The law requires that the following information be provided to injured Workers
in the state of California.
The State of California allows your employer to establish a medical provider
network (MPN) for all work-related injuries (Section 4616 of CA Labor Code
and DWC 9767). Cast & Crew's insurer is Zurich American Insurance Company
(Zurich) and utilizes the following MPN: FirstHealth.
A medical provider network (MPN) coordinates all work-related medical treatment.
The MPN is responsible for managing medical care (health care providers
and health care facilities). Treatment must be within the MPN. Your employer
will furnish provider names for your use.
In emergency situations, go to the nearest hospital or call 911. Care
outside the network is not compensable except in emergency situations.
If you are injured at work, your employer will provide the name of
a provider for the initial appointment. You are allowed to change your
provider within the MPN to a physician qualified to treat your Injury.
To change treating provider after initial treatment, call your employer,
claims professional or case manager for physician names.
An injured worker, when traveling on business, should seek the nearest
occupational health clinic or emergency facility for initial treatment.
Injured workers having difficulty arranging an appointment should call
their claims professional, case manager or employer.
You may be eligible to pre-designate a physician or to continue seeing
a physician with whom you are currently in treatment. For further information,
please contact Cast & Crew Workers' Compensation Department - (818)
The treating physician must contact the local claims office to obtain
prior authorization of treatment. Your employer, claims professional or
nurse case manager will assist you in identifying specialists.
Injured workers may receive treatment outside the MPN only if referred
by the insurer or MPN provider you are seeing. Specialty areas that are
not provided within the network will need to be pre-approved.
If you disagree with diagnosis or treatment, a second or third opinion
may be obtained. It must be requested within 20 days of the initial decision.
If a dispute continues to exist, you may request an independent medical
review from the state of CA, DWC by contacting I-415-703-4600.
The MPN is for benefits related to occupational injuries only
and does not apply to or change your employee medical benefits in any way.
If you have any questions about this document or your MCA, please contact
Cast & Crew Workers' Compensation Department - (818) 848-6022.