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Understanding medical provider networks (MPNs) for California workers’ compensation

On Behalf of | Nov 28, 2023 | Workers' Compensation

One of the biggest obstacles faced by injured workers in California is getting good medical treatment within the insurance company’s medical provider network (MPN).

Each MPN is required to include doctors who specialize in treating work injuries, but sometimes the right treatment can be hard to find. In some cases, injured workers may also disagree with a doctor’s diagnosis or treatment. Following are some important things to understand about MPNs and workers’ compensation in California.

What is an MPN?

An MPN — or medical provider network — is a group of health care providers. An MPN can be set up by an insurance company or a self-insured employer. Each MPN must be approved by the California Division of Workers’ Compensation (DWC) to treat workers who have been injured on the job.

State regulations require each MPN to include multiple doctors who practice medicine generally, as well as doctors who specialize in work-related injuries. MPNs must also meet certain requirements to make it easy enough for injured workers to access the care they need. Still, it can be difficult for injured workers to find the right treatment for specific injuries or illnesses, and it helps to have an experienced workers’ compensation lawyer on your side to help you navigate the workers’ comp system and get the care you need for your injury.

IMPORTANT: State regulations require MPNs to allow you a choice of your medical provider within the MPN after your first visit.

ALSO IMPORTANT: The MPN must provide an opportunity for you to seek second and third medical opinions if you disagree with a physician’s diagnosis or treatment. If you still disagree after a second and third opinion, you can request an MPN independent medical review, also called an MPN IMR. Again, it’s important to get help from a California workers’ compensation attorney if you have questions about any aspect of the process.