If you’re receiving workers’ compensation benefits in California and feel your doctor isn’t meeting your needs, you may wonder if you can switch. In most cases, you can change your treating physician, but there are rules to follow.
When can you switch doctors?
You can change doctors during workers’ comp treatment, but it’s not simple. Your employer or insurance company will provide a list of approved doctors, known as a Medical Provider Network (MPN). If your doctor is outside the MPN, you may need to request a change through the insurance company or workers’ comp system.
If you’re unhappy with your doctor, you can request a change. However, you must follow the proper procedure. In some cases, you may need to request a new doctor from the MPN, or if within a specific time frame, request a change outside the MPN.
How to request a doctor change?
To switch doctors, inform the insurance company and submit a formal request. You’ll likely need to provide a reason, like dissatisfaction with care or a belief that the doctor isn’t addressing your injury properly. If you’re outside the MPN, you might need approval from your employer’s workers’ comp insurance provider.
Sometimes, the insurance company may deny your request. If that happens, you may need to go through a dispute process, which could involve a hearing before a workers’ compensation judge.
What if your request is denied?
If your request to change doctors is denied, you can challenge the decision by requesting a second opinion or asking for a different doctor through the workers’ compensation system. A judge may review your case and make a decision.
Your doctor plays a key role in your recovery. If you’re not receiving the appropriate care, a new doctor could be essential to helping you recover effectively.
Changing doctors during workers’ comp treatment is possible, but you must follow the necessary steps to ensure approval. Document your reasons and be prepared to go through a dispute process if needed. Your well-being is the most important factor, and receiving the right care is key to returning to work.