As an injured worker in California, you have the right to receive medical care reasonably required to cure or relieve the effects of a work injury. 

Medical treatment is probably the most important benefit provided in the workers’ compensation system. First, our health is very important and cannot be replaced. In addition, medical treatment is usually necessary to receive other workers’ compensation benefits that follow from medical treatment, such as temporary disability.  A doctor’s opinion is often required to diagnose and determine the extent of the injury.  A doctor’s determination that the employee cannot work as a result of the work injury would be very helpful and instrumental in proving the employee’s right to temporary disability benefits.

The “Primary Treating Physician” (PTP) is the primary doctor for the employee in California’s workers’ compensation system.  There can only be one PTP at a time.  The primary treating physician acts as a medical treatment manager and can make referrals to specialists or secondary physicians. 

In California, most insurance companies that administer claims for work injuries have a Medical Provider Network (MPN). If the insurance company (claims administrator) has an MPN, the injured worker must generally choose a primary treating physician from within the MPN network, which can be done after the first doctor visit by submitting a request to change the treating physician. However, if there are not enough primary treating physicians in the MPN who are within a close enough distance, the employee may be able to select a PTP from outside the MPN. In addition, if the claims administrator does not have an MPN at all (which is unusual), treatment of course cannot be confined to an MPN. There are more complexities with the issue of selecting a primary treating physician that cannot be covered here.

When selecting a primary treating physician, it is usually best to select one who is experienced with workers’ compensation patients because there can be problems or complications if the PTP is not familiar with workers’ compensation procedures.