Getting hurt at work is stressful enough. Between the pain, the time off, and the paperwork, the last thing you want is confusion over your medical care.
One of the first questions people ask after a workplace injury is if they can see their own doctor.
The answer to that isn’t always simple. Sometimes you can, sometimes you have to start with a doctor chosen by your employer’s network.
In this post, we’ll explain if you can choose your own doctor in a workers comp case.
Can I Choose My Own Doctor In A Workers’ Comp Case?
Yes, you can choose your own doctor in some California workers’ compensation cases.
The easiest way to do this is by predesignating your personal physician before an injury happens. If you’ve done that and your doctor agreed in writing to treat work injuries, you can see them right away if you get hurt.
If you didn’t predesignate, you’ll usually need to start with a doctor from your employer’s Medical Provider Network or Health Care Organization.
After initial treatment, you may be able to request a switch to another doctor within the network.
In certain situations, like emergencies, you can see any doctor needed to get immediate care.
Also Read: Can Workers’ Comp Force You To See Their Doctor?
Predesignating Your Doctor Before An Injury
Predesignation is basically selecting your doctor before anything happens. You give your employer written notice that if you ever get injured, you want to use your regular doctor.
To predesignate, a few things need to line up:
- You have to give your employer the name and address of your personal doctor in writing before you get hurt.
- Your doctor has to agree in advance to treat you for work injuries.
- You need to have health coverage for non-work-related injuries at the time of the injury.
If you meet these conditions, you can skip the employer’s network and go straight to your predesignated doctor as soon as the injury happens.
That means you get someone familiar with your health history right from the start.
This is why a lot of experienced workers take the time to fill out the predesignation form early on. It gives you more control, and honestly, it can save a lot of frustration later.
If You Didn’t Predesignate
This is super common, so don’t stress. In this case, the rules shift a bit.
Many employers in California use what’s called a Medical Provider Network (MPN) or a Health Care Organization (HCO). These are basically groups of doctors approved to handle work injuries for that employer.
If your employer has one of these networks, you’ll usually have to start treatment with a doctor from that list.
It might feel a little restrictive, but that’s how the system is set up.
The idea is to give employers some control over medical costs while still providing care for injured workers.
You still have rights inside these networks, though, and you don’t have to stick with the first doctor they send you to forever.
Switching Doctors After Your Claim Starts
Here’s where things can get a little more flexible.
Even if you had to start with a network doctor, you usually have options to switch down the line.
If your employer has an MPN or HCO, you can typically change to another doctor within that same network if you’re not happy with the care. The number of switches and the process can vary, but the right to request a change exists.
If there’s no MPN in place, then you can choose your own doctor after the first 30 days of treatment.
That means you can move to a doctor you prefer, as long as they accept workers’ comp patients and are within a reasonable distance.
So don’t assume you’re stuck with the first doctor forever. You can ask for a change, and if the insurance company resists, there are ways to push back.
Also Read: How To Deal With Workers Comp Doctors
Emergency Situations
In a true emergency, the rules about networks don’t apply. You can see any doctor or hospital needed to get immediate care.
The top priority then is stabilizing your injury.
Once the emergency is under control, then the regular workers’ comp treatment rules kick in.
So you might get transferred into your employer’s network afterward unless you had a predesignated doctor in place.
What Employers Are Required To Tell You
Employers aren’t allowed to keep all this information hidden. California law requires them to give employees written notice about their medical network and the option to predesignate a doctor.
This usually happens when you’re hired or when any network changes occur.
They should also provide the forms needed to predesignate.
Unfortunately, a lot of employees glance over that paperwork and don’t think about it again until they’re injured.
By then, it’s too late to predesignate, and you end up in the default system.
Reading those notices early and filling out the form if you want your own doctor can save you a ton of stress down the line.
Also Read: IME Doctor Tricks You Should Know
Why Talking To A Workers’ Comp Attorney Helps
Workers’ comp law has a lot of small rules tucked into it. If you’re feeling overwhelmed or think your rights to choose a doctor are being ignored, an attorney can make a big difference.
A good workers’ comp attorney can:
- Help you understand your rights to predesignate or switch doctors.
- Push back if the insurance company drags its feet on approving a change.
- Step in if treatment is being delayed or denied.
Sometimes all it takes is a lawyer getting involved to move things along.
Plus, attorneys know the timelines and paperwork inside out, so they can spot issues that most people would miss.
Bottom Line
You might be able to choose your own doctor in a California workers’ comp case, but it depends on a few things.
If you predesignated a doctor before the injury, you’re in control from the start. If you didn’t, you’ll likely begin with a network doctor but may be able to switch later on.
Emergency situations give you flexibility right away, and employers are required to give you the info you need to make informed choices.
If things get complicated or your requests keep getting ignored, don’t just give up. A workers’ comp attorney can help you with anything.
Choosing the right doctor can impact your recovery, your benefits, and your overall experience with the claim. Taking a little time early on to understand your options can really pay off later
