Workers’ Compensation Lawyer San Diego, CA

Can you get a second opinion about medical treatment for a work injury?

Doctor checking patients elbow.

In California, there's a rarely used process that the workers' compensation attorneys at McLaughlin & Sanchez regularly utilize to help clients — and it's the second/third/MPN-IMR opinion processes contained within the laws for the medical provider network system (MPN).

Roughly 80% of all workers' compensation insurance companies use an MPN.

With very limited exceptions under California law, injured workers are mandated to receive treatment from a doctor within the insurance company’s MPN.

By law, the MPNs must allow you to get a second or third opinion from other doctors in the MPN should you question the medical treatment being recommended by the treating doctor.

In fact, after the third opinion, if you are still unsure of the treatment being recommended by the third opinion physician, an opinion may be obtained by an “MPN-IMR Physician.”

Here's what you should know...

What is an MPN-IMR?

MPN-IMR is short for a Medical Provider Network Independent Medical Review.

This is very different from most of the treatment reviews injured workers experience with respect to the insurance company's review (called utilization review – "UR") of the treatment being recommended by their treating doctor.

While this second/third/MPN-IMR process can be time-consuming, our legal team finds it very beneficial to clients.

What are the benefits of an MPN-IMR?

Most people truly appreciate having additional opinions regarding appropriate care for their work injury, and the process can be a great way to help injured workers receive the medical treatment they need and deserve.

In fact, should an injured worker's recommended medical treatment go all the way to the opinion of an MPN-IMR doctor, that doctor's opinion is final and the treatment can't be denied by the insurance company.

Injured workers can also demand a face-to-face evaluation with the MPN-IMR doctor, which provides an opportunity to speak directly with the doctor making the final recommendation for medical treatment.

"Many of our clients love the opportunity to get a second or third opinion about the medical treatment being recommended to them because it gives them peace of mind when there's a substantial recommendation for treatment being made, such as surgery," said attorney Denise LaVerde Sanchez. "While going through the process can be time-consuming, our clients don't mind because they know they'll be getting another medical opinion on treatment options.”

Attorney Sanchez also noted that clients value being able to speak with the MPN-IMR doctor in person to talk about their symptoms and discuss their concerns.

"This gives clients peace of mind because they get to talk to the actual doctor who makes the final decision on their recommended medical treatment," Sanchez said. "That means the decision wasn't made haphazardly or just on a pure review of documents like the insurance companies do for utilization reviews. Instead, clients know the MPN-IMR doctor actually took the time to review the records and evaluate them in person to determine the best medical treatment options."

McLaughlin & Sanchez can help you get the treatment you need

If you've been injured at work and want an additional opinion about the medical treatment being recommended for your injury, our workers' compensation lawyers can stand by your side and help you navigate the process.

Let our dedicated legal team take care of it all. We've got more than 30 years of combined experience handling workers' compensation claims and take pride in fighting for injured workers in California.

For a free case review, contact us today. We have offices conveniently located in San Diego, Temecula, and Chula Vista.

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