Legal Question in Workers Comp in California

Re: Workers Comp

Absolutely not as long as the selection followed the rules. Do not allow the insurance company to tell you you must go to the MPN doctor. Once you submitted a "predisgnation of personal physician" you avoid the MPN. I must cation you though, there are strict requirments regarding the proper selection of a pre-designated physician. If your physician does not qualify, you may have to go into MPN.

Labor Code �4600(d)(1) states in part:

"If an employee has notified his or her employer in writing prior to the date of injury that he or she has a personal physician, the employee shall have the right to be treated by that physician from the date of injury [4] If either of the following conditions exist:

(A) The employer provides nonoccupational group health coverage in a health care service plan, licensed pursuant to Chapter 2.2 (commencing with Section 1340) of Division 2 of he Health and Safety Code.

(B) The employer provides nonoccuational health coverage in a group health plan or a group health insurance policy as described in Section 4616.7"

The Statute goes on to describe what a "personal Physician" is and also states that the Designated physician must agree to be the designated physician.

Even if your doctor does not qualify or your employer does not have one of the aformentioned Health Care plans, there are other ways to get of of the MPN.

The predisgnated doctor must have treated you in the past. You should file an Expedited Hearing and get the Judge to Order the surgery. Your attorney can file this for you. If you do not have an attorney, I strongly suggest you consult an attorney.

The insurance company or employer may be in a penalty situation. If so it is possible the insurance company will have to pay your attorney. This means you will not have to pay an attorney if he/she file an expedited and gets an Order. You may also be entitled to penalties.

If you do not want to retain an attorney, you can contact your local Workers' Compensation Appeals Board local office and speak with the Information and Assistance Officer.

If you should have any further questions or need representation, you may contact the undersigned.

Good Luck and thank you for your inquiry.