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PRIMARY TREATING PHYSICIAN (PTP)

Defined by 8 CCR §9785: The “primary treating physician” is the physician who is primarily responsible for managing the care of an employee, and who has examined the employee at least once for the purpose of rendering or prescribing treatment and has monitored the effect of the treatment thereafter. The primary treating physician is the physician selected by the employer, the employee pursuant to Article 2 (commencing with section 4600) of Chapter 2 of Part 2 of Division 4 of the Labor Code, or under the contract or procedures applicable to a Health Care Organization certified under section 4600.5 of the Labor Code, or in accordance with the physician selection procedures contained in the medical provider network pursuant to Labor Code section 4616.

Note that under Labor Code §4061.5, “The treating physician primarily responsible for managing the care of the injured worker or the physician designated by that treating physician shall, in accordance with rules promulgated by the administrative director, render opinions on all medical issues necessary to determine eligibility for compensation. In the event that there is more than one treating physician, a single report shall be prepared by the physician primarily responsible for managing the injured worker's care that incorporates the findings of the various treating physicians.”

A “secondary physician” is any physician other than the primary treating physician who examines or provides treatment to the employee, but is not primarily responsible for continuing management of the care of the employee. 8 CCR §9785(a)(2). An employee may have no more than one primary treating physician. 8 CCR § 9785(b)(1).

The term "physician" is defined in Labor Code §3209.3. But see the following sections (3209.4 through 3209.10) for further clarification of who is and who is not a "physician" and for what purpose. Note that "a state licensed physician assistant or nurse practitioner, acting under the review or supervision of a physician and surgeon pursuant to standardized procedures or protocols within their lawfully authorized scope of practice" may provide treatment (Labor Code §3209.10).

There are special provisions when the Primary Treating Physician is a doctor of chiropractic.

If the employer mandates an injured workers' participation in its medical provider network (MPN), disputes regarding an applicant's need for treatment are governed by LC 4616.3.

Treatment is controlled by MTUS (state-mandated guidelines); see too Medical TreatmentMedical Provider NetworkChange of Treating PhysicianChiropracticUtilization ReviewIndependent Medical Review

Label Item Links Comments
Labor Code Labor Code §4600
LC §4600   
 

Change of Primary Treating Physician

"In the event that there is more than one treating physician, a single report shall be prepared by the physician primarily responsible for managing the
injured worker's care that incorporates the findings of the various treating physicians."


LC §4601

LC §4061.5
 
Regulations/Rules Directory of Primary Treating Physician regs

Reporting duties of PTP

Request for Authorization
Regs for PTP

8 CCR §9785

8 CCR §9785.5
 
Cases

Forms PTP's progress report

PTP's permanent and stationary report (2005 rating schedule)

PTP's permanent and stationary report (1997 rating schedule)

Request for Authorization
PR-2

PR-4


PR-3


RFA
 
Websites California Society Of Industrial Medicine (CSIMS) CSIMS   
Practice Tips  See CSIMS' practice tip for physicians' use of RFA CSIMS RFA Practice Tip  
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