Workers’ Compensation Recovery Program

About Us 

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.

Lien Process 

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.
Please visit the Department of Industrial Relations website for more information regarding workers’ compensation claims. (Not DHCS)
If funds will be placed into a Special Needs Trust, please go to the Special Needs Trust website for further instructions on notifying DHCS’ Special Needs Trust Unit.
 

Paying a Lien 

In order to apply a payment to the correct account, the DHCS account number must be included with each payment submission. For your convenience, the following payment options are available:
1. Payment via Electronic Funds Transfer (EFT) – To get started go to the EFT website. Two unique EFT options are available to suit your needs:
  • One-Time Payment – Ideal for Medi-Cal members and entities with few claims.
  • Enrolled User Payment – Ideal for entities with numerous claims and multiple payments. This option allows users to schedule advance payments and track payment history.
    •  Select “Register” to register as an Enrolled User - Allow DHCS 5 business days to create and confirm your new Enrolled User account
2. Payment via check – Submit to:
 
Department of Health Care Services
Third Party Liability and Recovery Division
Workers’ Compensation Unit - MS 4720
P.O. Box 997421
Sacramento, CA 95899-7421
 
Please reference the DHCS account number on the check and allow 15 to 30 business days for DHCS to receive and apply the payment.
 
If an insurance company issues a single check with both you and DHCS listed, please review visit the Frequently Asked Questions. Instructions are provided in Question 11 under the FAQs for Members/Attorneys heading.

Contact Information

Online Forms

Notify and update DHCS electronically using the Online Forms webpage.

Phone Support Unit

The Phone Support Unit provides information to Medi-Cal Members pursuing a workers' compensation claim.

Please visit the Phone Support Unit - Online Inquiries webpage for more information.

Contact Us

You may contact us by phone, by email, and by mail.

  • Phone: (916) 445-9891
  • Email: WC@dhcs.ca.gov
  • Mailing Address for written correspondence: 
Department of Health Care Services
Third Party Liability and Recovery Division
Workers’ Compensation Unit - MS 4720
P.O. Box 997425
Sacramento, CA 95899-7425
 
Last modified date: 10/31/2019 3:17 PM