After a workplace injury, one of the most important decisions you’ll make is who treats you. The doctor you see can significantly affect your recovery, your ability to return to work, and even the outcome of your workers’ compensation claim. But many injured employees wonder, can you choose your own doctor for a workers’ compensation case in California? The answer depends on when and how you make your choice. Here’s what every California worker should know about selecting a treating physician after a job-related injury.
In California, most employers have a Medical Provider Network (MPN), a group of approved doctors who specialize in treating workplace injuries. If your employer or their insurance company has an MPN, you’re generally required to choose your doctor from within that network.
Once your claim is accepted and you’ve been notified that an MPN is in place, you can choose a doctor from the list of available physicians. This gives you some flexibility, but you must stay within that network unless you meet specific criteria to change providers.
If your employer doesn’t have an MPN, the rules change. In that case, the insurance company can assign you a treating doctor for the first 30 days after your injury. After that, you may be able to switch to a different physician of your choice as long as they’re willing to accept workers’ compensation cases.
California law allows you to pre-designate your personal physician before an injury occurs. This means that if you get hurt at work, you can immediately see your own doctor instead of one assigned by your employer’s insurance company. However, there are a few conditions that must be met:
By pre-designating, you maintain more control over your medical treatment from the start. Many workers prefer this option because they already trust their doctor and don’t have to worry about being shuffled between unfamiliar medical offices.
It’s not uncommon for injured employees to feel that their assigned workers’ comp doctor isn’t fully addressing their needs. Maybe your appointments are rushed, your symptoms aren’t being taken seriously, or your treatment plan doesn’t seem effective. Fortunately, California law gives you the right to request a change of physician, though the process can vary depending on your employer’s setup.
If you’re being treated within an MPN, you can usually switch to another doctor within that same network. If your employer doesn’t have an MPN, you can request a change through the insurance company after the first 30 days. However, it’s important to follow the proper procedures when requesting a change; otherwise, your medical bills could be denied.
If you’re unsure how to handle the switch or your request is being ignored, consulting with a knowledgeable attorney can make a major difference. The workers’ compensation attorneys at the Law Office of Andrea R. Herman can help ensure you’re getting fair treatment and that your rights are protected every step of the way.
Sometimes, disputes arise between injured workers and insurance companies about medical issues, such as whether an injury is work-related, how severe it is, or whether more treatment is needed. When that happens, the state of California may require you to see a Qualified Medical Evaluator (QME).
A QME is an independent physician certified by the Division of Workers’ Compensation. Their job is to review your case, conduct an examination, and issue an impartial report. While you can’t choose any doctor you want for this evaluation, you do have a right to select from a panel of approved QMEs. This step is crucial for resolving disputes and ensuring your benefits continue without unnecessary delays.
Understanding your rights under California’s workers’ compensation system can be challenging, especially when you’re already dealing with an injury. Insurance companies often make the process confusing, and they may push you toward doctors who prioritize cost savings over your recovery. Having a dedicated attorney ensures that your medical treatment and benefits stay on track.
A skilled lawyer can help you:
With professional guidance, you can focus on healing while your legal team handles the paperwork, negotiations, and deadlines that come with a workers’ compensation claim.
If you’ve been injured at work and aren’t sure what your rights are when it comes to choosing a doctor, we’re here to help. At the Law Office of Andrea R. Herman, we understand the complexities of California’s workers’ compensation laws and how important quality medical care is to your recovery. Whether you need help switching doctors, appealing a denied claim, or ensuring your benefits are fully protected, we’ll stand by your side from start to finish.
Don’t wait to get the help you need; contact us today to speak with an experienced workers’ compensation attorney in Long Beach.
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