If you’re a longshoreman in California, especially around the Walnut Creek area, you might be scratching your head trying to understand your chiropractic insurance coverage. You’re not alone. Between navigating union benefits, dealing with injuries on the job, and figuring out what services are covered, it can feel like trying to decode a legal document… blindfolded.
At Elite Chiropractic Rehab & Wellness (ECRW), we work with International Longshore and Warehouse Union members every single day. We’re here to make chiropractic care more accessible—and less confusing. Let’s break it down step-by-step, so you know exactly what to expect, what’s covered, and how we help you move better and pain-free.
Step 1: Understand What Your Chiropractic Coverage Includes
If you’re a member of the International Longshore and Warehouse Union – Pacific Maritime Association (ILWU-PMA) health plan, you’re likely eligible for a wide range of chiropractic services.
Here’s what’s generally covered:
- Chiropractic treatment techniques for low back pain, spinal misalignment, shoulder discomfort, or headaches
- Manual therapy, spinal adjustments, joint manipulation, and massage
- Acupuncture treatments, when prescribed
- A set number of visits per calendar year (typically between 12–30), depending on medical necessity
- Coverage may include services for spouses and children in your household
The union’s health insurance plan generally covered all chiropractic services when deemed necessary. But there are still limits and rules.
What You Do: Call your benefit office or our front desk to confirm specific numbers for your plan
What We Do: We verify your benefits before your first appointment, so you never get hit with surprises
Step 2: Choose a Wallnut Creek Area Provider You Can Trust
Choosing the right chiropractic clinic matters, especially when you’re dealing with something as complex as ILWU-related benefits.
We recommend choosing a provider who:
- Is licensed in California and has experience working with ILWU-PMA plans
- Has a documented history of ethical billing practices (avoid providers that promise “too much”)
- Collaborates with physical therapy professionals if needed
- Is part of or familiar with your insurance health group
At Elite Chiropractic Rehab & Wellness in Walnut Creek, California, we serve longshoremen, dockworkers, and their families daily. Our team is trained in evidence-based medicine, physical therapy integration, and medical documentation specific to union members.
What You Do: Simply confirm your union membership and ID
What We Do: Handle provider verification, communication with the health group, and coordination with your physician if needed
Step 3: Know the Limitations and Caps
Your plan may cap the number of allowable visits or tie them to medical necessity. Here’s what that means:
Coverage may stop if:
- Documentation doesn’t show clinical progress
- Services go beyond pain management into “wellness-only” maintenance
- Improper codes or unsupported billing are submitted
This matters because prosecutors said misuse of these benefits has led to criminal charges, fraud cases, and even prison time. A federal grand jury indictment recently charged individuals in the Walnut Creek area with health care fraud and one count of aggravated identity theft.
Cases involved fake physical therapy claims, reimbursement for services not rendered, and even a health plan for sexual services under the guise of treatments.
What You Do: Keep us informed about pain patterns and medication use
What We Do: Carefully document your case with evidence-based signs and symptoms for each visit.
Step 4: Follow All Requirements to Stay Covered
To stay in good standing with your plan and avoid issues, there are several requirements:
- Medical necessity must be documented
- A referral or prior authorization may be needed for extended treatment
- Services must align with your diagnosed condition (e.g., nerve issues like radiculopathy, vertebral subluxation, or paresthesia)
The Department of Labor, through its Employee Benefits Security Administration, closely monitors health plan misuse. In one high-profile case, the owner of Back to Life Wellness Center LLC in California was charged with conspiracy to commit health care fraud and aggravated identity theft. Additionally, a dockworker was charged with making false statements to federal investigators. These cases stemmed from fraudulent billing of ILWU-PMA health benefits for services that were never provided.
What You Do: Report symptoms honestly and follow prescribed care plans
What We Do: Handle proper charting, coding, and submission to your union health plan
Step 5: Be Aware of Special Circumstances Like Medicare
If you’re a retired longshoreman or a dependent on Medicare, things shift a bit. Medicare coordination may limit how visits are reimbursed or require secondary billing.
You can ask us about:
- Dual billing processes
- Coordination with your primary physician
- Medicare-approved chiropractic services
What You Do: Let us know if you (or your spouse) are on Medicare
What We Do: Coordinate billing between Medicare and ILWU-PMA, from deductible to copayment
How We Help You Every Step of the Way
At Elite Chiropractic Rehab & Wellness in Walnut Creek:
- We verify your plan before care begins
- We avoid services not rendered or unsupported claims
- We document all care related to human musculoskeletal system and central nervous system issues
- We never charge for “wellness” visits unless specifically approved
- We align treatments with Web Content Accessibility Guidelines, ensuring all patients—including those with documented physical impairments—can access care
Why It All Matters Now More Than Ever
In high-risk jobs like yours, having proper care helps prevent downtime, surgery, or worse. Even well-intentioned patients can get trapped in unethical practices.
You Don’t Have to Navigate This Alone
The recent charges filed by the United States Attorney’s Office for the Central District of California show the consequences of poor documentation and criminal conspiracy via false claims. We know the rules. We play by them. And we’re here to help you heal from real injuries, with real care.
Whether you’re a new ILWU member, a retiree coordinating Medicare, or just someone looking for quality spinal manipulation after a long day—we’re here for you.
Ready to feel better?
Let’s verify your benefits and get you started with a pain-free, structured treatment plan.
Call us today or book an appointment online with Elite Chiropractic Rehab & Wellness in Wallnut Creek.
Your health. Your movement. Our priority.
