Item: Corsiglia McMahon & Allard, L.L.P.
Rating: 5
Author: Declan O.

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

Receiving MEdical Treatment Understanding 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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Chapter 4. Resolving Problems with Medical Care & Medical Reports

★★★★★

I absolutely cannot speak highly enough of CMA Law, particularly of Mr. McMahon, with whom I have had the most experience. My entire family and I trusted CMA with our case following a significant and life-altering vehicle accident, and to say they delivered is putting it lightly. They were reachable & personable at every stage of this arduous, complex, and scary process, made things easier at every stage, inspired us with confidence, and delivered results. If you're looking for a law firm to place the trust of you in your family in, look absolutely no further than CMA - this is your firm. Declan O.

I suffered a severe spinal injury while working as a farm mechanic in the Salinas Valley. The attorneys -Tim McMahon and Mark Sigala were fantastic from the beginning. They fought for me over 3 long years and in the end, we won a difficult liability case against the farm company who was using dangerous equipment. The defendants in the case tried everything to put the blame on me and even claimed I was their employee in order to avoid civil responsibility. Tim and Mark never gave up on me and my case. I cannot recommend them highly enough. They are fighters. Adrian A.

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