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.