​Workers’ Compensation Recovery Program

The Department of Health Care Services’ (DHCS) Workers’ Compensation Recovery Program seeks reimbursement for services that Medi-Cal paid on behalf of its members who have workers’ compensation claims with employers, insurance companies, or the Workers’ Compensation Appeals Board (WCAB). When a Medi-Cal member receives a settlement, judgment or award from a liable third party as compensation for injuries they incurred, the Workers’ Compensation Recovery Program is required by federal and State law to recover funds for any related services paid by Medi-Cal.

 

For claims involving personal injury, medical malpractice, or class action litigation, use the links below to the appropriate recovery unit.

The Medi-Cal member or personal representative is required by law to report an action or claim in writing to DHCS pursuant to Welfare and Institutions (W&I) Code Section 14124.70 et seq. DHCS  also receives workers’ compensation claims information from the Department of Industrial Relations in order to identify Medi-Cal members and their claims. If the injured worker is Medi-Cal eligible, DHCS orders and reviews the payment records. Medical providers have up to one year from the date of service to submit bills to Medi-Cal for payment. DHCS will confirm all injury-related services have been identified and submit a lien to the appropriate parties.