Can I Go to My Own Doctor After a Workers’ Comp Injury Claim?
In California, you may be able to see your own doctor after a work injury, but only if you pre-designated that doctor in writing before the injury.
You got hurt at work, and you need medical care fast. Naturally, you might want to see your own doctor, the one who already knows your health history and whom you trust. But if your injury happened on the job, California’s workers’ compensation system has its own rules about where you can go for treatment.
Here’s what you need to know before you make that doctor appointment.
The Short Answer: Sometimes, But Not Always
In California, whether you can see your own doctor after a work injury depends on when and how you make that choice.
Under California Labor Code §4600, your employer has the right to control medical care for the first 30 days after your injury, unless you pre-designated your personal doctor in writing before you got hurt.
That means:
- If you did pre-designate your regular doctor, you can go straight to them after your injury.
- If you did not, you will likely have to see a doctor from your employer’s or insurance company’s medical provider network (MPN) for the first 30 days.
After that period, you can usually switch doctors within the approved network, and in some cases, outside it.
What “Pre-Designating” a Doctor Means
Pre-designation is a simple but powerful step. It allows you to choose your own primary treating physician (PTP) before any workplace accident happens.
To pre-designate, you must:
- Have health insurance coverage for non-work-related medical issues.
- Provide your employer with a written notice naming your personal doctor or medical group.
- Ensure that the doctor has previously agreed to treat you for work injuries.
If you did not submit that form before your injury, your first visits must follow your employer’s network rules. But don’t worry, you still have rights.
If You Didn’t Pre-Designate
Most workers in California don’t pre-designate a doctor, which means they start treatment with an MPN doctor chosen by the employer or insurer.
This can feel frustrating, especially if you don’t trust that doctor to put your health first. But you still have important protections under California law:
- The MPN must include qualified physicians in your area.
- You can switch doctors within the MPN if you’re unhappy with your care.
- You have the right to request a second or third opinion if you disagree with the treatment plan.
If your employer does not have an MPN, you can generally choose any doctor authorized by the claims administrator.
When You Can Switch to Your Own Workers’ Comp Doctor
After the first 30 days of care, you may be able to switch to your own physician, even if you didn’t pre-designate.
You will need approval from your employer’s insurance company. In many cases, if your doctor is willing to treat you under workers’ comp rules and billing, the insurer will agree to the change.
An experienced workers’ compensation attorney can help make this process smoother by submitting proper notice and handling communication with the claims administrator.
Why the Workers’ Comp Treating Doctor Matters
Your primary treating physician does more than just help you heal. Their reports directly affect your entire claim, including:
- How long you can stay off work
- What temporary disability benefits you receive
- Whether you have a permanent disability rating
In other words, your doctor’s opinion can determine the value of your workers’ compensation case. That’s why it’s crucial to have a physician who listens, documents your symptoms accurately, and supports your recovery.
What to Do If You’re Unhappy With Your Workers’ Comp Doctor
If you feel ignored, rushed, or dismissed by your workers’ comp doctor, don’t stay silent. The doctor’s reports can directly impact your benefits and your recovery, so it’s important to speak up and take action early.
- Keep notes on each appointment, including what was discussed.
- Request a change of physician within the MPN (your attorney can handle this).
- Ask for a second opinion if you believe your treatment plan is inadequate.
- If the problem continues, you may request an independent medical review (IMR) through the California Department of Industrial Relations.
Remember, you deserve care that truly supports your recovery, not care that minimizes your injury or rushes you back to work before you’re ready. At Fontes Law Group, we help injured workers stand up for the medical treatment they’re entitled to under California’s workers’ compensation laws.
How Fontes Law Group Can Help
Dealing with a work injury is stressful enough without having to fight over medical care. At Fontes Law Group, we help injured workers in Santa Ana and Riverside understand their rights, get quality medical treatment, and secure the benefits they deserve.
Our team handles everything, from filing claims and choosing the right doctor to appealing denied benefits. We’re proud to serve Southern California’s bilingual community, offering support in both English and Spanish.
If you’re unsure whether you can see your own doctor after a workplace injury, don’t take chances. The sooner you get clear legal guidance, the better your outcome will be.
With offices in Santa Ana and Riverside, our team proudly serves Southern California’s bilingual community, providing guidance in both English and Spanish.
FAQs About About Workers’ Comp and Disability
Q: Can I get a second opinion if I disagree with my workers’ comp doctor?
Yes. California law allows injured workers to seek a second and even a third opinion within the MPN if they’re unhappy with their diagnosis or treatment plan. If issues remain unresolved, you can request an Independent Medical Review (IMR) to have your case evaluated by a neutral medical expert.
Q: What happens if I already saw my personal doctor before filing a workers’ comp claim?
If you went to your own doctor before officially filing your claim, the insurance company may not cover that visit unless your doctor was pre-designated. Once your claim is approved, your care must follow workers’ comp guidelines. An attorney can help you recover reimbursement in some cases.
Q: Can my employer force me to see a specific doctor?
Your employer can require you to use a doctor within their approved medical provider network (MPN) for the first 30 days after the injury. After that, you may request to change doctors or switch to your own provider with approval from the insurance company.
Q: Will switching doctors affect my workers’ comp benefits?
No. As long as the new doctor is properly approved within the workers’ comp system, switching physicians will not reduce your benefits. In fact, it can sometimes improve your recovery and help ensure your condition is fully documented for your claim.
Q: What if my employer doesn’t tell me about pre-designating a doctor?
Employers are required to give new hires information about their workers’ comp rights, including the option to pre-designate a personal physician. If your employer never gave you that information, a workers’ compensation attorney can help make sure your rights are protected.
Bottom Line
In California, you can see your own doctor after a workers’ compensation injury, but only if you meet certain requirements or get approval after the first 30 days.
Every case is unique, and small mistakes can delay your treatment or reduce your benefits.
Fontes Law Group is here to make sure that doesn’t happen. Call us today to speak with a bilingual workers’ comp attorney who will protect your rights and help you get the care you need to recover.
Need help understanding your workers comp case? Fontes Law Group offers bilingual legal support in Santa Ana, Riverside, and across Southern California.
If you are facing a settlement offer or have questions about your rights, contact Fontes Law Group today.