What are my options in choosing a
Primary Treating Doctor?
In California, Workers Compensation carriers are required to provide medical treatment following an industrial injury. However, this does not mean you can only receive treatment through the employer's doctors. In the case where you have been injured at work, and the employer recommended you to see a doctor. What are your options if after seeing the doctor several times, you notice one of the following:
The doctor is rushing you back to work.
The doctor is not spending any time with you.
The doctor doesn't seem to hear your complaints.
The doctor ignores your complaints.
The doctor seems to just want to help the insurance company.
You want to see your own doctor.
No actual treatment is being recommended.
One of many other complaints arises about your PTP.
PLANING BEFORE THE INJURY:
You have the right to pre-select your treating doctor in the event of a work-related injury. You should be given this option in your initial employment paperwork. If not given in the initial paperwork often the personnel department or the person in charge of workers' comp at your employer should have the proper form. To make this easier, here is the predesignation of personal physician form. Please verify with your doctor they will take California Workers' Compensation. However, many of you reading this have already had a work-related injury and need to change your primary treating physician (PTP) for your current Workers' Compensation Claim.
CHANGING PTP FOLLOWING INJURY:
The labor code requires employers to provide you with medical treatment following an industrial injury. As part of that treatment, you must use the doctor the insurance company selects for a minimum of 30 days. So, if you did not predesignate, you must wait 30 days to choose a different doctor.
After waiting the 30 days you may choose a new doctor. If you believe you are not getting the care you deserve or for whatever reason want a different doctor from the insurance company doctor, you can request a new doctor. Generally, the doctor must be within the Medical Provider Network (MPN) of the employer. However, in Redding, Susanville, Eureka, and Crescent City, there are very few doctors who will take on pre-existing workers compensation claims. As such, often the employer's provider network is not valid.
Once you have written the company requesting a different doctor, the company must provide you a different doctor within 5 days of your written request. If they don't - you can choose your own doctor.
Many times, rather than just asking for a change of doctor, it is better to request a list of doctors within the insurance companies provider network. Then you can select the doctor you would like off this provider list. Should you still have difficulties from the insurance company, this is the time to contact a workers' compensation attorney.