Your main priority after suffering a workplace injury is to get quality
medical treatment. Unfortunately, we sometimes come across doctors we
find unsatisfactory – resulting in a request to change physicians.
With workers’ compensation cases, however, each state has its own
set of rules and guidelines regarding doctor selection that one must follow.
In California, the process for changing your treatment doctor depends
on the following factors:
Did you predesignate a doctor?
If your employer offers group health coverage, you have the right to preselect
your doctor. If you’ve predesignated your doctor, you are given
the most freedom to switch. Under these circumstances, you are free to
change doctors and can do so at any time by simply notifying your employer’s
insurance company. There is also no waiting period or limit on the number
of times you can switch treatment doctors.
Does your employer have an MPN?
A medical provider network (MPN) is a group of healthcare providers set
up by the employer and approved by the Division of workers' compensation
to treat workers injured while on the job. With MPN, however, you are
given less freedom to switch doctors. If you are unsatisfied with the
first doctor, you are allowed to switch up to two times – but the
second and third doctor must be selected through the MPN. If for whatever
reason you are still unhappy, you can submit a request for an “independent
medical review” and explain why you are unsatisfied with the doctors
you’ve been given thus far.
What if your employer does not have an MPN?
In situations where your employer does not have an MPN, the rules for changing
treatment doctors become complex. There are certain waiting periods that
must pass before you can change doctors. If a health care group or doctor
was previously selected by your employer, you’ll be allowed to choose
your own doctor after 30 days pass.
The Law Offices of Wax & Wax are ready for your case. Call our workers’
comp firm at (818) 946-0608 today to learn how we can help.