Your Right to Choose Your Doctor After a Workplace Injury
When you’re hurt at work and dealing with a workers’ compensation claim, feeling stuck with a doctor who isn’t meeting your needs can be frustrating. Maybe the physician your employer sent you to seems rushed, dismissive, or isn’t helping you recover. California law often gives injured workers more control than they realize. Understanding your rights to change doctors during your workers’ comp case can make the difference between a recovery that gets you back to work and one that leaves you struggling with ongoing pain and limitations.
💡 Pro Tip: Document all your medical appointments, treatments, and concerns about your current care. This documentation becomes valuable if you need to justify a physician change to your claims administrator.
Need help navigating your workers’ comp case? Reach out to Kampf, Schiavone & Associates. Let us assist you in securing the care you deserve. Don’t hesitate to call us at (909) 885-1522 or contact us today!
Understanding Your Medical Rights with a Workers Compensation Attorney in Bernardino California
California law recognizes that injured workers deserve quality medical care. Labor Code section 4600 establishes your right to medical treatment that is reasonably required to cure or relieve the injured worker from the effects of the worker’s injury. Your employer must provide medical, surgical, and related services when reasonably required. For San Bernardino County workers, these protections apply across all industries. Working with a workers compensation attorney in Bernardino California, you’ll discover the law provides several pathways to change your treating physician, depending on your situation and whether your employer has established a Medical Provider Network (MPN).
💡 Pro Tip: Before your injury occurs, consider predesignating a personal physician in writing with your employer. This gives you the right to see your chosen doctor immediately after any workplace injury.
When and How You Can Change Your Treating Doctor
The timeline for changing doctors depends on several factors, but California law provides clear guidelines protecting your rights. Understanding these timelines helps ensure you don’t miss important opportunities to improve your medical care:
- After 30 days from reporting your injury, you generally gain the right to select your own treating physician, unless your employer has an MPN
- If no MPN exists, you can request a one-time physician change at any point during treatment
- Claims administrators must respond to your physician change request within 5 working days
- Workers who predesignated a personal physician can see that doctor from day one, bypassing the 30-day waiting period
- If your employer has an MPN, you must select from within that network rather than choosing any physician
💡 Pro Tip: Mark your calendar 30 days from when you reported your injury – this date often triggers important physician selection rights.
Taking Action to Change Your Doctor and Protect Your Recovery
When ready to change your treating physician, taking the right steps ensures a smooth transition and protects your benefits. Start by determining whether your employer has an MPN – this affects your options and process. If no MPN exists and you’re past the 30-day mark, you can select virtually any physician within a reasonable geographic area. Submit your physician change request in writing to your claims administrator, keeping copies. The law requires them to respond within five working days. If you encounter resistance or delays, having an experienced workers compensation attorney in Bernardino California becomes invaluable. Firms like Kampf, Schiavone & Associates understand these regulations and can ensure your rights to proper medical care are respected throughout your recovery.
💡 Pro Tip: Always request physician changes in writing via certified mail or email, creating a paper trail that proves when you made the request and starts the 5-day response clock.
Medical Provider Networks and Your Options
Understanding whether your employer has established a Medical Provider Network fundamentally changes your approach to changing doctors. MPNs represent pre-approved networks of physicians that some employers use to manage workers’ compensation care. If your employer has an MPN, you must generally select from doctors within that network. However, MPNs must provide adequate access to care, including physicians within reasonable distances and appropriate specialists for your injury.
Navigating MPN Requirements and Exceptions
Even within an MPN, you retain important rights. Networks must offer second and third opinions if you’re dissatisfied with your care, and they can’t force you to travel unreasonable distances. If the MPN lacks appropriate specialists or can’t provide timely appointments, you may have grounds to seek care outside the network. Working with a workers compensation attorney in Bernardino California helps you understand these exceptions and advocate for needed care. If you properly predesignated a personal physician before your injury, you might bypass MPN restrictions entirely, maintaining continuity with a doctor who already knows your medical history.
💡 Pro Tip: Request a complete copy of your employer’s MPN physician list immediately after your injury – you’ll need this to make informed choices about your care and understand your options.
Common Challenges When Changing Doctors
Changing physicians during your workers’ comp case isn’t always straightforward. Injured workers often face obstacles that can delay or complicate their care. Insurance companies may resist physician changes, claiming current treatment is adequate or questioning the medical necessity of switching providers. Some claims administrators drag their feet on the five-day response requirement. Understanding these potential roadblocks helps you prepare and respond effectively when seeking better medical treatment.
Overcoming Resistance to Physician Changes
When facing pushback on your physician change request, documentation becomes your strongest ally. Keep detailed records of why you’re seeking a change – whether it’s lack of improvement, communication problems, or treatment delays. California Labor Code Section 4600 establishes your right to medical treatment that is reasonably required to cure or relieve the injured worker from the effects of the worker’s injury. If your current physician isn’t providing appropriate care for your specific injury, you have legitimate grounds for change. Sometimes a workers compensation attorney in Bernardino California needs to intervene when claims administrators violate the five-day response deadline or wrongfully deny physician change requests. Your recovery should be the priority, and the law supports your right to seek physicians who provide comprehensive treatment plans.
💡 Pro Tip: Create a symptoms journal documenting your pain levels, limitations, and concerns with current treatment – this evidence strengthens your case for needing a different physician.
Frequently Asked Questions
Understanding Your Rights to Medical Care
Workers facing medical treatment issues during their comp cases often have similar concerns. These questions address the most common scenarios when considering a physician change.
💡 Pro Tip: Write down all your questions about medical care before meeting with an attorney – this ensures you get comprehensive answers about your specific situation.
Next Steps in Your Workers’ Comp Case
Knowing what to expect in the physician change process helps you make informed decisions about your medical care and recovery.
💡 Pro Tip: Start gathering your medical records and treatment notes now – you’ll need these documents whether you change physicians or need to consult a lawyer about your care.
1. Can I change doctors if my employer has a Medical Provider Network?
Yes, but your options work differently within an MPN. You must generally select from physicians within the network, but you can request second and third opinions if dissatisfied. The MPN must provide appropriate specialists and reasonable geographic access. If they can’t meet these requirements, you may have grounds to seek treatment outside the network.
2. What if my claims administrator doesn’t respond to my physician change request within 5 days?
California law requires claims administrators to provide an alternative physician within five working days of your written request. If they miss this deadline, document the delay and consider seeking legal assistance. This violation strengthens your position and may allow you to proceed with selecting your own physician while protecting your benefits.
3. Do I need a San Bernardino workers comp lawyer to change my treating physician?
While you can request a physician change on your own, legal representation often makes the process smoother, especially if you encounter resistance. An attorney ensures proper procedures are followed, deadlines are met, and your rights are protected throughout the transition.
4. How far do I have to travel to see a workers’ comp doctor?
California law requires reasonable geographic access to medical care. Medical Provider Networks (MPNs) are required by regulation to provide specialists within 60 minutes or 30 miles of a covered employee’s residence or workplace. Some legal guidance suggests that up to 60 miles may be considered reasonable for certain workers’ compensation medical examinations, though this varies by state and circumstance, and exceptions may apply in rural areas or where healthcare shortages exist.
5. What if I already saw my own doctor before starting workers’ comp treatment?
If you properly predesignated your personal physician in writing before your injury, you have the right to continue treatment with that doctor from the date of injury. Even without predesignation, medical treatment you received on your own may be reimbursable if it was reasonable and necessary. Consult a lawyer about these situations to protect your reimbursement rights.
Work with a Trusted Workers’ Compensation Lawyer
Navigating physician changes in your workers’ comp case becomes much easier with experienced legal guidance. A knowledgeable attorney understands both the regulations and practical realities of dealing with insurance companies and claims administrators. They can review whether your employer has an MPN, ensure your physician change requests meet legal requirements, and advocate for your right to proper medical care when administrators delay or deny reasonable requests. Having legal representation sends a clear message that you understand your rights and won’t accept substandard medical treatment. When your health and livelihood are at stake, working with a trusted workers compensation attorney in Bernardino California helps ensure your recovery remains the priority.
Feeling overwhelmed with your workers’ comp case? Let Kampf, Schiavone & Associates guide you through the process with ease. Give us a ring at (909) 885-1522 or contact us to ensure you receive the care you’re entitled to.