Work Comp MPN Rule
Hi everyone Dustin here from Lawatyourside.com and a question I get all the time is, Can I treat with my own personal doctor through my own insurance for a work related injury?
Let’s say you get injured at work, can you go to your own doctors? Can you go through doctors with your own insurance? Or do you have to go to a doctor through your work? And the answer is, it depends.
If your work has what’s called an MPN (medical provider network) generally speaking you’re supposed to treat with the MPN. Now if you don’t treat with their doctors and you treat it on your own technically you may have to pay for you doctor appointments out of your own pocket. So if you go to treat on your own, you don’t have any health insurance but you treat on your own, technically you may have to pay for those doctor appointments.
If you have an attorney representing you, those doctors may be treating you on a lien basis. So the doctors aren’t going to come after you personally for reimbursement of the medical expenses, but they may go after the insurance company later on.
Now if you go through your own personal insurance, maybe personal insurance aside from your work related insurance, you can do that but the workers comp may or may not have to pay for your personal doctors.
The main issue that comes with this is, if your employer has accepted your claim, and they’re providing medical treatment to you, generally it could be good to go with them. But what happens a lot of times is that the doctors who are working for the employers and for the insurance companies, they are being paid by the employers, paid by the insurance company so sometimes you’ll see that they don’t provide full treatment.
Either they will send you back to work too early, they don’t do the proper diagnostic testing on you that you may need, they may not give you the full treatment that you may need so they send you back to work and you’re still in pain. And you can’t go back to work or maybe they do provide treatment but at the end of the treatment they say that your permanent disability level, which is the disability that you have, they may rate it too low. They may rate it lower than what it really is because if they’re rating it too high and providing too much treatment and providing surgeries, they probably not going to be on that medical provider network very long.
So, generally speaking you should be treating with them but if they’re not providing you proper treatment or their impairment rating is too low, in the end that may come to a point where you want to call an attorney and get their advice. You are entitled to medical treatment and if a doctor with the medical provider network is not providing proper treatment then you may be entitled to go outside of the network and treat with your own doctor or treat on a lien basis or treat outside and the insurance company would have to pay, it would not be coming out your pocket.
It really is a fact specific case, there’s case law on it, there’s a lot of rules on it. It’s really important to talk to someone who has really navigated those areas and dealt with that. It can get more complicated if that’s what happening to you.
If you want further assistance in your work related injury or you want to talk to a lawyer and want your questions answered or you want us to represent you in your workers compensation case please feel free to give us a call in the number below or click the link below and fill out the submission form and well do our best and work our hardest to ensure that we give you all the benefits that your entitled to under the law and we help you have a smooth efficient case so you can get back to be as healthy as you can be and also receive all the benefits that you’re entitled too. Thanks so much.