Wednesday, June 11, 2014

Quirky Physician Predesignation Requirement to Be Lifted

An effective way to take some control over your workers’ compensation claim is to predesignate your personal physician to provide treatment in the event you sustain an industrial injury. Absent a predesignation, you will be limited to physicians within the employer’s medical provider network, which can be wholly frustrating if not a little dangerous.

Currently, an employee is not eligible to predesignate a personal physician unless the employer provides non-occupational group health coverage, whether or not the employee participates in the coverage. That odd provision in the workers’ compensation regulations will be deleted effective July 1, 2014. As of that date, predesignation will be an available option for an employee with non-occupational health care coverage regardless of whether the employer offers  medical coverage to employees.

Thus, as of July 1, 2014, in order to make an effective predesignation election, you must: (1) provide your employer with notice of your predesignation prior to industrial injury; (2) actually possess health care coverage at the time of the injury; and, (3) obtain your personal physician’s agreement to the predesignation before the injury occurs. 8 CCR § 9780.1(a)(1)-(3).

The Division of Workers’ Compensation provides an optional predesignation form (DWC Form 9783) which can be used to provide notice of the predesignation and to evidence your physician’s agreement to the predesignation. The forms may be downloaded from http://www.dir.ca.gov/dwc/forms.html, or may be obtained by calling (800) 794-6900. (Caveat: Be sure to only use forms with 2014 revision date.)