If you get hurt at work, you may be hoping to pick your own doctor. Many injured workers quickly realize that picking your doctor isn’t as simple as calling the one you’re used to. California has specific workers’ compensation rules for who is allowed to treat you. Insurance companies also have some control over your medical care that is important to understand.
At Ratto Law Firm, P.C., our California workers’ compensation attorneys help you navigate a claim and your medical treatment after a work injury. Let us help protect your rights.
The Default Rule: Your Employer Controls the First Doctor
In most cases, if you’re injured at work and you have not predesignated your personal doctor, your employer has the right to send you to a doctor within its Medical Provider Network (MPN).
An MPN is a group of doctors approved by the employer’s workers’ compensation insurance company. These doctors understand the workers’ comp system, but they also work within the insurer’s guidelines, which can sometimes limit treatment options.
If your employer has an MPN, you generally must start treatment with one of those doctors. If your employer does not have an MPN, you can usually choose any doctor after the first visit.
Predesignation: The Only Way to Choose Your Own Doctor From the Start
California law allows you to choose your own doctor before you get hurt, but only if you meet certain requirements.
You can predesignate your personal physician if:
- You have health insurance for non-work injuries
- Your doctor agrees in writing to treat you for work injuries
- You submit the predesignation form to your employer before the injury
If all conditions are met, you can see your own doctor immediately after a work injury. This is the strongest way to maintain control over your medical care.
What If You Didn’t Predesignate? You Still Have Options
Even if you didn’t predesignate, you are not stuck with the first doctor forever. California law gives injured workers several opportunities to change physicians.
1. Switching Doctors Within the MPN
If your employer uses an MPN, you can switch to another doctor within the network at least once. Many workers do this when the first doctor minimizes their injury, rushes them back to work, or refuses to order diagnostic tests.
2. Requesting a Second and Third Opinion
If you disagree with your diagnosis or treatment plan, you can request:
- A second opinion from another MPN doctor
- A third opinion if you still disagree
If the third doctor recommends different treatment and the insurance company refuses to authorize it, you may be able to request an Independent Medical Review (IMR).
3. If the MPN Is Invalid or Not Properly Provided
If your employer fails to:
- Properly notify you of the MPN
- Provide access to MPN doctors
- Give you the required MPN information
you may be allowed to choose any doctor you want.
What If Your Employer Does Not Have an MPN?
If no MPN exists, the rules are more flexible.
- Your employer can send you to a doctor for the first visit only
- After that, you can choose your own treating physician
What If You Don’t Trust the Insurance Company’s Doctor?
You’re not alone. Many injured workers feel that MPN doctors:
- Downplay injuries
- Delay diagnostic testing
- Push workers back to the job too soon
- Avoid recommending surgery or advanced treatment
If you feel your doctor is not listening or not treating you appropriately, you have the right to:
- Request a new doctor
- Seek a second or third opinion
- Challenge treatment denials through IMR
- Consult a workers’ compensation attorney
A lawyer can help ensure you receive care from a doctor who prioritizes your recovery, not the insurance company’s bottom line.
When an Attorney Can Make a Difference
Doctor choice is one of the most contested issues in California workers’ compensation. An attorney can help you:
- Determine whether the MPN is valid
- Change doctors legally and strategically
- Challenge treatment delays or denials
- Ensure your medical records accurately reflect your injury
- Protect your right to long-term care and disability benefits
Learn More About Doctor Choice in California Workers’ Comp Cases
If you were hurt at work, you have the right to seek compensation and protect your other rights. When you can or can’t pick your doctor can make a big difference in your life, and we help you understand your specific situation.
Our team at Ratto Law Firm, P.C. provides you with the advice and representation you need. Contact us today for a consultation.