General Claims Handling – California Workers Compensation Self Insurance Practice Test 2026 - Free Claims Handling Practice Questions and Study Guide

The approval of necessary medical services in California Workers' Compensation is governed by the Department of Industrial Relations (DIR). This department oversees the workers' compensation system and is responsible for enforcing labor laws and ensuring that injured workers receive appropriate medical care. The DIR establishes the rules and regulations that dictate how medical services are authorized, including the use of the Medical Treatment Utilization Schedule (MTUS), which helps to determine the necessity and appropriateness of medical treatment for injured workers.

The court system primarily deals with disputes regarding claims and is not directly involved in the approval of medical services. The State Legislature creates laws, but it is the DIR that implements and regulates those laws as they pertain to workers' compensation medical services. The Insurance Commissioner oversees insurance companies that offer workers' compensation insurance but does not have the authority to approve medical services directly. Therefore, the role of the DIR is critical in the framework of California's workers' compensation system regarding medical service approval.