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What do I do if I disagree with my doctor?

A worker who is injured and seeks payment for medical treatment under workers’ compensation can choose a doctor from a selection offered by the employer’s insurance company. However, some workers may have disagreements with their doctor over a number of different issues. If this is the case for you, you should know that California law provides ways to dispute your doctor’s claims and even allow you to select a new doctor if necessary.

Some injured workers have a problem with the treatment plan recommended by their doctor. According to the California Department of Industrial Relations website, you have the option to change your doctor. The doctor still has to be authorized by the employer’s insurance company, which can be chosen through the medical provider network set up by your employer’s insurance company.

If you are not ready to change your doctor, California law allows you to seek a second and even a third opinion from other doctors. Again, these doctors must be part of the selection offered by your employer’s medical provider network. In the event you still have a problem with the opinions offered, you can seek an independent medical review (IMR) to resolve the situation.

Some disagreements involve issues other than your diagnosis or treatment. A doctor may decide to not clear a worker to return to work, but the worker may disagree with the assessment. Some workers will disagree with a physician on whether they need more medical treatment in the future or if they are disabled and to what degree. In these scenarios, state law requires disputing workers to ask for a qualified medical examiner (QME) to resolve the issue.

No injured worker should feel that their health is being compromised. There are options available if you want to question your doctor’s assessment of your situation. Since workers’ compensation issues take many forms, do not consider this article as legal advice. It is intended for general education only.

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