Selecting & Changing a Workers’ Comp Claim Doctor in California

Doctor speaking to patient

When a workplace accident occurs and you suffer a moderate to severe injury, California workers’ compensation rules require you to see a medical provider as soon as possible. Oftentimes, your employer will direct you to an urgent care facility, assuming your injuries were not serious enough to warrant a trip to the emergency room. What if you are not happy with the medical provider your employer has predesignated for you, though? Can you select your own treating doctor as a workers’ compensation claimant in California?

Seeing Your Own Doctor After a Workplace Injury

California allows injured employees covered by workers’ compensation insurance to see their own medical provider first after a workplace accident, but only when certain prerequisites have been met. To start, you need some sort of health insurance coverage that provides for care absent of any workplace accidents. Next, before you are in a workplace accident, you need to notify your employer through a written notice that you have that type of separate insurance and you have a preferred medical care provider under that plan. Lastly, your medical provider needs to agree before any workplace accidents that they will see and treat you if one such accident ever occurs.

You can follow a similar process for medical groups, too, not just individual doctors. In this way, you can designate an entire medical center as your preferred care location after a workplace accident. Otherwise, if your chosen doctor is unavailable, you will probably still be using a doctor from your employer’s medical provider network.

Changing Your Doctor After Treatments Have Begun

In many cases, you will not know if you are going to be happy with your medical provider until after you have started your medical treatments. What can you do if you decide your doctor is not understanding your treatment objectives or your needs?

In California, you can switch doctors during the first 30 days after your work-related injury if your employer or the responding insurance company has not created a medical provider network or if they do not have a contract with a specific healthcare organization. When you request to change doctors in such a situation, the person handling your claim will usually choose your new doctor unless you have already told them of a preferred medical provider before your accident occurred.

When your employer has a medical provider network, you can decide to see a new doctor within that network twice, often without complication. Subsequent change requests will need to be submitted through a separate and complicated application process, though. You can similarly switch doctors once if your employer has a contracted healthcare organization. The objective, in any case, is getting you connected with a medical provider that makes you feel comfortable so you can have the best chance of recuperating from your injuries.

For help with your workers’ compensation claim in Santa Clarita, California, go with the Law Offices of Wax & Wax. Our attorneys have more than 100 years of collective trial experience, allowing us to represent clients in some of the most complicated workers’ comp cases imaginable. Call (818) 946-0608 to learn more.