To meet the obligation to furnish medical care, you or your insurance carrier can designate the physician who provides medical treatment for the first 30 days after an injury. An employee can predesignate a personal physician. If the employee has made a valid predesignation, then the personal physician may immediately assume treatment for a work-related injury.

However, the employee’s personal physician can refuse to provide medical treatment because the injury requires a different medical specialty. In this case, the employee should use your designated physician.

Upon an employee’s request within the 30-day period, you must allow one change in physician. If the employee has properly predesignated a personal chiropractor or personal acupuncturist, they may change to that provider. Otherwise, you maintain control over that choice.

After the 30-day period expires, the employee can select their own treating physician, subject to any applicable MPN. Employees who are covered by an MPN can only request a change of physician within the network.

The employee can predesignate their physician for workers’ compensation treatment if:

• The employee notified you of the choice in writing before the date of the injury.
• The employee has non-occupational group health care coverage in a health services plan.
• The physician is the employee’s primary care physician or a surgeon holding an M.D. or D.O. (Doctor of Osteopathic Medicine) degree and is licensed under the Business and Professions Code.
• The physician previously directed the employee’s treatment and maintains the employee’s medical records and medical history.
• The physician agrees to be predesignated as the employee’s treating physician for occupational injury or illness.

The law requires the Administrative Director to suspend physicians from participating in the workers’ compensation system (treating or evaluating) when they have been convicted of insurance fraud or otherwise have had their medical license suspended or revoked. Any physician who has been formally suspended cannot be a treating physician on a workers’ compensation claim, and the employer is entitled to deny payment of the physician’s bills.1 The list of suspended medical providers is available on the state's website.

1. Lab. Code secs. 139.21(a)(1), 4603.2(b)(5)(B)