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What happens when you and the workers’ compensation doctor don’t agree?

| Jul 12, 2021 | What You Need To Know

You were hurt on the job, and you’ve been off work for a while. Initially, the doctor you’ve been seeing through your company’s medical provider network (MPN) seemed okay, but now you’re no longer convinced that they have your best interests at heart.

What can you do about the situation?

You can challenge what the doctor is saying

It depends on the specific circumstances of your case. Generally speaking, however, California law gives you numerous options.

If you disagree with the MPN doctor’s plan for your care or your diagnosis, you have the right to ask for a second (and third) opinion from other doctors in your company’s MPN. If you still believe that your treatment plan isn’t what it should be, you can then ask for an Independent Medical Review (IMR).

If you disagree with any other part of the MPN doctor’s assessment, you will have to request a review by a qualified medical examiner (QME). This includes your MPN doctor’s assessment of:

  • Any permanent or temporary disability rating
  • When you are fit to return to work in any way, including light-duty assignments
  • What kinds of reasonable accommodations you may need to do your job.

In addition, you may need a medical exam by a qualified medical examiner if your claim is denied or unfairly delayed for some reason. 

It’s critically important to take action without delay if you do have a disagreement about your workers’ compensation claim with your MPN doctor. Failure to take timely legal action can cost you your rights, your financial security and your future. An experienced advocate can help you learn more. 

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