Medical treatment is one of the most important parts of California’s workers’ compensation system. When an employee develops an injury or illness because of work, treatment may be necessary to relieve symptoms, support recovery, determine work restrictions, and help the employee safely return to employment.
California’s medical treatment system continues to evolve. In 2026, the Division of Workers’ Compensation updated treatment guidelines and utilization review regulations while also studying how quickly injured workers receive care. Understanding the basic process can help workers recognize what may happen after treatment begins.
How Medical Treatment Begins After a Work Injury
An injured employee should generally report a work-related injury or illness to the employer promptly. Emergency medical treatment should not be delayed when immediate care is necessary.
After an employer learns about an injury, California workers’ compensation procedures include providing the employee with a DWC 1 claim form. Filing the claim form starts the formal process for seeking workers’ compensation benefits.
California’s Division of Workers’ Compensation explains the process in its official injured-worker claim guidance.
Medical Care While a Claim Is Being Reviewed
Workers sometimes assume that no medical care is available until the insurance carrier makes a final decision about a claim. California’s DWC states that after a worker files the claim form, an employer generally must authorize appropriate medical treatment while the claim is being considered, subject to the statutory limit applicable during that period.
Workers should tell healthcare providers that the condition is work-related and keep copies of important treatment records, work-status reports, and correspondence.
Who Provides Workers’ Compensation Medical Care?
Many California employers use a Medical Provider Network, commonly called an MPN. An MPN is a group of healthcare providers established to treat occupational injuries and illnesses.
The rules governing physician selection can depend on whether an employer has an MPN, whether a worker properly predesignated a personal physician before the injury, and other circumstances. Because these details can affect where treatment is provided, injured workers should review the information supplied by their employer or claims administrator.
What Is the Medical Treatment Utilization Schedule?
California uses the Medical Treatment Utilization Schedule, or MTUS, to establish evidence-based medical treatment guidelines for workers’ compensation care.
The MTUS addresses treatment for many occupational injuries and conditions and is intended to guide medical decisions within the workers’ compensation system.
In August 2026, California implemented updated MTUS guidelines addressing ankle and foot disorders as well as hip and groin disorders. Workers and providers can review current information through the Division of Workers’ Compensation MTUS resources.
Why Updated Treatment Guidelines Matter
Medical knowledge changes over time. Updating evidence-based guidelines allows California’s workers’ compensation system to incorporate newer research when determining which treatments are considered appropriate for particular conditions.
For workers, this means treatment recommendations may be evaluated using current guidelines rather than policies that were in place many years earlier.
What Is Utilization Review?
Utilization review, often abbreviated as UR, is the process used to determine whether requested medical treatment is medically necessary under California workers’ compensation requirements.
A treating physician may submit a request for authorization for treatment. Depending on the requested service and applicable rules, that request may be subject to utilization review.
New Attention on Early Treatment in 2026
The Division of Workers’ Compensation released a new study in August 2026 examining the effect of Senate Bill 1160 on utilization review and medical treatment.
SB 1160 reduced prospective utilization review requirements for certain treatment provided during the first 30 days following a workplace injury. The 2026 research found that approval rates for treatment requests during this early period remained above 90 percent both before and after the law took effect.
The study also identified a modest improvement in access to guideline-consistent physical therapy for workers with conditions for which physical therapy was recommended.
Workers interested in the research can review the DWC report on utilization review and medical treatment.
What Happens When Treatment Is Disputed?
Workers’ compensation medical disagreements can involve whether a particular treatment is medically necessary, the extent of an injury, work restrictions, or whether a worker has reached maximum medical improvement.
California has procedures for addressing different types of medical disputes. For example, certain disputes involving utilization review decisions may proceed through Independent Medical Review.
Other disagreements may involve a Qualified Medical Evaluator or other workers’ compensation procedures.
Work Restrictions and Returning to Work
Medical care is closely connected to return-to-work decisions. A treating physician may determine that an employee can return to regular duties, needs temporary restrictions, requires modified work, or cannot work while recovering.
Follow Written Restrictions
Workers should understand the restrictions listed by their treating physician. These may address lifting, standing, repetitive movements, driving, reaching, working at heights, or other job activities.
Returning to tasks that conflict with medical restrictions can create additional health and workplace safety concerns.
Medical Travel Reimbursement Changed in 2026
Workers may have to travel to physicians, hospitals, physical therapy appointments, pharmacies, or medical-legal evaluations as part of a workers’ compensation claim.
California increased the workers’ compensation mileage reimbursement rate for medical and medical-legal travel to 76 cents per mile for qualifying travel on or after July 1, 2026. The rate applies based on the date of travel rather than the original injury date.
Workers should consider keeping accurate records of qualifying travel, including appointment dates and mileage.
Keeping Medical Records Organized
Work injury treatment can generate a significant amount of paperwork. Keeping organized records can make it easier to understand what treatment was recommended and what happened during the claim.
Useful records may include medical reports, work-status notes, treatment requests, appointment information, mileage records, prescriptions, correspondence from the claims administrator, and copies of important forms.
Understanding the Larger Workers’ Compensation Process
Medical treatment is only one component of workers’ compensation. A claim may also involve temporary disability, permanent disability, return-to-work issues, or supplemental job displacement benefits.
For a broader explanation, read How California Workers’ Compensation Works. Workers can also review our guide to workplace safety in California’s Central Valley for information about preventing occupational injuries.
Central Valley Injury provides general educational information about California workplace injuries and workers’ compensation. Rules and medical guidelines may change, so workers should verify important information through current California government resources.
This article provides general educational information and is not legal or medical advice.