You got hurt at work. Now
what?
Getting quality medical care is your top
priority after suffering an injury or illness. Nothing is more important than
one’s health. However, obtaining medical
treatment under the California Workers’ Compensation system can be challenging
to say the least.
priority after suffering an injury or illness. Nothing is more important than
one’s health. However, obtaining medical
treatment under the California Workers’ Compensation system can be challenging
to say the least.
What can you do?
Pick a great doctor. Sometimes that’s easier
said than done. Your Primary Treating Physician (PTP) is the medical professional
who will provide care for the relief of your industrial injuries. Their role in
the outcome of your case will significantly impact the benefits you
receive.
said than done. Your Primary Treating Physician (PTP) is the medical professional
who will provide care for the relief of your industrial injuries. Their role in
the outcome of your case will significantly impact the benefits you
receive.
Your PTP will not only diagnose your condition
and address if the injuries were caused by your work, but they will also
request approval for your treatment. Your PTP may refer you to other medical
specialists as needed for the care and relief of your injuries. Additionally,
your PTP will advise the insurance carrier/your employer if and when you need
time off of work to recover or if modified duty work is possible. Finally, your
PTP will create a medical history that will play heavily into future
determinations of any lasting limitations or permanent disability you may have
suffered due to your industrial injuries. In short, selecting a good PTP is
crucial to not only the care of your injuries, but also your workers’ compensation
case in its entirety.
and address if the injuries were caused by your work, but they will also
request approval for your treatment. Your PTP may refer you to other medical
specialists as needed for the care and relief of your injuries. Additionally,
your PTP will advise the insurance carrier/your employer if and when you need
time off of work to recover or if modified duty work is possible. Finally, your
PTP will create a medical history that will play heavily into future
determinations of any lasting limitations or permanent disability you may have
suffered due to your industrial injuries. In short, selecting a good PTP is
crucial to not only the care of your injuries, but also your workers’ compensation
case in its entirety.
How do you pick a Primary Treating Physician?
Hopefully,
you have predesignated your PTP or a qualified medical group. Under the
existing California Labor Code ((§§ 4600, 4600.3
(2018)), you
may predesignate your PTP if you have followed detailed rules about such a selection
(see DWC Form 9783 to make your
pre-designation). However, most of us
haven’t taken advantage of this flexibility afforded under the Labor Code, so
your PTP selection will generally be limited by your employer’s Medical
Provider Network (MPN).
you have predesignated your PTP or a qualified medical group. Under the
existing California Labor Code ((§§ 4600, 4600.3
(2018)), you
may predesignate your PTP if you have followed detailed rules about such a selection
(see DWC Form 9783 to make your
pre-designation). However, most of us
haven’t taken advantage of this flexibility afforded under the Labor Code, so
your PTP selection will generally be limited by your employer’s Medical
Provider Network (MPN).
When your employer/its insurance company has
established a MPN, you’ll generally have to choose a doctor in that network.
However, after the first 30 days post injury (Cal. Labor Code §§
4600, 4600.3, 4616.3), you will be able to select a PTP of your own choice
within the MPN.
established a MPN, you’ll generally have to choose a doctor in that network.
However, after the first 30 days post injury (Cal. Labor Code §§
4600, 4600.3, 4616.3), you will be able to select a PTP of your own choice
within the MPN.
Need Help?
If you’re having problems with medical issues
in your workers’ compensation case such as dissatisfaction with the care you’ve
been receiving, disagreement with your doctor’s opinions about your diagnosis
or work limitations, or the insurance company is failing to respond to the
doctor’s recommended treatment, it would be beneficial to schedule a consult
with Mastagni Holstedt.
If you’re having problems with medical issues
in your workers’ compensation case such as dissatisfaction with the care you’ve
been receiving, disagreement with your doctor’s opinions about your diagnosis
or work limitations, or the insurance company is failing to respond to the
doctor’s recommended treatment, it would be beneficial to schedule a consult
with Mastagni Holstedt.
Mastagni Holstedt can help you navigate the
complicated process of changing doctors and fighting for approval of necessary
medical care. We may also be able to recommend good PTPs who understand the
complexity of the California workers’ compensation system. Contact us today to
see how we can help.
complicated process of changing doctors and fighting for approval of necessary
medical care. We may also be able to recommend good PTPs who understand the
complexity of the California workers’ compensation system. Contact us today to
see how we can help.
