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Requesting Consulting Physicians Within an MPN

Posted by Sure S. Log on Feb 22, 2023 12:51:44 PM

Labor Code 4616.3(c) establishes a process that allows injured employees to obtain second and third opinions from physicians within a medical provider network. It states, "If an injured employee disputes either the diagnosis or the treatment prescribed by the treating physician, the employee may seek the opinion of another physician in the medical provider network. If the injured employee disputes the diagnosis or treatment prescribed by the second physician, the employee may seek the opinion of a third physician in the medical provider network."

Per LC 4616.4(b), "If, after the third physician's opinion, the treatment or diagnostic service remains disputed, the injured employee may request an MPN independent medical review regarding the disputed treatment or diagnostic service still in dispute ... in accordance with Section 4616.3." That's referred to as an MPN IMR.

California Code of Regulations § 9767.7 supports those statutes. CCR 9767.7(a) restates that an employee may obtain a second and third opinion from physicians within an MPN if he or she disputes either the diagnosis or the treatment prescribed by the treating physician. CCR 9767.7(b) states that to invoke that right, the employee must:

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Topics: MPN, Medical Treatment, IMR, LC 4616.3

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