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  1. #1
    Join Date
    Feb 2009
    Posts
    1

    Default When Can I Choose My Own Doctor?

    My workers compensation claim was made in the State of: California

    The doctors my ins. company sends me to are miles away, whereas I am within walking distance of a Kaiser hospital and a doctor who actually cares. Its been 4 months since I strained my wrist with no improvement, and I asked my claims administrator if I could switch doctors, since the law seems to say I can do so after thirty days. She said I could only go to doctors on their blue shield network. What are my options?

  2. #2
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: When Can I Choose My Own Doctor?

    you can change doctors within the Medical Provider Network whenever you wish.
    you only get free choice if you've predesignated. here's a link to the FAQs and rules
    http://www.dir.ca.gov/dwc/mpn/DWC_MPN_FAQ.html

    All employees of an employer with an approved MPN are required to receive medical treatment through the MPN for work injuries, EXCEPT:

    Those employees who properly pre-designate a physician anytime before an injury occurs, even if the pre-designated physician is a provider in the MPN's network. [8 CCR 9780.1, 8 CCR 9782];
    Those employees with injuries prior to the effective date of the MPN whose care has not been transferred into the MPN [8 CCR 9767.9]; and
    Those employees who are otherwise exempted from the MPN by the MPN payor or employer.

  3. #3
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: When Can I Choose My Own Doctor?

    The doctors my ins. company sends me to are miles away, whereas I am within walking distance of a Kaiser hospital and a doctor who actually cares.
    comet, if your MPN choices are beyond a 'reasonable distance', defined as 25/30 miles from your home, you may be entitled to treat outside the MPN the ER/IC has in place.

    So when you say ''miles away'' you need to be more specific.
    Whether you feel the doctor you are seeing 'cares' or not isn't relative to your ability to treat outside the network.

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