Filing a workers’ compensation claim can be a long and tedious process. It involves filling out and exchanging several documents, not to mention that this all happens while you’re suffering a potentially crippling injury.
Once your employer approves your claim and sends it to the insurer, you can start receiving medical treatment for your injuries. But with so many hands involved in the claims process, who chooses the physician who’ll treat you? Do you get to pick, or is it your employer? Or is it the insurer?
State laws on selecting physicians
According to California law, the employer selects the physician for the initial treatment of an injured employee. But there are exceptional cases where the employee can choose their physician:
- Through pre-existing health care coverage: An employee can predesignate a personal physician in writing – as long as it was designated before the accident and injury and said employee has pre-existing health care coverage for non-occupational injuries or illnesses.
- Employer lacks health care network: The laws also say that if an employer does not have a medical provider network, the employee may select their treating physician. The physician must’ve treated the employee in the past and agreed to treat the employee’s workers’ compensation injuries prior to the injury. The physician must also have the employee’s medical records on file.
Other workers’ compensation claims considerations to make
Whether you are going with a physician of your choice or the one recommended by your employer, here are some important considerations you should make:
- Claim timeframe: If your employer doesn’t deny your workers’ comp claim within 90 days, you can count your injury as covered.
- Medical treatment approval: Within the day you file a claim, your employer has to authorize appropriate medical treatment.
- Additional pay: Your employer may grant you extra compensation if it fails to make timely indemnity payments.
Filing a workers’ compensation claim is tricky and challenging, but always remember that while you can pick which physician will treat you, there are restrictions and rules in place. When in doubt, you can consult California’s workers’ compensation board for answers to more specific questions.