Workers’ Compensation Recovery Program
The goal of the Workers’ Compensation Recovery Program (WCRP) is to identify and recover Medi-Cal expenditures involving Workers’ Compensation (WC) claims filed with insurance carriers, employers, or the Workers’ Compensation Appeals Board (WCAB). The Department of Health Care Services (DHCS) seeks reimbursement for services paid by Medi-Cal to treat beneficiaries with work-related injuries from third party entities that are, or may become, liable to pay all or part of the medical costs provided to the Medi-Cal beneficiary.
The Medi-Cal beneficiary or personal representative is required by law to report in writing to DHCS pursuant to Welfare and Institutions Code Section 14124.70 et seq. A notification, or referral, must be submitted online within 30 days of filing a WC claim. To submit new case referrals and updates to existing cases, please use the Online Forms link provided below. It is very important that the information provided is accurate and complete. DHCS will not return a lien for cases with missing or inaccurate information.
If the injured claimant is Medi-Cal eligible, DHCS will send a Notice of Lien stating Medi-Cal’s rights to recovery. After DHCS receives notification that the carrier has accepted responsibility and the WC claim has settled or the beneficiary has completed treatment, DHCS will order the appropriate payment records for the injured Medi-Cal beneficiary to create a final lien. Upon establishment of a lien, DHCS will provide a lien letter and a list of itemized services paid by Medi-Cal related to the individual claimants’ work injuries. The lien documentation will be sent to the Medi-Cal beneficiary or personal representative and the liable third party.
If all, or a portion of the settlement will be placed into a special needs trust and you have questions please go to the Special Needs Trust website.
Please visit the Department of Industrial Relations website for more information regarding Workers’ Compensation claims. (Not DHCS)
Paying a Lien
When you receive our lien amount and are ready to pay the lien, we accept Electronic Fund Transfers (EFT) and checks, but prefer EFT payments. Regardless of which method you use to pay, you will need your DHCS Account Number to ensure payment to the correct account.
There is no fax line or mailing address available for this program. Please submit your new case notifications and case update information via the WCRP Online Forms.