Legal Question in Workers Comp in California

I have a back injury and have been off work for over 6 months. I seem to be getting the run-around having surgery. First opinion was in January advising surgery, second opinion was in February agreeing with the first. Nothing has been done since February. I go to the primary every month and we talk but no action. As a second opinion I requested a surgeon several friends had experience with. It was denied stating they were out of the area. The second opinion surgeon I agreed to perform the surgery is operating in the same area as the spine specialists that Worker Comp said they were out of the area. How can I request a surgeon I am comfortable with, who is willing to do the surgery promptly, and stop hearing excuses? I am in pain, frustrated, and tied of having restrictions on my life.

What are my options?


Asked on 7/08/14, 1:41 pm

1 Answer from Attorneys
Nancy Wallace Nancy Wallace Atty at Law

Only the QME and the MPN Treating physician reports are admissible in Workers Compensation actions.

If you find a surgeon you like on the MPN* (*Medical Provider Network), the insurer must authorize that MPN physician; there isn't anything in the Labor Code permitting the insurer to deny it's own MPN physician based on mileage.

Most people cannot figure out which physicians on the MPN are horrible and which are real doctors. Know that about 15% have moved or are dead, about 70% are 'in bed' with the insurer and won't help you and are completely worthless, and about 15% are good guys.

If you do not have the skills to find a good guy in that 15% on your comp insurer's MPN, you should be a local certified specialist attorney who knows the good surgeons in your region on that MPN list. SEEING THE WRONG DOCTOR CAN END ALL BENEFITS.

Read more
Answered on 7/19/14, 3:53 pm


Related Questions & Answers

More Workers' Compensation Law questions and answers in California