If you are unhappy with the medical treatment you're receiving, contact your State Fund claims representative and explain why you are dissatisfied. Our claims representative can try to resolve the problem with the physician. You can also request a change of physician at any time during your injury. Your claims administrator/State Fund must consider your request for a physician change.
Prior to 1/1/05, you may change your treating physician or chiropractor 30 days after report of the injury if you have not predesignated a doctor.
After 1/1/05, you may change your treating physician 30 days after report of the injury if you have predesignated a doctor and your employer does not participate in Medical Provider Networks. If your employer has an established Medical Provider Network, you may change to a second or third physician of your choosing within the network. If you are still dissatisfied, you may then request an Independent Medical Review regarding the disputed treatment or diagnostic service.
If your employer provides an HCO, after at least 90 days (or up to 180 days), you may go to a physician of your own choosing.
Be sure to tell your claims representative the name and address of your new physician. We'll continue to pay the approved medical bills and reasonable transportation costs once we are notified.
The information provided is not intended to supersede or be used in lieu of the “notice of benefits” handout that employers are required to provide to workers. For State Fund policyholders, this notice is in the New Employee's Guide to Workers' Compensation (English/Spanish) - e13286 [448 k].