Is Chiropractic Care Covered by Workers' Comp in California?

Is Chiropractic Care Covered by Workers' Comp in California?

Yes. California Labor Code section 4600 lists chiropractic treatment as medical care an employer must provide for a work injury, the same as a doctor visit or surgery.

A neck, back, or shoulder injury is a common reason workers ask this question. California law does not treat chiropractic care as extra or optional. The law lists it next to medical, surgical, and hospital care. That is the same sentence that sets out what an employer owes an injured worker.

That coverage is not unlimited. California sets a visit limit for chiropractic care. It also decides which chiropractor you see first, and checks every request against the state's own treatment guidelines. Those rules, not a flat yes or no, decide whether your next visit gets paid.

This guide covers the visit limit and its exceptions. It also covers how your employer's medical network affects which chiropractor treats you, what the state's guidelines add on top of the visit count, and what to do if a request for more care gets denied.

How Many Chiropractic Visits Does Workers' Comp Pay For?

Up to 24 chiropractic visits per injury, unless your employer approves more in writing or you are in authorized postsurgical care.

California Labor Code section 4604.5 sets this limit for any injury occurring on or after January 1, 2004. The statute states it plainly:

Notwithstanding the medical treatment utilization schedule, for injuries occurring on and after January 1, 2004, an employee shall be entitled to no more than 24 chiropractic, 24 occupational therapy, and 24 physical therapy visits per industrial injury.

Three details in that sentence matter in practice. First, the count runs with the injury, not the calendar year. It never resets every January. Second, chiropractic, occupational therapy, and physical therapy are each tracked on their own. Using up one allowance does not touch the others on the same claim. Third, the limit names chiropractic visits by name. It does not reach acupuncture. The law covers acupuncture as its own category, with no matching visit number.

Two exceptions open the limit back up. Your employer can authorize extra visits in writing. Paying for those extra visits once does not waive the limit for a later request. Chiropractic care you get as part of an authorized postsurgical plan also falls outside the count. It must follow the state's postsurgical treatment schedule. For the complete visit-cap rule, and how the related treatment-guideline presumption works, see our full guide to Labor Code 4604.5's visit-cap and guideline rules.

What Happens Once You Use All 24 Chiropractic Visits?

Your chiropractor can no longer serve as your treating physician, so your claim moves forward with a different authorized provider.

Labor Code 4600 adds a rule that surprises many injured workers. Reaching the cap does not just stop new visits from being paid.

A chiropractor shall not be a treating physician after the employee has received the maximum number of chiropractic visits allowed by subdivision (c) of Section 4604.5.

Once you reach that cap, your chiropractor stops being the provider in charge of your claim. It is not just that you cannot send more visits to them. In practice, your file needs a new treating physician. This is usually an MPN doctor, or whoever your claims adjuster names. That new doctor keeps directing your care, writes your work-status reports, and tracks your recovery. If your chiropractor believes you need more care, raise that with the adjuster before the visits run out. Written employer authorization, covered above, is the one path that lets the same chiropractor keep treating you past visit 24.

Which Chiropractor Do You Get to See?

Most injured workers see a chiropractor through the employer's Medical Provider Network, unless they named a personal chiropractor in writing before the injury happened.

California gives employers a structured way to control who treats a work injury, including chiropractic care. It also gives workers a narrower way around that control.

If your employer has a Medical Provider Network, or MPN, approved under Labor Code 4616, you choose a chiropractor from that network's list. You can ask to change doctors inside the network if the first one is not a good fit. If your employer has no active network, Labor Code 4600 lets you choose your own doctor, chiropractor, or other provider. That right starts 30 days after you report the injury.

A separate, narrower rule can move a chiropractor to the front of that line sooner. Suppose you told your employer in writing, before the injury happened, that you have a personal chiropractor. California law gives that notice real weight:

If an employee requesting a change of physician pursuant to subdivision (a) has notified his or her employer in writing prior to the date of injury that he or she has a personal chiropractor, the alternative physician tendered by the employer to the employee, if the employee so requests, shall be the employee's personal chiropractor.

That rule only reaches a chiropractor who was already your regular provider. The chiropractor must be licensed under California's chiropractic licensing law, and must have directed your care and kept your records before you were hurt. It works through your one-time change of physician, not from the first day of your claim. For the full mechanics, including the five-working-day response deadline, see our guide to Labor Code 4601's one-time change of physician rule. This personal-chiropractor path is different from predesignating a personal physician under Labor Code 4600. That rule requires a medical doctor, not a chiropractor. Our guide on choosing between the MPN and predesignating your own doctor walks through that broader decision.

Does the State's Treatment Schedule Also Limit Chiropractic Care?

Yes. Every chiropractic request is also measured against the state's Medical Treatment Utilization Schedule, separate from the 24-visit count.

Labor Code section 4604.5 does two jobs at once. Beyond the visit cap above, subdivision (a) does something separate. It makes the state's treatment guidelines, called the Medical Treatment Utilization Schedule, or MTUS, presumptively correct about how much treatment an injury needs. California's own regulations build the MTUS. They sit in title 8 of the California Code of Regulations, starting at section 9792.20. Those regulations lean mainly on the Occupational Medicine Practice Guidelines, published by the American College of Occupational and Environmental Medicine. Your chiropractor's request for authorization still has to fit what that guideline supports.

A treating doctor can rebut an MTUS guideline. That takes real medical evidence, though, not just a preference for more care. Outside that narrow path, a guideline-based request should move forward through your claims administrator's ordinary review, as long as it stays under 24 visits. Our full guide to Labor Code 4600 and the MTUS schedule covers how that review works, and what else the schedule decides.

If a chiropractic request is denied anyway, the written decision should name the guideline the reviewer used. You can challenge that denial through independent medical review. See how independent medical review works under Labor Code section 4610.5 for the deadline and the form that applies.

Does More Chiropractic Care Raise Your Settlement?

No. Attending more chiropractic visits does not, by itself, raise what a claim settles for.

It is a natural question once you know the care is capped. Does using fewer visits, or all 24, change the number your claim settles for? It does not work that way. A permanent disability rating, your wage, and your future medical needs drive that number. An attendance count at the chiropractor does not. The same visit-cap statute that limits chiropractic care applies an identical 24-visit rule to physical therapy. Our guide on whether physical therapy increases a workers' comp settlement walks through why that is true, and what actually moves the number.

A chiropractic request can be delayed. It can be cut off at 24 visits with no written authorization in sight. It can be denied outright. The facts of your claim decide what to do next. A short conversation can usually tell you whether the denial is routine, or worth challenging. Eman Yazdchi reviews each California workers' compensation matter individually. Call (661) 273-1780 for a free consultation. Or use the contact form to describe what your claims adjuster has said about your chiropractic care.