Getting the right doctor after a work injury

If you have suffered a serious injury on the job, you do not want to go to just any doctor. You want to see a doctor who has special skills and training in the area of medicine related to your injury. This will improve your chances of receiving appropriate treatment right away so you can get back on your feet and back on the job. This is not always easy when you are dealing with workers’ compensation. 

Where should your medical care come from? Can you just go to your family doctor after a work injury? The answers to these and other questions depend on the type of injury you have suffered. However, understanding your rights regarding workers’ compensation insurance coverage is an important part of filing a successful claim and obtaining the benefits you need and deserve. 

Who picks my doctor? 

After a work injury, you may need medical attention. Of course, if the injury is serious, you may go to the emergency room, in which case the doctors on call will stabilize you and tend to your injuries. If your injury is not an emergency, one or more of the following may apply: 

  • You will visit a doctor in your employer’s or insurer’s Medical Providers Network, which is a group of health care providers approved by California’s Division of Workers’ Compensation. 
  • Your employer may have a contract with a health care organization, or HCO, that provides managed care for employees who suffer job-related injuries or illnesses. 
  • You may see your own personal physician if you have predesignated him or her as the doctor you will see immediately after a work injury. 
  • In cases where an employer has neither an MPN nor an HCO, the claims administrator of your employer’s workers’ compensation insurance will select a doctor for you. 

If you are unhappy with the doctor in your employer’s network, you can change to another doctor in the network. You must follow certain procedures and adhere to the guidelines for switching care providers. In certain cases, you may be able to pick your own doctor outside the network even if you have not predesignated a physician.  

For example, if your employer failed to notify you of your rights under California’s workers’ compensation laws or if you are not receiving adequate care from your employer’s MPN or HCO, you may have the right to seek a new doctor who is skilled in treating your type of injury. The most important factor is finding a doctor who can provide the kind of treatment you need to improve your chances of making as complete a recovery as possible. 

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