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What To Do if You Disagree With a Workers’ Comp Doctor in California
If you suffered an injury on the job and feel that your pain is not fully understood or that treatment ended too quickly, you may need to speak to a workers’ comp attorney. In California, a doctor’s opinion plays a major role in how a claim moves forward. Speak with a Morgan Hill, CA workers’ compensation lawyer who can help you understand your options and what steps may help protect your benefits.
Why Does the Workers’ Comp Doctor Have So Much Control Over My Case?
Medical opinions guide nearly every part of a California workers’ compensation claim. The treating doctor decides what care is needed, whether you can work, and when recovery is complete. These opinions also influence disability benefits and long-term outcomes.
California Labor Code § 4600 requires employers and insurance carriers to provide medical treatment that is reasonably required to cure or relieve the effects of a work injury. Because the law ties benefits and treatment to medical findings, insurance companies rely heavily on doctors’ reports when making decisions.
Disagreeing with a doctor does not mean your case is failing. It often means there is a medical dispute that needs to be resolved through the process set out by California law.
What Is a Qualified Medical Evaluation (QME) in California?
A Qualified Medical Evaluation, or QME, is used when there is a disagreement about medical issues in a workers’ compensation case. These disputes may involve diagnosis, treatment needs, work restrictions, or disability status. A QME provides an independent medical opinion to help resolve those disagreements.
California Labor Code § 4062 explains how medical disputes are raised and how the QME process begins. In many cases, a panel of doctors is requested from the state. One doctor from that panel is selected to examine you and review your medical records. The QME then prepares a written report that addresses the disputed issues.
QME reports often carry significant weight. Judges may rely on them when deciding benefits, so it is important to attend the evaluation and provide complete and accurate information about your injury.
Can I Change My Workers’ Comp Doctor in California?
Some injured workers are able to change their treating doctor, but the rules depend on the situation. Many employers use a Medical Provider Network, also called an MPN. An MPN is a group of doctors approved to treat workers’ compensation injuries.
In California, if you are being treated within an MPN, you are usually allowed to change doctors within that network if you are not comfortable with your current provider. There are specific steps and time limits that apply. Changing to a doctor outside the network is more challenging and usually requires special circumstances.
How Does a Medical Dispute Affect My Workers’ Comp Benefits?
Medical disputes can affect several parts of your workers’ compensation claim. Depending on the issue, benefits may be delayed or adjusted while the disagreement is reviewed. Common areas that may be impacted include:
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Medical treatment approvals, including therapy, medications, or procedures
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Temporary disability payments if the doctor believes you can return to work
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Permanent disability ratings that affect long-term payments or settlement value
Not all benefits stop during a dispute, but delays can happen. Keeping appointments, following treatment plans, and responding to notices on time can help reduce disruptions.
Schedule a Free Consultation With Our Santa Clara County, CA Workers’ Compensation Attorney
A disagreement with a workers’ comp doctor does not mean your case is over. California law provides clear ways to challenge medical opinions and seek fair treatment. If you need help, a Morgan Hill, CA workers’ compensation lawyer at Raul Martinez Injury Law Firm can guide you through your options and next steps.
Our team brings many years of combined experience focused on workers’ compensation law. Contact us today at 408-848-1113 to schedule a free consultation. Hablamos Español.
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If you are facing challenges with a workers’ compensation claim, reach out to Raul Martinez Injury Law Firm today. You will receive clear guidance, steady support, and an advocate who understands how much this moment matters. Call 408-848-1113 to get the help you need.
