Medical Provider Networks (MPN) in Workers Comp Cases

Workers Comp Medical Provider Networks (MPN)

MPN stands for Medical Provider Network. In the context of California Workers Comp cases, an MPN is a group of health care providers set up by a Workers Comp Insurance Company (or by a self-insured employer) to treat workers injured on the job.

Do I Have to Use an MPN Doctor (Medical Provider Network)?

It is not mandatory for an employer in California to set up and use an MPN.  So – if you have been injured at work – your employer might or might not have an MPN.

However, if your employer does have an MPN, you are required to receive medical treatment through your company’s MPN, and its doctors & health care providers for your work injuries (with some limited exceptions).

Medical Provider Network (MPN) Requirements:

All MPNs must be approved by the Division of Workers Compensation’s administrative director. California Workers Compensation Laws have very strict requirements for the establishment of an MPN by an Insurer or Employer:

  • Every MPN must include a mix of doctors who specialize in work-related injuries and doctors who have expertise in general medicine.
  • The MPNs must meet “access to care standards” for all common occupational injuries and work-related illnesses.
  • MPNs must follow all medical treatment guidelines established by the Division of Workers Compensation.
  • Employees must be given a choice of provider(s) in the network, after their first visit.
  • MPNs must offer the injured worker a second and third opinion if he/she disagrees with the diagnosis or treatment offered by the treating physician.
  • If disagreement exists after the second and third opinion, the injured worker may request an independent medical review (IMR).

Additionally, a minimum of three primary treating physicians and three providers for each commonly used specialty within the access standards must be available to injured employees.

These providers include doctors, surgeons, dentists, psychologists, optometrists, podiatrists, and physical therapists. If chiropractors & acupuncturists are commonly used by the employees being treated, then the MPNs must include acupuncturists and chiropractors as well.

Further, under the permanent Division of Workers Compensation’s MPN regulations, a toll-free number must be provided to employees for use in obtaining MPN assistance if the MPN service area covers more than one area code.

Workers Comp Attorneys Can Help With MPN Issues

Our experienced Long Beach Workers Compensation attorneys are here to help you with all aspects of your California Workers Comp Case – including issues arising from your Medical Provider Network (MPN). Our experienced lawyers would be happy to discuss your unique situation with you, to ensure that you receive the maximum workers compensation benefits for which you may qualify.

Call our Workers Compensation attorneys for a FREE CONSULTATION: 562-622-4800.

Workers Compensation attorneys for Los Angeles, Orange County & Southern California, including: Anaheim, Carson, Bellflower, Compton, Downey, Fullerton, Garden Grove, Huntington Beach, La Habra, La Mirada, Lakewood, Long Beach, San Pedro, Santa Ana, Torrance, Wilmington, Whittier and Yorba Linda.

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