Second Opinions in Workers’ Compensation Claims

After a work injury, immediate treatment options are limited.  The California workers’ compensation system only allows treatment inside a medical provider network (MPN) that workers do not choose.  Instead of choosing your own doctor to provide treatment options for your work injury, the doctor is instead chosen by the insurance company.  The insurance company is more likely to guard its own bottom line than to insure any one injured worker is receiving the best treatment from the doctor chosen on his behalf.  Injured workers, however, do have some limited recourse if they are unhappy with their treating doctor.

Injured workers in California, though initially limited to a doctor of the insurance company’s choosing, do have the option to seek second and third opinions if they are unhappy with the diagnosis or treatment provided by their initial doctor.  But even then, options still remain limited.  The second and third opinions are still limited to the MPN designated by the insurance company.  If a worker is still unhappy after their third opinion inside the MPN, only then may he or she request an independent medical review (IMR) from a doctor outside of the MPN.

Getting to that stage of a workers’ compensation claim is difficult.  To seek a second opinion, injured workers must provide notification to the insurance company that they want a second opinion, choose a physician from the MPN, schedule an appointment with the new physician within 60 days, and finally notify the insurance company of the appointment date.  The same steps must be taken for a third opinion.  It could be several weeks or months before injured workers can seek an IMR from a preferred physician not associated with the insurance company’s MPN.

The Law Offices of Scott Warmuth helps injured workers find the correct doctor to help them treat their injuries.  Our workers’ compensation attorneys help our clients switch doctors as often as it takes to ensure they receive the best treatment possible.  Our workers’ compensation legal services are provided with a no recovery, no fee guarantee and initial consultations are free.  Call us at 888-517-9888 to speak with a workers’ compensation expert today!

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