Work Comp Medical works with several qualified physicians. Click here to see list of physicians.

STEP 1: Download Intake Form: Click Here
STEP 2: Print Intake Form
STEP 3: Fill out and Fax to 619-704-1077

Note:

• Injuries before 2005- parties are allowed to choose a QME after an AME attempt.
• Injuries after 2005- parties request a panel of QME’s

For more info see FAQ relating to: SB 899
STEP 1: Download Intake Form: Click Here
STEP 2: Print Intake Form
STEP 3: Fill out and Fax with the AME Attempt Letter to 619-704-1077

Click here to see list of physicians.

STEP 1: Download Intake Form: Click Here
STEP 2: Print Intake Form
STEP 3: Fill out and Fax with relating documentation to 619-704-1077

• If applicable; Please fax authorization letter.
• If applicable; please fax physician referral for consult and treatment.

Click here to see list of physicians.

Consultation and Treatment:
STEP 1: Download Intake Form: Click Here
STEP 2: Print Intake Form
STEP 3: Fill out and Fax with relating documentation to 619-704-1077

• If applicable; Please fax authorization letter.
• If applicable; Please fax physician referral for consult and treatment

Click here to see list of physicians.

Currently, there are very few MPN’s that have treating psychiatrists that will take workers’ compensation patients. Our staff will seek authorization outside the MPN.

Additional information:
Title 8, California Code of Regulations, sections 9767.1 – 9767.15 (MPN regulations).
The regulations are posted: http://www.dir.ca.gov/dwc/mpn/DWC_MPN_Main.html

Click here to see list of physicians.