One of the biggest frustrations for injured workers is being told they have to see the insurance company’s doctor. The good news: California law gives you more control over your medical care than you might think. Here’s how doctor selection works in workers’ comp.

The First 30 Days: MPN Rules

For the first 30 days after your injury, your treatment must be within the insurance company’s Medical Provider Network (MPN). An MPN is a group of pre-approved doctors and specialists.

  • Your employer should provide you with a list of MPN doctors
  • You can choose any doctor within the MPN
  • If you’re not happy with the first doctor, you can switch to another MPN doctor

After 30 Days: Switch to Your Own Doctor

After the initial 30-day period, you can switch to your own doctor — even if they’re outside the MPN — as long as they agree to treat you within the workers’ comp system.

Pre-Designation: The Best Protection

If you pre-designated your personal physician before your injury, you can see them from day one. To pre-designate:

  • You must have health insurance at the time of injury
  • Your doctor must agree in writing before the injury occurs
  • The pre-designation form must be on file with your employer

QME and AME: Independent Medical Evaluations

If there’s a dispute about your medical condition, an independent evaluator will examine you:

  • QME (Qualified Medical Evaluator) — assigned by the DWC medical unit if you don’t have a lawyer
  • AME (Agreed Medical Evaluator) — chosen by agreement between your attorney and the insurance company

Having a workers’ comp attorney means you can participate in selecting your AME, which often leads to more favorable evaluations.

Injured at Work? Get a Free Case Review Today.

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What If the Insurance Company’s Doctor Downplays My Injury?

This happens frequently. Insurance company doctors have a financial incentive to minimize your condition. If you believe a doctor is not accurately reporting your symptoms or limitations:

  • Get a second opinion from your own doctor
  • Request an AME through your attorney
  • Document all your symptoms in writing

Get a Lawyer Who Fights for Your Medical Rights

Attorney Eman Yazdchi — a Certified Specialist with 20+ years of experience — knows how to challenge biased medical opinions and get you the treatment you need. Call Yazdchi Law today for a free consultation.

Injured at Work? Free Consultation Board-Certified Workers' Comp Specialist
CALL (661) 273-1780