Initially, you may need to see a doctor chosen by your employer or their insurance. However, after 30 days, you can switch to a physician of your choice within the network.

 

1. Immediately After the Injury (First 30 Days)

When a worker is injured on the job:

• The employer or their workers’ compensation insurance company controls the medical treatment for the first 30 days after the injury is reported.

• The employee is usually sent to a designated clinic or physician chosen by the employer or insurer.

• These doctors are often part of a Medical Provider Network (MPN).

The purpose is to:

• Ensure the injury is evaluated quickly.

• Ensure treatment is provided by doctors familiar with workers’ comp rules.

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2. After the First 30 Days

After 30 days from the date the injury is reported, the employee usually gains more control.

If the employer uses an MPN

Most California employers do.

The injured worker may:

• Choose another doctor within the MPN

• Request a different treating physician

• Change doctors again if needed within the network

This means the employee does not necessarily have to stay with the original clinic.

However:

• The new doctor must still be inside the MPN.

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3. If the Employer Does NOT Have an MPN

If there is no Medical Provider Network:

After the first 30 days, the injured worker may:

• Choose any doctor they want for treatment.

This situation is less common today because most insurers maintain MPNs.

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4. Predesignation (Choosing Your Own Doctor Before the Injury)

California allows employees to predesignate a personal physician before any injury occurs.

If this was done correctly:

• The worker may treat with their own doctor immediately, even during the first 30 days.

Requirements for predesignation:

The physician must:

• Be the worker’s regular doctor

• Have treated the worker previously

• Agree to treat the work injury

• Be the worker’s primary care physician

The employee must give written notice to the employer before the injury occurs.

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5. Changing Doctors Within the MPN

Inside an MPN, workers can usually:

• Switch to another doctor once without much difficulty

• Request help from the MPN contact or medical access assistant

• Seek a second or third opinion if they disagree with treatment recommendations.

If disputes arise about treatment, the issue may go through Utilization Review and Independent Medical Review (IMR).

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6. Special Rule for Chiropractors and Acupuncturists

Workers may choose chiropractors or acupuncturists within the MPN, but treatment is generally limited to:

• 24 visits total (combined chiropractic, acupuncture, and physical therapy visits)

Unless additional visits are authorized.

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7. When the Insurance Company Controls Treatment Longer

The employer/insurer may retain control longer if:

• The employee does not request a change

• The employee stays with the initial doctor voluntarily

• The employer properly maintains an MPN

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Example Scenario

An employee reports a back injury at work.

1. Employer sends them to Company Clinic A.

2. After 30 days, the employee decides they prefer another physician.

3. They may switch to Dr. Smith within the MPN.

4. Dr. Smith becomes the Primary Treating Physician (PTP) and manages the claim.

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Key Takeaway

The simplified rule is:

First 30 days → employer controls treatment.
After 30 days → employee may choose a doctor within the employer’s MPN (or any doctor if no MPN exists).

Predesignation is the only way to immediately treat with your own doctor from day one.

Accurate documentation of your injury, medical treatments, and communications with your employer is crucial for supporting your claim and ensuring you receive appropriate compensation.

If your claim is denied, it's important to consult with a legal professional to explore your options for appeal and ensure your case is handled correctly.

A lawyer can provide expert guidance, help you understand your rights, and represent your interests to maximize your compensation.