Can I Change Doctors in a California Workers’ Compensation Case

Workers’ compensation is insurance provided to California workers who have been seriously injured on the job performing their normal job functions. Workers Compensation benefits can include wage replacement income, rehabilitation and medical coverage and death benefits to surviving beneficiaries of workers who have been killed on the job.

Workers compensation benefits are mandated under state law for some employers and are provided as a right to the employee. California work comp benefits are not contingent on you, the employee, proving that your employer’s negligence caused or contributed to your work injury. You and/or your dependents or survivors, in turn, cannot sue your employer for additional damages after a work injury but generally must accept compensation in the form or work comp benefits.

How do I change doctors in California Work Comp case?

Under California law, if you are injured or become ill as a result of your job, you are required to see a doctor who has been selected by your employer. The exception to this is if you have properly pre-designated a “personal physician.” The designation must be done in writing before your California work injury or illness occurs and your employer must be providing group health insurance.

A question that may concern you is, “Under California workers’ compensation laws, am I allowed to change doctors? If I do change doctors is my employer responsible for paying that doctor?”

Your employer’s medical control varies according to the medical delivery model. If it is a traditional model, it is 30 days. If it is health care organization (HCO), it is 90 or 180 days. If it is a medical provider network (MPN), it is the life of the claim. If you have pre-designated a personal physician it is 0 days.

Under the traditional model, if you want to change doctors before the 30 days of employer medical control expires, you are allowed to do so if you notify the claims administrator. The claims administrator will then give you a list of doctors to choose from. In most instances, you are required to choose a doctor who is within your employer’s medical provider network (MPN).

If you decide to change physicians, your employer is responsible for paying that doctor. However, you need to know that not every physician that is listed in your employer’s MPN may be accepting new workers’ compensation cases or seeing new patients. You should call the doctor and make sure that they will take you and your case before making the change to that physician.

Hiring a Work Compensation Lawyer

California workers’ compensation law is complicated, but you are at the right place. The employment attorneys at www.usworkerscomp.com can review your California work comp case and answer your questions. Fill out the FREE evaluation form if you would like a work comp lawyer’s office to contact you about your work comp claim in California.