"Can I get a second opinion?"

Route 1 — just change doctors inside the network

If your employer has a Medical Provider Network, 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 review.

And the MPN route has an exit that nothing else does. Under § 4616.4, 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 review — and a UR denial is appealed through Independent Medical Review, on a 30-day deadline.

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

And check the UR decision for procedural defects first — a defective UR decision goes to a judge rather than into IMR, which is a materially better forum. How to check.

Route 4 — the medical-legal evaluation

If the dispute is about your permanent disability, your work restrictions, apportionment, or causation — not about a specific treatment — that is resolved by a QME or an AME.

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