Changing Your Doctor After Being Discharged from Care

At Franco Muñoz Law Firm, we want to help you understand your rights when it comes to workers’ compensation. One important topic is what happens if you want to change your treating doctor after you have been discharged from care. Let’s break it down.

What Does Discharged from Care Mean?

When your treating doctor says you are “discharged from care,” it means:

• Your injury is considered permanent and stationary (not expected to improve or worsen).
• You are cleared to return to work.
• No more doctor visits or treatments are needed.

The Old Rule: Tenet/Centinela Case

A long time ago, in a case called Tenet/Centinela Hospital Medical Center v. WCAB (Rushing) (2000), the court decided that if a doctor says you are discharged, you can’t change your treating doctor just because you might need future medical care. You had to follow specific rules to change doctors.

The New Rules: What Has Changed?

Now, the rules have changed. According to current laws:

• You can choose a new treating doctor if your current doctor says you need ongoing or future medical treatment.
• If you are part of a Medical Provider Network (MPN), you can pick a new doctor from the MPN after your first medical evaluation.

The Gonzalez Case

In a more recent case called Gonzalez v. Vermont Healthcare Center (2024), the Workers’ Compensation Appeals Board (WCAB) looked at these new rules. Gonzalez got injured and was treated by an MPN doctor who later discharged him, saying he was cured with no need for further treatment. Gonzalez tried to pick a new doctor within the MPN, but the employer denied it.

What Did the WCAB Decide?

The WCAB said Gonzalez couldn’t choose a new treating doctor after being discharged. The law says if you disagree with your discharge, you must use the Qualified Medical Evaluator (QME) process to dispute it. Here’s what you need to know:

• If your doctor says you are discharged, you can’t automatically pick a new doctor.
• If you think you still need treatment, you have to go through the QME process to challenge your discharge.
• If the QME says you need more treatment, then you might be able to choose a new treating doctor.

Important Points to Remember

• Released from Care: This means your doctor thinks you don’t need any more treatment.
• QME Process: If you disagree with being discharged, you can use the QME process to get a second opinion.
• Medical Provider Network (MPN): If you are in an MPN, you must choose a doctor from within the network unless otherwise directed by the QME process.

What Should You Do?

If your treating doctor has discharged you and you believe you still need medical care, follow these steps:

1. Request a QME: Ask for a Qualified Medical Evaluator to review your case.
2. Get a Second Opinion: The QME will decide if you need more treatment.
3. Follow the QME Decision: If the QME says you need more treatment, you can then choose a new treating doctor.

Understanding these rules can help ensure you get the medical care you need after a workplace injury. If you have any questions or need help with your workers’ compensation claim, contact Franco Muñoz Law Firm today.