the legislature, and in turn the employer the power to approve more than 24 visits was an unconstitutional delegation of power, and also violated his constitutional right to equal protection under the law.
A California court of appeal rejected all of these constitutional challenges to section 4604.5(d). The court upheld the employer’s right to limit chiropractic treatment to 24 visits.
“[W]e will not second-guess the wisdom of the Legislature in meeting the workers’ compensation crisis in this state by, among other things, specifying the maximum amount of chiropractic care an injured worker may receive for a single industrial accident. The Legislature clearly has the constitutional authority to make that determination.”
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Download entire July 2008 Legal Update in PDF format.
This article is intended as a brief overview of the law and are not intended to substitute as legal advice. Any questions or concerns regarding any statute or case law should be addressed to a licensed attorney. Copyright © 2008 by Barker Olmsted & Barnier, APLC. San Diego, California. All rights reserved.
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