The following information is an overview of the pre-designation process. Please read the Pre-Designation of Physician form - English (PDF) / Pre-Designation of Physician form - Spanish (PDF) completely for all the information regarding this process.
Pre-designation of a Physician
If you are injured at work, you are required to seek treatment at a designated medical facility. If you pre-designate a physician, you will have to seek treatment through a designated medical facility until we receive documentation of the physician's agreement to be pre-designated.
You are able to pre-designate a provider if the following conditions are met:
- Your employer offers group health coverage
- The doctor is your regular physician, who shall be either a physician who has limited his or her practice of medicine to general practice or who is board-certified or board eligible internist, pediatrician, obstetrician-gynecologist, or family practitioner, and has previously directed your medical treatment, and retains your medical records;
- Your "personal physician" may be a medical group if it is a single corporation or partnership composed of licensed doctors of medicine or osteopathy, which operates an integrated multi-specialty medical group providing comprehensive medical services predominantly for non-occupational illnesses and injuries;
- Prior to the injury your doctor agrees to treat you for work injuries or illnesses;
- Prior to the injury you provided your employer the following in writing: (1) notice that you want your personal doctor to treat you for a work-related injury or illness, and (2) your personal doctor's name and business address.
Pre-designation of a chiropractor or acupuncturist
Please read the Notice of Personnal Chiropractor or Personal Acupuncturist- English Spanish completely for all the information regarding this process.