When you’re hurt or sick, you need to be able to rely on your doctor, and that’s not easy to do if you’re forced to see a provider who you’ve never met before. Fortunately (unlike in many other states), California offers injured workers the ability to use their primary care physician (PCP) as their provider of choice in a workers’ compensation claim – but only if employees have the foresight to “predesignate” them with their employers.
If you’re hurt or sick and you’ve failed to predesignate your provider as your treating physician for workers’ comp and your employer contracts with a medical provider network (MPN) or a health care organization (HCO), you’ll have to work with one of their chosen physicians. Here’s why that arrangement isn’t to your advantage:
Medical autonomy is important
You have more control over your own medical care when you’re working with a doctor that you know and trust. Your comfort level with your PCP can make it easier for you to ask questions about your care and assert yourself – and that can lead to better medical outcomes.
As is continuity of care
There’s always a risk that a workers’ comp physician will see you as “an injured body part,” and not a “whole patient.” Your PCP may have a much more comprehensive understanding of your overall health and what effect the work injury or illness has on you. That can influence their treatment decisions in a profound way.
Some doctors make their living handling workers’ comp patients for various companies – and they can be keenly aware that their livelihood depends on not being seen as too “worker-friendly” in nature. Your own PCP is much more likely to give you a fair assessment of your injuries and your ability to return to work.
Because your treating physician has a lot of influence over the trajectory of your workers’ comp claim, it’s always wisest to predesignate your provider. If it’s too late, however, and you are struggling to get your benefits approved, it may be time to consider seeking legal assistance.