“I can’t take care of myself, and my family is doing everything.”

What the statute says

Labor Code § 4600(h). Home health care services are covered where they are reasonably required to cure or relieve the effects of the injury — but the employer is not liable for any services provided more than 14 days before the date the employer received a physician’s prescription for them.

Read that carefully, because two things are hiding in it.

First: a family member can be the provider. The statute does not require a licensed agency. A spouse, an adult child, a parent, a sibling — someone who is already doing this work unpaid can be the person compensated for it.

Second: the 14 days is a lookback, and it runs from the employer’s receipt, not from the date the prescription was written. The statute says the employer is not liable for services provided “more than 14 days prior to the date of the employer’s receipt of the physician’s prescription.”

That distinction is worth money. A prescription written on the 1st and received on the 20th protects only from the 6th onward — the nineteen days you sat on it are gone and do not come back. Get it written, then get it delivered the same week, and keep proof of the date it was received.

What counts as home health care

More than people assume. Bathing, dressing, toileting, transfers, wound care, medication management, meal preparation, and transportation to appointments all count where they are required because of the injury.

Housekeeping and yard work generally do not — the line is care for the person, not maintenance of the household. That distinction gets argued, and the argument is won on how the physician writes it.

How to actually get it

1. Ask the treating physician for a written prescription for home health care, with the hours per day and the specific tasks. “Patient requires assistance” is not enough. It needs to say what, how much, and why.

2. Get it to the claims administratorClaims administrator / adjuster The person handling your claim for the insurer or self-insured employer. in writing, dated. The date they receive it is what starts the 14-day lookback.

3. Keep a log from today forward — date, hours, who provided the care, what they did. Reconstructed hours a year later are what gets disputed.

4. Expect utilization reviewUR Utilization Review. The process that approves, modifies, or denies each treatment request. A modification is a denial of what it left out.. Home health care requests go through the same UR process as any other treatment, with the same deadlines and the same 30-day IMRIMR Independent Medical Review. The appeal from a UR denial. 30 days (10 if the dispute is only over drugs on the MTUS Drug List). clock if it comes back denied. How to challenge a denial.