I was injured at work. Do I have to file workers comp and see the company's physician, or can I see my own physician for now?

Asked about 2 years ago - Long Beach, CA

I was injured during work and had to visit the emergency room. I am to schedule a follow-up appointment the next day with a specialist. I currently have health insurance coverage through my spouse (no health insurance through my employer) and was wondering, could I see my own insured physician and then be reimbursed by worker's comp later? Or do I need to file worker's comp. immediately?

Attorney answers (5)

  1. Richard Michael Laden

    Contributor Level 13

    5

    Lawyers agree

    Answered . Assuming your employer knows of your injury at work you should have been given an Employee's Claim for Workers Compensation Benefits form to complete and return. Your employer also should have notified its workers' compensation insurer of your injury. If the employer/insurer has a Medical Provider Network (MPN), you should have been referred to a doctor from the network for examination and treatment. If you claim has been denied by the employer/insurer, you have the right to seek treatment with whatever doctor you want up to $10,000.00. Once you receive notice from the insurer of the MPN, you may be forced to select a doctor from the network.

    Your best bet is to hire an attorney who is skilled in workers' compensation cases. You can call or email me. I regularly handle cases all over Los Angeles County including Long Beach. Or you can select one here at AVVO or at www.caaa.org.

    The information given is generic and does not constitute legal advice, which would only be given after a complete... more
  2. Craig Stephen Wasserman

    Contributor Level 6

    2

    Lawyers agree

    Answered . I agree with my associate and you need to get into a work comp attorney, who can look at the MPN of the employer and determine if there are better doctor's to send you to, than the initial treater.

    Craig S. Wasserman, Esq. (714) 231-1910

  3. Brett A. Borah

    Contributor Level 20

    2

    Lawyers agree

    Answered . Mr. Wasserman and Mr. Laden have given you good advice.

    Report the injury. During the 90 day investigation period, you can go to any doctor you want and they will pay up to $10,000 worth of treatment. Once they accept the claim, you have to pick a doctor out of the medical provider network (mpn). A good attorney can help you find a good treater in the MPN.

    There are some great W.C. attorneys in Long Beach. Find a good one here at www.avvo.com or at ww.caaa.org. CAAA is the association for attorneys here in California who represent injured workers. Or you can call me for a referral. Good luck.

  4. George Ellis Corson IV

    Pro

    Contributor Level 20

    1

    Lawyer agrees

    Answered . You MUST tell your MD that the injury was work-related. That gives your doctor the chance to call for authorization, and gives Kaiser or Blue Cross the chance to seek reimbursement for the services that they pay. If the WC carrier authorizes the visit, you are Golden.

    Attorneys are very competitive. Choose the Best Answer so we know who helped you the most.
  5. Juan Manuel Armenta

    Pro

    Contributor Level 11

    Answered . It depends. Your employer is required to notify the carrier of the injury but you are not required to subject yourself to some of the nonsense the carrier can put you through. You are perfectly within your rights to use your private healthcare. That will usually get care faster and your private carrier can seek reimbursement later. But, again that decision can be complicated. I can tell you that I have had clients take the private route when the work comp carrier is up to nonsense.

    This site is informational only and creates no attorney client relationship or a reasonable expecation of accuracy... more

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