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Supreme Court to review case involving reports from doctors outside of workers comp medical network


The California Supreme Court is set to review an appellate court ruling in Elayne Valdez v. Workers' Compensation Appeals Board, a case that allowed doctors who are not part of an employer's workers comp medical network to submit medical reports in comp cases.

The high court's seven justices voted unanimously Wednesday to review the Valdez case, according to the Supreme Court docket. The court will consider an unpublished ruling by California's District Court of Appeal from last May, which allowed the admission of reports from doctors outside of medical provider networks.

Ms. Valdez was injured in 2009 while working for Warehouse Demo Services, court records show. She began treatment with a physician who was a part of the company’s established provider network for workers comp.

However, she later sought treatment from a non-network doctor referred by her attorney after complaining the MPN physician caused her more harm than good.

The employer and insurer Zurich North America argued that Ms. Valdez did not “avail herself of the ability to change her treating physician to another physician within the MPN” as called for by regulations, according to records in the appellate court case. But Ms. Valdez argued that she was never told “how she could go about changing doctors within the MPN.”

The Workers' Compensation Appeals Board ruled that Ms. Valdez had the right to seek second and third opinions from doctors within the MPN. It also ruled that California's labor code “precludes the admissibility of non-MPN medical reports with respect to disputed treatment and diagnosis issues.”

California's second district appellate court annulled that decision last spring. It ruled there is "no statutory requirement that the employee's treating physician be part of the employer's MPN," and that state law allows any "medical records 'relevant to the determination of the medical issue'" to be used in workers comp cases.