The doctor overseeing a workers’ compensation claim in California has a lot of power. They decide what treatment someone requires. They decide what accommodations a worker needs to do their job safely. They determine when a worker can return to employment and when their benefits end in many cases.
It is only natural to worry that the doctor overseeing a workers’ compensation case might have a degree of bias. A physician with a pre-existing relationship with a business, for example, may prioritize controlling claim costs over the best outcome for an employee.
Employees worried about their rights during a workers’ compensation claim may want more information so that they can protect themselves. They may want to choose the doctor providing their care.
Who has the authority to choose the doctor treating a worker with a job-acquired health challenge?
Workers often have that authority
Technically, workers can predesignate the physician who oversees their treatment long before they ever get hurt. They can file paperwork before they require benefits asking for a specific professional to manage their care if they ever need to file a claim.
Workers who have predesignated a healthcare professional of their own choosing can usually see that physician without any concern about coverage eligibility after an on-the-job injury or a diagnosis with a work acquired illness.
However, not all workers predesignate the physician before they make a claim. There are also special situations in which predesignation may not lead to a worker making their own selection.
A claims adjuster might make that call
In scenarios where a worker has not already designated the professional providing their care, the claims adjuster chooses who treats them initially. That selection only remains enforceable for the first 30 days of treatment.
If a worker requires more care than that, they can select their own physician following the first 30 days of treatment. Most of the time, as long as the physician participates with workers’ compensation, an employee can choose them as their physician during a claim.
If an employer has a Medical Provider Network (MPN), that can slightly alter the options available to the injured worker. The same is true of cases involving a health care organization (HCO) utilized by an employer.
Learning more about basic workers’ compensation rules can help those coping with job-related medical challenges. Seeking legal guidance is a good way to get started.