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California employers gain more control over workplace injury care

Residents of San Diego and other areas in California might be aware that a change in state policy makes a new form of treatment option available to employers in the event of an injury connected to a workers' compensation claim. It may be helpful for employees to be aware of these changes and the implications that they have in terms of medical care provided to injured employees.

What is a medical provider network?

Several years ago, Medical Provider Networks became available to California employers for workers' compensation. An MPN is essentially a group of health care providers that has been approved by the state's Division of Workers' Compensation to treat employees that were injured while working. The state requires that MPNs adhere to certain standards of quality for the treatment of common workplace injuries, and under law an injured employee always has the right to request a second or third medical opinion if there is an issue with the primary treating physician.

Extension of employer medical control

A recent study conducted by the California Workers' Compensation Institute showed that the use of physician networks has greatly increased since the MPN policy became effective in 2005. In fact, it is at an all-time high as more and more injured employees are being channeled through physicians' networks.

The study showed that the use of physician networks for outpatient services relating to workers' compensation claims increased from 51 percent in 2004, right before the MPN policy was enacted, to over 64 percent of claims in 2005. The utilization of MPNs within the 30 days after the injury has grown only slightly from 70 percent of claims in 2004 to 74 percent of claims in 2005. In contrast, the utilization of physician networks for services past the initial 30 days after the injury grew from 39 percent of claims in 2004 to 57 percent of claims in 2005.

This shows that employer controlled networks are treating injured employees for longer periods of time than they were before MPNs were established. The numbers from the study show that the use of networks has become a lot more common, and that it is now typical in California for injured employees to go through a network provider from the very beginning of their claim.

Workers' compensation benefits

An attorney who specializes in workers' compensation claims can be of assistance with any questions or issues that arise during the course of the claim, whether it relates to the treatment being given to the employee or any other part of the legal claim. Injured workers can receive help at any point in the claims process. A San Diego workers' compensation attorney can help the injured worker and their families with the claims process.

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