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Workers’ compensation in California: Can you choose your doctor?

On Behalf of | Jun 16, 2024 | Workers Rights

If you suffer injuries in a workplace accident, you may prefer seeing your personal doctor because you already have an established relationship and history with them. However, the rules of choosing a doctor for workers’ compensation claims can be complex. Here is what you should know if you are wondering whether you can choose your treating doctor after a workplace accident in California.

Most employers in California have established medical provider networks (MPNs) or groups of pre-approved health care providers selected by the employer or insurance company to treat injured workers. If this is the case in your situation, you may have to choose a doctor from the list provided in the MPN unless in an emergency. Similarly, if you are enrolled in a State of California-certified health care organization (HCO) for workers’ compensation, you must first seek treatment from the HCO after a workplace accident.

You may pre-designate your treating doctor

You can inform your employer in writing and before any workplace injury that you want your personal doctor to treat you after a workplace injury. However, certain conditions must be met to pre-designate your treating doctor.

First, you must be covered by your employer’s group health coverage that covers non-work-related injuries. Second, your doctor must agree to be pre-designated and willing to treat you for workplace injuries.

Avoid costly mistakes

You could miss out on workers’ compensation medical benefits if you receive treatment from an unauthorized doctor, even if they are your preferred physician. Your employer or the insurance company may refuse to cover your medical expenses, meaning you will have to pay the bills out-of-pocket.

Learning more about your rights and obligations after a workplace accident can help protect your interests and effectively navigate any hurdles. For instance, your employer may not have an MPN or HCO, or you might want to change your treating doctor for various reasons.

Seeking legal guidance can help you understand how everything works and avoid mistakes that could prove costly or affect your workers’ compensation claim.