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CALIFORNIA STATE UNIVERSITY LOS ANGELES Employee Predesignation of Personal Physician The California Labor Code grants an employee, who has sustained an occupational injury or illness the right to

How to fill out predesignating a personal physician

How to fill out predesignating a personal physician

1. Fill out a predesignation form provided by your health insurance plan or employer.
2. Provide your personal information, such as full name, date of birth, and contact information.
3. Indicate the name and contact information of the physician you wish to predesignate.
4. Sign and date the form to indicate your agreement with the predesignation.

Who needs predesignating a personal physician?

1. Individuals who want to ensure they receive care from a specific physician or specialist when seeking medical treatment.
2. Patients with chronic conditions who have an established relationship with a healthcare provider and want to continue receiving care from them.

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What is predesignating a personal physician?

Predesignating a personal physician allows an employee to choose a doctor before they suffer a work-related injury, ensuring that they can receive medical treatment from a preferred physician.

Who is required to file predesignating a personal physician?

Employees who wish to predesignate a physician are required to file predesignating forms with their employer.

How to fill out predesignating a personal physician?

To fill out a predesignating form, the employee must complete a specific form provided by their employer, which includes the personal physician's details and any necessary signatures.

What is the purpose of predesignating a personal physician?

The purpose of predesignating a personal physician is to streamline the process of receiving medical care for work-related injuries by allowing employees to choose a trusted physician in advance.

What information must be reported on predesignating a personal physician?

The information required includes the employee's name, the physician's name and contact information, and any necessary signatures from both the employee and the employer.