Second Opinions in Workers’ Compensation Claims

California workers’ compensation claims are notoriously limited when it comes to immediate treatment options.  Injured workers are initially limited to an assigned physician for their first visit, and many assume that they are stuck with that assignment.  However, if an injured worker is unhappy with the diagnosis or treatment provided by their assigned physician, they can seek a second and third opinion, but options still remain limited.

Choice of doctor is limited to a medical provider network (MPN) designated by your workers’ compensation insurance company.  While MPNs must meet certain state regulations, they do not typically offer extended options.  Injured workers are allowed to seek second and third opinions from other physicians associated within the MPN if they do not agree with their initial diagnosis or treatment plan.  Only after the second and third opinions can an injured worker request an independent medical review (IMR) from a doctor not associated with the MPN.

Making things more complicated are time constraints and required notifications.  Injured workers must provide notification that they are seeking a second opinion to a person designated by the insurance company, choose a physician, schedule an appointment within 60 days, and then notify that designated person of the appointment date.  If the worker again disagrees with the physician, the same steps must be taken for a third opinion.  If an injured worker disagrees with the third opining physician, he or she may seek an IMR.

Workers’ compensation laws in California are complicated.  Workers’ comp attorneys help injured workers make sense of the law.  The Law Offices of Scott Warmuth can help you by handling the paperwork so you can focus on your recovery.  Call 888-517-9888 today for a free consultation.

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