Medical care is the heart of a workers' compensation claim. In California, your treatment is supposed to be provided at no cost to you when your injury is work-related — but the system has specific rules about which doctors you can see and how treatment gets approved.
The Medical Provider Network (MPN)
Most California employers use a Medical Provider Network — a list of doctors approved to treat work injuries. If your employer has an MPN, you'll generally choose your treating doctor from that network. You usually have the right to switch to another doctor within the MPN if you're unhappy, and to get a second or third opinion inside the network.
Predesignating your own doctor
If you told your employer in writing before your injury that you wanted your personal physician to treat you (and your doctor agreed in advance), you may be able to treat outside the MPN. This "predesignation" has to be set up ahead of time — it's not something you can do after you're hurt.
How treatment gets approved: utilization review
When your doctor recommends treatment, it doesn't always happen automatically. The request goes through utilization review (UR) — a process where the insurer checks whether the treatment matches California's official Medical Treatment Utilization Schedule (MTUS) guidelines. UR can approve, modify, or deny a request.
If UR denies or modifies treatment your doctor says you need, you have the right to challenge it through Independent Medical Review (IMR). See our IMR guide for how that works.
Your primary treating physician
Your primary treating physician (PTP) coordinates your care and writes the reports that drive your whole claim — including whether you can work, what restrictions you have, and eventually whether you have permanent impairment. Because those reports carry so much weight, it matters that your doctor clearly understands and documents how your injury happened and how it affects you.
Mileage and out-of-pocket costs
You can be reimbursed for mileage to and from medical appointments and the pharmacy, as well as certain out-of-pocket medical expenses. Keep a log of dates and distances and save your receipts.