What changed in California workers’ comp in 2026

January 2, 2026 — four treatment guidelines replaced

Replaced effective January 2, 2026 — each amendment filed December 18, 2025 (Register 2025, No. 51):

Corrected August 19, 2026. This section previously said two guidelines were replaced. Four were. Verified against the DWCDWC Division of Workers’ Compensation, part of the Department of Industrial Relations. Administers the system. Information Services Center: 1-800-736-7401.’s own MTUSMTUS Medical Treatment Utilization Schedule. California’s treatment guidelines. Four of them — shoulder, elbow, hand/wrist/forearm and traumatic brain injury — were replaced January 2, 2026. listing and against the regulations: 8 CCR § 9792.23.2 and § 9792.23.4 each carry “Amendment filed 12-18-2025; operative 1-2-2026.”

• Shoulder injuries
• Traumatic brain injury
• Carpal tunnel and RSI

Note the section number on that last one. Traumatic brain injury sits under Special Topics at § 9792.24.5, not under Clinical Topics with the orthopedic guidelines. Anyone searching the 9792.23 series for it will not find it.

Why it matters: a utilization reviewUR Utilization Review. The process that approves, modifies, or denies each treatment request. A modification is a denial of what it left out. denial resting on a superseded guideline is resting on something that no longer exists — and so is an appeal that cites it. In the current shoulder guideline: MRI for rotator cuff tendinopathy is strongly recommended; steroid injection for adhesive capsulitis is strongly recommended; rotator cuff repair for chronic massive tears is not recommended; and platelet-rich plasma carries no recommendation, which produces an automatic denial.

The traumatic brain injury replacement matters more than its profile suggests. TBI is the injury most often missed at intake — nobody loses consciousness, nobody orders imaging, and the symptoms are attributed to stress. A replaced guideline changes what a reviewer will approve.

April 1, 2026 — the MTUS added mental health guidelines

8 CCR § 9792.23.8, the Workplace Mental Health Guideline, was amended effective April 1, 2026 — filed April 3, 2026, Register 2026, No. 14 — and it now incorporates three ACOEM modules.

Added August 19, 2026. This page had missed this entirely, and it is the most consequential MTUS change of the year for a large class of claims.

Psychiatric injury Public safety presumptions

The PTSD and Acute Stress Disorder module is the addition. The other two were already there. Why this matters more than the orthopedic updates: psychiatric claims are the hardest category in California workers’ compensation to get treatment authorized in. A guideline is what a utilization reviewer measures a request against — and where none existed, denials rested on general standards and were correspondingly hard to challenge.

This is directly relevant to: anyone claiming psychiatric injury under § 3208.3; public safety members relying on the PTSD presumption; and workers injured in an assault, where § 4660.1(c)(2)’s violent-act exception makes the psychiatric component ratable.

April 30, 2026 — the MTUS Drug List was updated

DWC adopted updates to the MTUS Drug List effective April 30, 2026. Why it matters: whether a drug is exempt or non-exempt on that list decides whether your physician must obtain prior authorization — and for a non-exempt drug the utilization review decision is due in five business days with no extension available (8 CCR § 9792.9.8(b)(3)). A drug that moved between categories changes the process, not just the paperwork.

Utilization review and the formulary

June 1 and August 1, 2026 — four more guidelines

Effective June 1, 2026: Eye Disorders (8 CCR § 9792.23.9) and Initial Approaches to Treatment. Effective August 1, 2026: Ankle and Foot Disorders (§ 9792.23.7) and Hip and Groin (§ 9792.23.10).

The Initial Approaches to Treatment guideline is the one to watch — it governs the earliest phase of care, which is where the § 9792.9.7 thirty-day no-prior-authorization window also operates.

April 1, 2026 — the utilization review regulations were restructured

The UR regulations were reorganized into §§ 9792.9.1 through 9792.9.8. Why it matters: UR deadlines and procedural requirements are where defective decisions are found — and a late UR decision goes to a workers’ compensation judgeWCJ Workers’ Compensation Judge. Decides your case. There is no jury. rather than into 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)., which is a materially better forum. Citing the pre-April regulation numbers is citing regulations that no longer exist.

How to check a UR denial for defects If IMR upheld the denial

July 13, 2026 — Labor Code § 5909’s transmittal trigger was made permanent

This is the change most likely to be missed. § 5909 deems a petition for reconsiderationPetition for Reconsideration Appeal from a final order. 20 days. A non-final order takes a Petition for Removal instead. denied unless the Appeals Board acts within 60 days. The trigger for that 60 days moved once, was scheduled to move back, and was then locked in place.

THE OPERATIVE TEXT NOW READS

“A petition for reconsideration is deemed to have been denied by the appeals board unless it is acted upon within 60 days from the date a trial judge transmits a case to the appeals board.” The trial judge must give notice of the transmittal to the parties and the Board, and service of the accompanying report under § 5900(b) counts as that notice.

We had this backwards until we re-read the chaptered bill, and we have logged that: this site announced a reversion to the filing trigger on July 1. The Legislature undid the sunset twelve days later, on July 13. Because SB 171 was chaptered after July 1, whether the filing trigger governed a petition acted on inside that twelve-day window is an open question, and one worth an attorney’s attention on the specific dates in a file.

Our correction What SB 171 actually changed

Reed v. County of San Bernardino (WCABWCAB Workers’ Compensation Appeals Board. The court system that decides these cases. 23 district offices statewide. significant panel decision, November 5, 2024), which held the clock began when the case appeared as “Sent to Recon” in EAMSEAMS Electronic Adjudication Management System. The Board’s case file system., was construing the trigger that is still operative today.

July 1, 2026 — medical mileage rose to 76¢

Up from 72.5¢, which itself took effect January 1, 2026. The rate applies to travel on or after the effective date regardless of date of injuryDate of injury For a cumulative or occupational disease claim, the law sets it as when you first suffered disability and knew or should have known it was work-related — not when the wear began. Almost every deadline runs off this..

Which rate does your trip earn?

July 2026 — SB 171 rewrote SIBTF

The Subsequent Injuries Benefits Trust FundSIBTF Subsequent Injuries Benefits Trust Fund. Pays where a pre-existing disability plus an industrial injury produce a substantially greater disability. Rewritten by SB 171 in July 2026. was rewritten, retroactively, with a June 1, 2026 grandfather snapshot. Anything written about SIBTF before then describes the old rules.

SIBTF pays workers who had a pre-existing disability and then suffered an industrial injury that, combined, produces a substantially greater disability. It is paid by a state fund, not by the employer — genuinely additional money, and chronically under-claimed.

What changed and what it means

Still in effect from 2024–2025, and still widely missed

Decisions worth knowing from 2023–2026

This page is maintained. If you are reading it long after the review date above, the items below the most recent entry may have moved.