“Can I get a second opinion?”

Route 1 — just change doctors inside the network

If your employer has a Medical Provider NetworkMPN Medical Provider Network. Your employer’s list of physicians. After the first visit you may switch within it without permission., you may switch to any other physician in it after the first visit — without asking permission.

This is the most under-used right in the treatment process. If you do not like your treating physician, change. No form, no fight, no deadline.

The employer must give you access to a current MPN provider list. How the MPN works.

Route 2 — the MPN second and third opinion process

If you disagree with your MPN physician’s diagnosis or treatment plan, §§ 4616.3 and 4616.4 provide an escalating process: a second opinion from another MPN physician, then a third, then MPN independent medical reviewIMR Independent Medical Review. The appeal from a UR denial. 30 days (10 if the dispute is only over drugs on the MTUS Drug List)..

And the MPN route has an exit that nothing else does. Where the reviewer agrees with you, “the injured employee may seek the disputed treatment or diagnostic service from a physician of his or her choice from within or outside the medical provider network,” and the employer is liable for the cost.

Route 3 — IMR, when a specific treatment was denied

If the dispute is whether a specific requested treatment is medically necessary, that went through utilization reviewUR Utilization Review. The process that approves, modifies, or denies each treatment request. A modification is a denial of what it left out. — and a UR denial is appealed through Independent Medical Review, on a 30-day deadline (10 if the dispute is only over drugs on the MTUSMTUS Medical Treatment Utilization Schedule. California’s treatment guidelines. Four of them — shoulder, elbow, hand/wrist/forearm and traumatic brain injury — were replaced January 2, 2026. Drug List).

Note a modification is a denial of what was left out, and it starts the same clock. More.

And check first whether the UR decision was on time — under Dubon II (WCABWCAB Workers’ Compensation Appeals Board. The court system that decides these cases. 23 district offices statewide. en banc, 2014), an untimely UR decision is invalid and the dispute goes to a judge rather than into IMR, which is a materially better forum. Every other defect in a UR decision is resolved by IMR. How to check.

Route 4 — the medical-legal evaluation

If the dispute is about your permanent disabilityPD Permanent Disability. Compensation for lasting impairment. A different and much lower weekly rate — 2026 maximum $290/week., your work restrictions, apportionmentApportionment Dividing permanent disability between industrial and non-industrial causes. It is to disability, not to findings on an image., or causation — not about a specific treatment — that is resolved by a QMEQME Qualified Medical Evaluator. A state-certified physician who resolves disputes. Unrepresented workers get a panel of three by random draw. or an AMEAME Agreed Medical Evaluator. A physician both sides agree on. Available only to represented workers, and practically very hard to move away from..

Represented workers can agree on an AME. Unrepresented workers get a QME panel from a random draw. The panel deadlines are short and unforgiving. The QME process. · What is an AME?

Which route is which