Workers' compensation carriers continue to disrupt an injured workers access to necessary and appropriate medical treatment. These efforts affect the system in many ways, including, but not limited to: (1) keeping workers on disability longer than necessary, (2) adding litigation costs to the system, (3) increasing permanent disability awards for injured workers due to lack of treatment, and (4) unnecessarily taking up the time of the workers' compensation judges on such matters.
California workers' compensation carriers' policies routinely lead to the knee jerk denial and delay or care prescribed by physicians from within their own network or doctors. The result? Unnecessary costs are added to the system and injured workers don't get the care they need.
Many people are only vaguely aware that the workers compensation system in California even exists. Often, they only become aware of it after they suffer an injury. It is a little known fact among workers, even union workers, that you can pre-designate who you want to treat you before you are injured. Doing so can be your best protection in the event that you are hurt. You need to get the agreement of the doctor that he or she will serve as your primary treating doctor if you get hurt at work. If you do not do this in advance and advise your employer in writing that you are predesignating a doctor in the event of a workplace injury, you will often be required to be treated by a doctor off a list selected by your employer-a company doctor.
The current state of affairs for medical treatment for injured workers is without a doubt rigged in favor of insurers who game the system to deprive workers of needed medical treatment and to push the costs of reasonable medical treatment off onto private health insurers, Medicare and MediCal. First, 80% of all workers injured at work are required to treat with doctors listed in the workers' compensation carrier's Medical Provider Network ("MPN"); the MPN is created and maintained by the workers compensation insurers. If a physician who is on the MPN recommends care which the insurer feels costs the insurer too much money, those physicians are weeded out by the insurer through economic profiling and taken off the MPN list. This means that doctors are reluctant to provide care which would otherwise would be reasonably medically necessary. We have had client's say that their doctor has said "I would prescribe 'X' treatment, but the carrier will bump me off the MPN."