In a new panel decision by the reconsideration unit, the Board ruled for the first time that nothing in the Labor Code prevents an employee from treating with a doctor of his own choice outside his employer's Medical Provider Network.
The case is Jesse Chavez vs. Brinks, Inc and Liberty Mutual, LBO 389599.
The employer met all the requirements regarding MPN's and the employee had not pre-designated a doctor.
Nevertheless, the panel overturned the trial judge's ruling that the employee was entitled only to treatment within the MPN. It ruled that Labor Code Section 4605 didn't stop the employee from going outside the MPN (the section reads: "Nothing contained in this chapter shall limit the right of the employee to provide, at his own expense, a consulting physician or any attending physicians whom he desires.").
But applicants' attorneys shouldn't uncork the champagne just yet. First, aside from a probable appeal, nothing in the decision changes the current system of PD rating evaluations outlined in Sections 4060, 4061 and 4062. Second, most employees can't afford to pay for their own treatment and the decision doesn't answer the question of who's going to pay for the doctor (since Section 4605 says "at his own expense").
So this might help more well-to-do employees with treatment options (and maybe those with concurrent health plans they can use) but not many others.
Only time will tell what to make of this... but it does spice things up a bit.
- Help for the Injured Worker
