Your Right to Medical Care: Why a Security System Counts in Workers’ Comp

Understanding the Scope of Care Under LC 4600: The Duty to Cure or Relieve

In the realm of Workers’ Compensation, the employer’s duty under Labor Code (LC) 4600 is clear: they must furnish medical treatment reasonably required to cure or relieve the injured worker from the effects of their injury. A recent case, Derboghossian v. All Tune & Lube, 2024 Cal. Wrk. Comp. P.D. LEXIS 85, sheds light on the nuances of this duty, particularly when it involves unconventional forms of medical treatment.

Case Summary: Derboghossian v. All Tune & Lube

The Workers’ Compensation Appeals Board (WCAB) held that the defendant was liable for the reimbursement of a replacement security system for the applicant. This decision was rooted in the following sequence of events:

1. Initial Injury and Security System Installation (2011):
   • The applicant sustained an injury resulting in permanent total disability.
   • In response to a recommendation from the applicant’s treating physician, the defendant reimbursed the applicant for installing a home security system in 2011.
   • The system was deemed necessary to assist the applicant, who is blind and suffers from psychological injury.
2. System Upgrades and Replacement (2012 and 2019):
   • In 2012, the defendant reimbursed the applicant for system upgrades.
   • In 2019, the applicant installed a new security system. The defendant submitted the request for a new system to utilization review (UR), which denied it.
3. WCAB’s Ruling:
   • The WCAB ruled that, although a home security system is not typically considered medical treatment, it becomes so when prescribed by a doctor for a patient with specific needs (in this case, blindness and psychological injury).
   • The decision established in 2011 that the security system was reasonable and necessary medical treatment remained valid.
   • The WCAB differentiated this case from Patterson v. The Oaks Farm (2014) 79 CCC 910, noting that tangible medical equipment like a security system must be maintained as long as needed by the applicant.

Key Takeaways from the Ruling

• Medical Treatment Definition: The scope of what constitutes medical treatment can extend beyond conventional medical services to include durable medical equipment when prescribed by a physician for specific medical conditions.
• Continuity of Care: Once medical equipment is authorized, the defendant must ensure its maintenance and replacement as long as the applicant requires it.
• Penalties for Non-compliance: The WCAB concluded that the defendant’s failure to provide a good-faith basis for the delay in reimbursing the applicant warranted penalties under LC 5814 and attorney fees under LC 5814.5.

This case underscores the importance of understanding and adhering to the broad scope of care required under LC 4600. Employers and insurance carriers must recognize that the duty to cure or relieve an injured worker’s condition may involve non-traditional forms of treatment, and failure to comply can result in significant penalties.