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Anyone who sustains a workplace injury must seek prompt medical care. However, do injured workers in California get to choose their own doctors? The answer can be fairly complicated, but individuals do have the right to choose their own doctor but under the rules established through state workers’ comp laws.
The number one priority after any type of workplace injury is seeking medical care. If an emergency situation arises as a result of an on-the-job injury, there is no time to question whether or not the closest emergency medical facility is an approved doctor. Emergencies must be treated by the closest specialist able to stabilize the situation.
Even if the initial workplace incident does not seem to be an emergency but signs or symptoms of an injury arise later, even outside of the workplace at home, workplace injury victims should seek immediate medical treatment from the closest doctor able to handle their symptoms.
Information available from the California Department of Industrial Relations says that state law requires workers’ compensation claims administrators to authorize and pay for any medical care “reasonably required to cure or relieve the effects of the injury.”
Generally, a workplace injury victim will be shuffled to a doctor approved by the workers’ compensation insurance carrier.
The state of California says that a person can be treated by their regular doctor if the worker pre-designated their personal physician or medical group before they sustained an injury. Not every employee is allowed to pre-designate their own physician. Some employers have insurance carriers that do restrict the network.
If an employer has Medical Provider Network (MPN), this means that they have a group of physicians and other health care providers selected by the employer and the insurance carrier to treat injured workers. MPNs must be approved by the state, and each MPN includes a mix of physicians specializing in work-related injuries and other general areas of medicine.
If your employer has a Health Care Organization (HCO), this means that there is an organization certified by the state to provide medical care to injured workers. And HCO must have healthcare providers that understand the workers’ compensation system and occupational health. After your first medical examination, you are allowed to switch to another doctor in the HCO at least one time. If you have health insurance through your employer, you are allowed to switch to a doctor outside of the HCO 180 days after the workplace injury or illness is reported. If you do not have employer-provided health insurance, you are allowed to switch out of the HCO 90 days after the injury or illness is reported.
If you believe that you are not being treated fairly by your workers’ compensation insurance carrier or employer, we encourage you to reach out to a skilled workers’ compensation attorney in Riverside as soon as possible. Your attorney can examine the facts of your case and help you work towards the best possible path of recovering all compensation that you need.