Preselect Physician
Choose Your Doctor Now in Case of Workplace Injury
Medical Provider Networks are a product of the "reform" of workers' compensation law that was slammed through the California Legislature in 2004 by Governor Arnold Schwarzenegger. The new law took effect in January 1, 2005. Employers in California lobbied heavily for this 'reform' in order to reduce their workers' compensation obligations.
Now, most of the employers with a UFCW contract employ a Medical Provider Network to "treat" their injured employees.
If you get injured while doing your job, an employer wants a doctor from its Medical Provider Network to examine you, treat you and decide when you're ready to get back to work. In fact, employers of UFCW members are known to demand it."
As a result of the new law, if you do not have a Physician Predesignation Form on file at the time of your injury, your employer can restrict you to a company-approved network physician. If you don't like the doctor you've chosen from the list, your only option is to choose another doctor from the same list.
It doesn't matter if these doctors don't know you and never treated you before. You're stuck with them and must abide by their decisions.
If they decide on a course of treatment, that's your course of treatment. If they say your treatment is finished, your treatment is finished. If they say you're ready to go back to work, you go back to work!
There is an appeals process, but its rules and procedures are stacked against you. Before an employee can submit an appeal, he or she must first obtain three separate opinions from network providers. Each of these doctors may require that you submit to diagnostic testing.
If you are still not satisfied, you may then request an Independent Medical Review by submitting an application to the administrative director of the California Workers' Compensation Division.
Once this is submitted, the medical review unit will study all the information, conduct an additional physical examination and issue a decision.
This hardly seems consistent with the goal of assuring that you will receive the best treatment and are able to return to work as soon as possible.
Under the old system, even if you did not have a Physician Predesignation Form on file, you could choose your own doctor 30 days following your injury. No longer.
But there is something you can and should do. Complete the form titled "Designation of Personal Treating Physician" available to print-off by clicking here.
Using this form, you can designate in advance the physician who would examine and treat you if you get hurt on the job. This physician must have treated you previously, have your medical records in his or her possession, and consent to being designated.
Submit the form to your employer and obtain proof that it was submitted. Keep a copy for your records.
You can submit the form at any time, but if you wait until you get hurt, the form will not apply to this injury. Now is the time to act in your own best interest.
Your Union will assist you in affirming your rights under the law. If your personal physician is hesitant to sign his or her consent on the form, find out why and we may be able to help you answer his or her concerns.
Remember, all medical bills resulting from your work-related injury or illness should be sent on to your company. Your UFCW-negotiated medical benefits should never be used to treat work- related injuries or illnesses.
We share your employer's desire to see you back on the job as soon as possible. But your health and physical wellbeing must not be compromised in the process.