How to Choose Your Own Doctor for Your Workers' Comp Claim

How to Choose Your Own Doctor for Your Workers' Comp Claim

In most states, a person who suffers an on-the-job injury is able to go see their trusted physician for treatment. California does things a little differently, though, and it can lead to some confusion.

Most employers in California will have set up a network of doctors as part of their workers’ compensation plans. If you suffer an injury while at work or performing work related duties, you will only be permitted to see the doctor of their choosing at first. This is true of both minor injuries and those that require emergency medical attention.

If you are not satisfied by the diagnosis or review of the first physician, you can request a second opinion. If approved, you will be sent to another doctor within the same network of doctors selected by your employer. Still not happy? You can get a third opinion from yet another doctor in that network. Only after you feel mistreated, ignored, or misunderstood by that third doctor can you request to see a doctor outside of their network, such as your own doctor.

How to See Your Own Doctor First

Going through hoops to see your own doctor is less than ideal, especially if you have reason to believe the physicians selected by your employer will favor your employer, i.e. minimize the actual compensation you require to recuperate. There are actually two ways you can go see your own doctor first in California, though.

  1. Pre-designation: At any point in your employment, you can file a request with your employer to see your own physician, should you ever get in an accident. If your employer provides group health coverage, your request for pre-designation must be accepted. You can then go straight to your doctor once you are injured.
  2. Dishonest practices: If you did not predesignate your doctor and suffer an on-the-job injury, you may be able to go straight to your trusted physician if your employer has conducted illegitimate business practices. For example, you must be told of your right to predesignate a doctor, you must be given a workers’ comp form as soon as your employer is aware of your accident, and there must be ample workers’ comp right information available to you at work. If one of these conditions are not met, California law permits you to see your own doctor first, as there is now reason to believe that your employer will mishandle your treatment.

As it can be seen, there is plenty of room for confusion or error when filing a workers’ comp claim in California. For help with your filing, and the potential case that could follow, turn to Ufkes & Bright and our Santa Ana workers’ compensation lawyers. We have a former insurance claims adjuster with more than 40 years of experience on our staff, allowing you to gain unrivaled insight for your claim. Contact us today to get more information about our services.

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