Wednesday, December 26, 2018

Treating Your Work Injury – The Role of a Primary Treating Physician

You got hurt at work. Now what? 
Getting quality medical care is your top priority after suffering an injury or illness. Nothing is more important than one’s health.  However, obtaining medical treatment under the California Workers’ Compensation system can be challenging to say the least.

What can you do?
Pick a great doctor. Sometimes that’s easier said than done. Your Primary Treating Physician (PTP) is the medical professional who will provide care for the relief of your industrial injuries. Their role in the outcome of your case will significantly impact the benefits you receive. 

Your PTP will not only diagnose your condition and address if the injuries were caused by your work, but they will also request approval for your treatment. Your PTP may refer you to other medical specialists as needed for the care and relief of your injuries. Additionally, your PTP will advise the insurance carrier/your employer if and when you need time off of work to recover or if modified duty work is possible. Finally, your PTP will create a medical history that will play heavily into future determinations of any lasting limitations or permanent disability you may have suffered due to your industrial injuries. In short, selecting a good PTP is crucial to not only the care of your injuries, but also your workers’ compensation case in its entirety.

How do you pick a Primary Treating Physician?
Hopefully, you have predesignated your PTP or a qualified medical group. Under the existing California Labor Code ((§§ 4600, 4600.3 (2018)), you may predesignate your PTP if you have followed detailed rules about such a selection (see DWC Form 9783 to make your pre-designation).  However, most of us haven’t taken advantage of this flexibility afforded under the Labor Code, so your PTP selection will generally be limited by your employer’s Medical Provider Network (MPN). 
When your employer/its insurance company has established a MPN, you’ll generally have to choose a doctor in that network. However, after the first 30 days post injury (Cal. Labor Code §§ 4600, 4600.3, 4616.3), you will be able to select a PTP of your own choice within the MPN. 

Need Help?
If you’re having problems with medical issues in your workers' compensation case such as dissatisfaction with the care you've been receiving, disagreement with your doctor’s opinions about your diagnosis or work limitations, or the insurance company is failing to respond to the doctor’s recommended treatment, it would be beneficial to schedule a consult with Mastagni Holstedt.
Mastagni Holstedt can help you navigate the complicated process of changing doctors and fighting for approval of necessary medical care. We may also be able to recommend good PTPs who understand the complexity of the California workers’ compensation system. Contact us today to see how we can help.