What Is California Labor Code §4061.5: The Treating Physician's Combined Report?

The treating physician primarily responsible for managing the care of the injured worker or the physician designated by that treating physician shall, in accordance with rules promulgated by the administrative director, render opinions on all medical issues necessary to determine eligibility for compensation. In the event that there is more than one treating physician, a single report shall be prepared by the physician primarily responsible for managing the injured worker’s care that incorporates the findings of the various treating physicians.

What does California Labor Code 4061.5 require?

One treating physician gives the medical opinions that decide your workers' comp eligibility.

Several parts of a workers' compensation claim turn on a medical opinion: whether the injury is work related, when you can return to work, and how much disability you have. Labor Code 4061.5 gives that job to one treating physician, often called the primary treating physician, or PTP. The PTP is whichever doctor is mainly in charge of your care, or a doctor that the PTP names to prepare the report.

The rule applies to every injured worker in the California workers' compensation system who has a treating physician. It covers the medical issues needed to decide your eligibility for compensation, not one narrow type of claim. Whether you see a single doctor for your whole claim or several specialists for different body parts, Labor Code 4061.5 still points to one treating physician for the opinions that count. This rule has been part of California law since 1993 and remains in effect today.

What happens when more than one doctor treats your injury?

One physician must combine every treating doctor's findings into a single report.

If a specialist treats part of your injury while your PTP handles the rest, the law does not let each doctor file a separate opinion on your eligibility. The physician in charge of your overall care has to prepare one report, and that report must include what the other treating physicians found. The goal is a single medical opinion the claims administrator and a workers' compensation judge can rely on, rather than several opinions that might not agree with each other.

Can you object to the treating physician's combined report?

Yes, through the written objection process in Labor Code 4062.

Labor Code 4062 lets you, or the claims administrator, object in writing to a medical determination the treating physician makes. That timeline does not apply when the issue already falls under Labor Code 4060, Labor Code 4061, or the utilization review process in Labor Code 4610, since each of those has its own procedure.

• If you have an attorney: object in writing within 20 days of receiving the report, then the disputed issue goes to a Qualified Medical Evaluator (QME) through the panel strike process in Labor Code 4062.2.
• If you do not have an attorney: object in writing within 30 days of receiving the report, then the claims administrator must give you the form to request a three doctor QME panel under Labor Code 4062.1.

Either deadline can be extended for good cause or by agreement with the claims administrator. Read the full deadline and the rest of the process on our Labor Code 4062 guide.

How does this report affect your permanent disability notice?

Your treating doctor's combined opinion is usually the medical basis for your permanent disability notice.

Together with your last temporary disability payment, your employer must send a notice under Labor Code 4061 about permanent disability. That notice has to say either that no permanent disability is owed, or state the amount and explain how your employer reached that figure. The medical opinion your treating physician gave under Labor Code 4061.5 is usually what that notice relies on.

What should you save or ask about a Labor Code 4061.5 report?

Keep the report, note the date you received it, and ask whether every treating doctor's findings made it in.

Write down the date you received the report. That date starts the Labor Code 4062 objection clock. Ask your primary treating physician, or PTP, whether the report folds in findings from every doctor who has treated your injury, not just the PTP's own exam. If a specialist's findings seem to be missing, say so in writing and keep a copy for your file.

If a Labor Code 4061.5 report left out a doctor's findings, or you are not sure whether to object, Yazdchi Law P.C. reviews each California workers' compensation matter individually. Call (661) 273-1780 or use the contact form for a free consultation. The firm serves injured workers across California from its Palmdale office.