The most pressing issue is their well-being, which means seeking medical care is the priority.
If you have a compensable workers’ compensation injury, your employer’s insurance provider —workers’ compensation coverage or self-insurance — is responsible for paying 100% of your medical bills. That includes immediate medical care, doctor’s visits, prescriptions, x-rays, MRIs, physical therapy, surgeries, or any medical devices you might need.
Does My California Employer Get to Choose Which Medical Provider I See?
Your employer must pay for medical care if you get hurt on the job — whether or not you miss time from work. In times of emergency care, you may see any doctor and have it covered by workers’ compensation.
Going forward, your healthcare provider may be designated in one of two ways: Through a Health Care Organization (HCO) or a Medical Provider Network (MPN)
In California, HCO and MPN are both groups of medical professionals that provide treatment to work injury victims. However, the main difference is that an HCO is associated with the California Division of Workers’ Compensation, while the employer and their insurance provider select an MPN.
In most cases, injured employees will first be treated in the HCO or MPN unless they predesignated their doctor or medical group.
After your first medical examination, you may switch to another doctor in the HCO at least once. If you have health insurance through your employer, you may switch to a doctor outside the HCO 180 days after your illness or injury is reported to your employer. If you do not have employer-provided health insurance, you can switch to a doctor outside the HCO 90 days after your illness or injury is reported to your employer.
If you are not treated in an HCO or MPN, you can switch to a new doctor once during the first 30 days after your illness or injury is reported to your employer. The insurance company has the right to choose the doctor but must do so within five working days after you make the request. If the insurance company misses the deadline, you can select your doctor.
After 30 days, you may switch to a doctor if your employer or insurer still has not established an MPN.
Do You Have Questions About Your California Workers’ Compensation Claim?
If you have suffered a California workplace injury or illness and do not fully understand the workers’ compensation benefits you are entitled to, or if your claim is being disputed or has already been denied, contact our experienced workers’ compensation attorneys in Whittier today by calling (562) 698-6446 to schedule a free consultation.