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Andrea Dalessandro
✦ Certified Specialist in Workers’ Compensation Law — Certified by the State Bar of California, Board of Legal Specialization ✦
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By Eman Yazdchi, Esq. · Certified Specialist in Workers' Compensation Law, State Bar of California Board of Legal Specialization
In California, Labor Code §4600 imposes a duty on the employer or insurer to provide all medical treatment that is reasonably required to cure or relieve the injured worker from the effects of the industrial injury. The §4600 reasonableness standard is measured against the Medical Treatment Utilization Schedule and enforced through §4610 utilization review.
California Labor Code §4600 requires the California employer or workers' compensation insurer to provide all medical, surgical, chiropractic, acupuncture, and hospital treatment — including nursing, medicines, medical and surgical supplies, crutches, and apparatus including orthotic and prosthetic devices and services — that is reasonably required to cure or relieve the injured worker from the effects of the industrial injury. The §4600 California rule is the foundational benefit obligation: the medical-care duty runs from the date of injury and lasts for as long as the worker reasonably requires treatment for the industrial condition.
Under California Labor Code §4600, treatment is "reasonably required" when it falls within the Medical Treatment Utilization Schedule (MTUS) adopted by the Administrative Director — the evidence-based treatment guidelines that govern California comp medical care. The §4600 California reasonableness standard means MTUS-compliant care is presumed reasonable; non-MTUS care can still be reasonably required, but the provider must rebut the MTUS presumption with substantial medical evidence. The §4600 standard is enforced operationally through California Labor Code §4610 utilization review and California Labor Code §4610.5 independent medical review.
Under California Labor Code §4600, the California medical-treatment obligation covers a broad range: physician visits, surgery, hospital stays, physical therapy, chiropractic and acupuncture (subject to California Labor Code §4604.5 visit caps), prescription medications, durable medical equipment, orthotic and prosthetic devices, nursing care, and home health services when reasonably required. The §4600 California rule also covers diagnostic testing — MRI, CT, X-ray, nerve conduction — when medically indicated, plus medical transportation and mileage reimbursement at the IRS standard rate when the worker travels for treatment.
Under California Labor Code §4600 (the treatment duty) and California Labor Code §4610 (utilization review), the §4600 California obligation is operationally enforced through prospective UR — the insurer reviews each treatment request from the treating physician under MTUS and either approves, modifies, or denies. The §4600 California duty exists independently of UR — UR is the mechanism by which the insurer decides which §4600 California requests it will fund. When UR denies medically necessary care, the worker challenges through California Labor Code §4610.5 independent medical review and California Labor Code §4610.6 IMR procedures.
Under California Labor Code §4600 (the treatment duty) and California Labor Code §4616 (medical provider networks), most California comp medical care is delivered inside the employer's MPN. The §4600 California treatment duty is satisfied when reasonably required care is provided by MPN physicians. The §4616 California MPN must include physicians of every relevant specialty, geographically accessible, with the worker's right to predesignate a personal physician before injury and to one MPN change of treating physician after a treatment dispute develops. The §4600 California obligation and §4616 California MPN framework operate together as the comp medical-care delivery system.
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Tap to call →Last reviewed by Eman Yazdchi, Esq., May 2026.
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