NEW DESIGNATED TREATER REQUIREMENTS FOR WORKERS’ COMPENSATION

The recent changes to California’s Workers’ Compensation laws have given the employer more control over an injured worker’s medical care. Under the new law, if the employer hasn’t established a Medical Provider Network, an injured worker must see a doctor selected by the employer for the first thirty days of the claim. After 30 days, the worker can change to a treating physician of his or her choice. The exception to this rule is that an injured worker may treat with the doctor of his or her choice if that doctor has been predesignated.

Predesignation takes medical treatment control away from the employer and lets you get treatment from a doctor who knows you and your medical history–a doctor who is more interested in getting you healthy than rushing you back to work. Any worker who has a regular physician should predesignate that physician for workers compensation purposes because treatment in the first 30 days of an injury can have a significant effect on long-term recovery. Unfortunately, the new laws have made predesignation more difficult that it was previously.

To predesignate a treating physician, three requirements must be fulfilled:

    1. The physician must be the employee’s regular physician;
    2. The physician is the employee’s primary care physician and has previously directed the employee’s medical care and retains the employee’s medical records, including his or her medical history; and
    3. The physician must agree to be predesignated.

At this time, the courts haven’t tackled the question of how much medical care the physician must have provided for requirement number two. Is a physical enough? Or do the physician and patient have to have a history going back several years? At this time, we recommend that you have a record of at least one visit with the physician of your choice; but the longer the history, the less chance of the predesignation being challenged.

On the following page is a form to predesignate your physician. Fill it out and have your doctor sign it. Remember that any doctor who treats you for workers’ compensation purposes must also provide regular reporting as required by the Labor Code. Once the form is complete, keep a copy for your records and give the original to your employer’s Human Resources Department or Workers’ Compensation Coordinator. This predesignation form may by copied freely or you can contact Mastagni, Holstedt & Amick for a form made specifically for your group or organization.