When you’ve filed a workers’ compensation claim, your treating physician holds a lot of power over your future. Not only are they directing your medical care as you recover, but their opinion controls numerous aspects of your claim, including when you’re released to return to work.
In California, you do have some ability to pick your own doctor – but it’s not the total freedom you might expect. You need to think ahead and take action before a workplace injury or illness actually happens.
Predesignation protects your ability to choose for yourself
If you want to retain more control over your workers’ comp claim, you can predesignate your doctor by notifying your employer using the appropriate forms. However, you can only do so if:
- Your employer offers group health insurance benefits
- You’re already an established patient in the doctor’s practice
- Your choice is a medical doctor (M.D.) or doctor of osteopathy (D.O.)
- Your doctor agrees to see you for injuries covered under workers’ comp
If you qualify to predesignate and don’t, you may be restricted to a doctor that is in your employer’s Medical Provider Network (MPN) or Health Care Organization (HCO) for some time. Even then, you aren’t without at least some ability to change physicians or seek second opinions.
It’s important to note that if you need emergency medical treatment after an injury or the manifestation of an acute illness, you don’t have to seek prior approval. You can (and should) go to the nearest emergency room to resolve critical situations. Predesignation only applies to your follow-up care or non-emergency medical care.
Having a physician you trust can be critical to your overall recovery – and predesignation can help you avoid ending up with a doctor who is more concerned about your employer’s interests than they are your health.
Workers’ comp claims are supposed to be a better, easier alternative to litigation, but the system doesn’t always work as intended. If you’re struggling to get the benefits you need, it may be time to seek legal guidance.
