What Is 8 CCR §9767.6: Treatment and Change of Physicians?

The insurer or employer shall notify the employee of his or her right to be treated by a physician of his or her choice within the MPN after the first visit with the MPN physician and the method by which the list of participating providers may be accessed by the employee.

What does section 9767.6 require?

It requires the insurer to start your MPN treatment quickly, keep paying for it while your claim is pending, and let you pick your own doctor inside the network after your first visit.

This rule sits inside Article 3.5 of Title 8, the chapter that sets up Medical Provider Networks. It applies to every covered employee whose employer or insurer treats a work injury through an MPN, from the day the injury is reported through any later change of doctor inside that network. This site's MPN guide explains how the network itself works and how to find your own doctor list.

How fast must your first MPN exam and treatment start?

The insurer must arrange your first MPN exam under the network's own access rules, then start treatment within 1 working day after you file your claim form.

Once you report a work injury, or file a claim, the insurer, your employer, or the company that runs the MPN must arrange your first exam with an MPN physician. That exam has to meet the access standards a related regulation sets for the network. Then, within 1 working day after you file your DWC-1 claim form under Labor Code section 5401, the insurer must start providing treatment that follows the state's medical treatment guidelines.

Does your treatment stop while the insurer decides your claim?

No. The insurer must keep paying for your MPN treatment, capped at $10,000, for as long as your claim has not been accepted or denied.

Many injured workers worry that care will stop until the claim is decided. Section 9767.6 says the opposite. The insurer must provide MPN treatment for the injury you reported and keep providing it until the date the claim is rejected. Until that date, the insurer's total liability for that treatment is limited to $10,000. If your care is interrupted before a decision is made, put your request for care in writing and ask your claims administrator where your claim stands.

Can you choose or change your doctor inside the MPN?

Yes. After your first visit with the MPN doctor who treats you, you may pick any other doctor already in the network who fits your injury.

Your first MPN visit does not lock you into that doctor. After that visit, you may select a treating physician from anywhere in the network. That choice, and any later choice, has to match the doctor's specialty or real experience with your type of injury. A chiropractor can act as your treating physician too, but only up to the 24 visit cap this card explains, unless your employer or insurer agrees in writing to more visits. Once that cap is reached, you pick a different MPN doctor who is not a chiropractor, or the insurer assigns you one.

What must happen once you pick a new MPN doctor?

The insurer has 20 days to send your newly chosen doctor the medical records connected to your claim.

Once you tell the insurer which MPN doctor you picked, it has 20 days to deliver the relevant medical records for your claim to that doctor, including any test and lab results already on file. Any MPN doctor you see later can also ask for more records if needed. The insurer must give every MPN doctor your network identification number and the contact details for sending treatment requests and bills, so paperwork does not stall your care.

Can your employer switch you to a different MPN doctor?

Not through the usual Petition for Change of Physician. Section 9767.6 blocks that path once you have chosen a doctor inside the MPN, apart from one narrow exception written into a related regulation.

Outside an MPN, Labor Code section 4603 lets an employer ask the administrative director to change your treating physician. Inside an MPN, this regulation generally blocks that same petition once you have picked a treating doctor in the network, aside from one narrow exception set out in a related rule. If your employer still petitions under Labor Code section 4603 while you are treating inside the MPN, the only physicians it can offer come from the current MPN provider list, and each one still has to meet the network's access standards. Labor Code section 4616 is the law that lets an insurer set up an MPN in the first place.

What should you do about starting MPN care or changing doctors?

Write down the key dates, ask in writing if care or records are delayed, and call if your employer tries to move you out of a doctor you chose.

Keep a copy of the date you reported your injury, the date you filed your claim form, and the date of your first MPN exam. If treatment stalls, or a newly chosen MPN doctor never receives your records, put the request in writing to your claims administrator and keep a copy. This site's Concentra guide covers your rights and options if your first MPN visit happens at a clinic like that one.

Call (661) 273-1780 or use the contact form for a free consultation. Yazdchi Law P.C. represents injured workers across California from its one office in Palmdale and reviews each matter individually before deciding whether to take it on.