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What are my medical provider rights after a workplace injury?

For employers and their workers’ compensation insurance carriers, reducing the costs of workplace injury is an important goal. A variety of steps can be taken toward this end. One of these, according to industry experts, is for employers to work on building solid working relationships with the physicians that treat their workers.

Building strong working relationships with physicians can help employers and insurers reduce costs by preventing misdiagnosis and mistreatment, as well as improving outcomes for injured worries. All this is well and good, of course, but injured employees need to know that they do have certain rights when it comes to selecting a physician for treatment.  

One of the important rights workers have in California is to predesignate a personal physician or medical group in case they are injured on the job. A predesignated physician or medical group will provide treatment to the injured employee when they are injured, regardless of the providers the employer chooses to work with. If there is no such predesignation, injured employees will, most of the time, receive treatment from within an approved medical provider network or a health care organization selected by the employer and insurer.

In cases where the injured employee does not predesignate and the employer or insurer has not identified a medical provider network or health care organization, the claims administrator is able to select the physician who provides the initial treatment.

In situations where the employee failed to predesignate, he or she may still be able to select a primary treating physician if he employer did not provide information about workers’ compensation rights and doesn’t offer treatment after the injury occurs, or in cases where the employer or insurance company selects inadequate treatment or refuses necessary care. Injured employees who feel they may be involved in such a situation can benefit from working with an experienced attorney.

In our next post, we’ll talk a bit about an employee’s right to switch providers. 

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