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Getting a Second Opinion When You Disagree About Workers’ Comp Treatment

Receiving MEdical TreatmentUnderstanding workers’ compensation can be difficult — there are many rules at play. While these rules are supposed to keep all parties on equal footing, many times the detailed laws in this area leave the injured worker unsure of what steps need to be taken.

One issue that comes up frequently is what needs to happen if you and your doctor disagree. This disagreement can occur over several issues, including the cause of an injury, the treatment that is needed, or the type of work that you can do while recovering.

There is typically a way in the workers’ comp scheme to challenge a doctor’s opinion by going to see another doctor. How that doctor is selected, however, will vary based on the decision being challenged by the injured worker. If you and your doctor do not agree on what treatment is needed for your injury, then it is your right to get another opinion.

Challenging Medical Treatment Within a Medical Provider Network

For workers receiving medical treatment within a medical provider network (MPN),first consider switching doctors within the MPN.

If you still cannot reach an agreement after you have switched, you have the right to get opinions from up to two more doctors within the MPN. If you still do not agree with the doctors, you can get an independent medical review that is set up by the Division of Workers’ Compensation (DWC). If that doctor agrees with you on the issue of necessary treatment, you may be treated by a doctor outside the MPN.

Challenging Medical Treatment Within a Health Care Organization

If you are getting treated within a health care organization (HCO), you should first seek out a new doctor within the HCO. If you do not agree with the new doctor, you can request another physician from within the HCO. If an agreement can still not be reached, you can request that the HCO resolve the dispute.

Seek Help from a California Workers’ Comp Lawyer

When you cannot get the care you believe you need, you should consider contacting a lawyer. Some of the steps outlined above are on a strict timetable. Failure to adhere to the deadlines set by law could mean you have waived your objection.

Our firm seeks to get our clients’ health back and also make sure our clients are compensated for lost wages, as allowed under the law. The award-winning San Jose Workers’ Comp attorneys at Corsiglia McMahon & Allard, L.L.P. can be reached at (408) 289-1417. Call today to see what our firm can do for your case.

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