Getting medical care through workers’ compensation does not always mean you have to stay with the first doctor you see. If your Riverside department or its insurer uses a Medical Provider Network, or MPN, the network controls much of where you receive treatment. But California also gives you important rights within that system. You may be able to switch physicians, seek additional medical opinions, or challenge a diagnosis or treatment plan you believe does not address your injury properly.
For police officers, firefighters, sheriff’s personnel, and other first responders, choosing the right treating doctor can matter even more because medical reports can ultimately affect treatment, work restrictions, and your ability to return to demanding duties. Our experienced workman comp attorney in Riverside has often seen problems arise when first responders assume the insurer’s first doctor is their only option. In today’s post, we help you understand your MPN rights so you can exercise more control over your care.
What is a Medical Provider Network in California?
An MPN is a network of healthcare providers established by an insurer or self-insured employer and approved by California’s Division of Workers’ Compensation. If your employer uses an MPN, you will generally receive treatment within that network unless an exception applies. The network includes physicians who handle occupational injuries as well as specialists who can treat particular conditions.
For first responders, the specialty can matter. A physician treating a shoulder injury from firefighting duties or a knee condition affecting patrol work should understand both the medical problem and the physical demands you need to meet on the job.
Can you change doctors within an MPN?
Yes. You generally do not have to remain with the first MPN physician throughout your claim. After your initial appointment, California allows you to select another available doctor within the network. The claims administrator should provide information that helps you locate MPN physicians who can treat your condition.
You should consider changing doctors when:
- Communication with the current physician has broken down
- The doctor does not appear to understand your actual job duties
- Your condition requires a different medical specialty
- You have concerns about the recommended treatment
- Your symptoms or limitations are not being addressed adequately
What if you disagree with your MPN doctor’s diagnosis or treatment?
California gives you a specific process for challenging an MPN physician’s diagnosis or treatment recommendation. You can first seek a second opinion from another physician within the network. If you still disagree, you may request a third opinion from another MPN doctor.
When requesting a second or third opinion, you choose from available MPN providers with the appropriate specialty. You generally need to schedule the appointment within 60 days after receiving the provider list, or you may risk losing that particular right to another opinion. If you still disagree after the third opinion, you may request an MPN Independent Medical Review.
Does MPN review cover disputes about returning to work?
Not every disagreement with your treating physician goes through the MPN second-opinion process.
The MPN process focuses mainly on diagnosis and medical treatment. If you disagree with your doctor about issues such as whether you can return to work, whether you have permanent disability, or whether you will need future medical care, California DWC directs workers toward the Qualified Medical Evaluator process instead.
How can I get in touch with the leading workman comp attorney in Riverside?
If you are stuck with a doctor who does not understand your injury, your job duties, or the treatment you need, don’t lose precious time—call Workers Compensation OC without delay. We specialize in helping first responders across Riverside navigate the state’s Medical Provider Network and take the right steps when care is not working.
We can also answer all your questions on permanent disability apportionment and first-responder claims, retraining benefits if you can’t return to your old job, and how workers’ compensation interacts with disability retirement.
Whether you’re located in Downtown or any other part of Riverside or OC, contact us to set up a free consultation with our team. We’ll review your case and use all legal means to help you secure a favorable outcome. Reach out to us today!
