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Choosing a Doctor

If you are injured at work, your employer is entitled to choose a physician from their Medical Provider Network for your initial evaluation. However, you can change your doctor 30 days after reporting your injury. A Sacramento workers’ compensation attorney can help you choose the right doctor, what factors to consider, and whether you can get a second or third opinion. Choosing a doctor can be hard, especially in a workers’ compensation case, so give us a call or visit us at Sacramento Workers’ Compensation Attorneys, P.C. so we can assist you.

How to choose a doctor in the Medical Provider Network?

After your initial evaluation, your employer or your workers’ compensation insurance should notify you of your right to be treated by a different physician within the Medical Provider Network. They should also show you how to access the list of providers in the Medical Provider Network.

You may be treated by a doctor of your own choice if a Medical Provider Network has not been established within 30 days from the date the injury is reported. However, it’s important to choose a doctor based on the doctor’s specialty, their expertise in treating a particular injury, and/or on your condition.

If you choose a physical therapist to act as your treating physician, you can do so until you have reached the 24-visit cap authorized by your employer or your workers’ compensation insurance. If you’ve reached your cap and are authorized for more treatment, you must choose another physician who is not a physical therapist to treat you. If you do not select another physician to treat you, your employer or insurance can choose for you.

Moreover, you cannot choose or change physicians if you are released from care by your treating physician. Being released from care means that your primary treating physician theoretically has determined that your condition has reached a permanent and stationary status. This means there is no need for continuing or future medical care.

What are some factors to consider when choosing a doctor?

Choosing a doctor from a Medical Provider Network is not always a bad thing. They are generally familiar with treating occupational illnesses and understand how the workers’ compensation process works. When people are injured at work, they want their own doctor to treat their injury; however, it can be complicated. Sometimes a doctor will say you need a certain treatment. If they are not familiar with the workers’ compensation process, they may not know how to write the reports and properly get the treatment approved.

There are many factors to consider when choosing a doctor in a Medical Provider Network. The first factor is whether the physician’s specialty is right for your type of workers’ compensation injury. For example, it’s harder to get treatment for your leg injury from a doctor who specializes in back injuries. You also need to find out if the physician is accepting new patients, if you can book an appointment in the allotted time frame, and if their office is accessible from your home.

Most importantly, our Sacramento workers’ compensation attorneys advise you to read reviews. Reviews will tell you whether the doctor is right for you and your case. We do suggest you look past unfortunate factors in reviews like the doctor showing up late to appointments or their lack of bedside manner. You should look for their response rate to appointments and information requests and how well they write reports.

The doctor may be good at treating your injury, but if they cannot write the needed reports, they may not be the best physician for your workers’ compensation case. Don’t be afraid to keep looking for a physician within your Medical Provider Network or call us at Sacramento Workers’ Compensation Attorneys, P.C., so we can help.

Can I get a second or third opinion when choosing a doctor?

If you dispute the diagnosis or treatment prescribed by your primary treating physician, you have the right to get a second or third opinion. Continue receiving treatment from your physician while you go through the process. Be aware that you waive your right to getting a second opinion if you do not make an appointment within 60 days of getting the list of doctors in your Medical Provider Network. If you decide to get a second or third opinion, it is your responsibility to do the following:

  • Inform your physician that you dispute their diagnosis or treatment either orally or in writing;
  • Select a new physician from your Medical Provider Network;
  • Make an appointment with the new physician within 60 days; and
  • Inform your current physician of the appointment date.

It is your workers’ compensation insurance’s responsibility to: 

  • Provide you a list of physicians from your Medical Provider Network;
  • Inform you of your right to request copies of your medical records to send to the “2nd opinion” physician;
  • Contact your current physician so the current physician can provide copies of your medical records to you or your second opinion physician before the appointment; and
  • Notify (in writing) that your new doctor has been chosen to provide a second opinion and why the first opinion is being disputed.

If they deem it appropriate, the physician will write a report offering an alternate diagnosis/treatment or write a report stating why they agree with the first diagnosis. Copies of the report will be provided to you, your workers’ compensation insurance, and your current treating physician within 20 days of the appointment. If you still disagree with the diagnosis or treatment plan after receiving your second opinion, you may seek a third opinion from a physician in your Medical Provider Network. The process of seeking a third opinion is the same. If you disagree with the third physicians’ opinion, you can file for an Independent Medical Review.

What can you do?

Choosing a doctor from a Medical Provider Network is different than filing a “Petition for Change of Treating Physician” form or a DWC-Form 280. Choosing a doctor can be hard. Let a Sacramento workers’ compensation attorney help. Our attorneys can help you choose the right doctor, what factors to consider, and whether you can get a second or third opinion.