Can a Chiropractor be Predesignated as a Personal Physician?
If ten practitioners familiar with workers’ compensation law were asked if a chiropractor can be predesignated as a personal physician, the likelihood is that nine (if not all ten) would say yes.
Although a chiropractor is included within the Labor Code definition of a physician, (Labor Code section 3209.3), Labor code section 3209.6 delineates the scope of the definition making it clear that a chiropractor may not hold him or herself out as a physician.
This delineation is consistent with Labor Code section 4600(d)(2)(A) which allows an injured worker to be treated from the date of injury by his or her personal physician if the physician or surgeon is licensed under section 2000 of the Business and Professions Code – i.e., the Medical Practice Act.
Chiropractors are licensed under section 1000, et seq. which states: “The license to practice chiropractic shall authorize the holder thereof to practice chiropractic in the State of California as taught in chiropractic schools or colleges; and, also, to use all necessary mechanical, and hygienic and sanitary measures incident to the care of the body but shall not authorize the practice of medicine, surgery, osteopathy, dentistry or optometry, nor the use of any drug or medicine now or hereafter included in materia medica.” (Bus. & Prof. Code sections 1000-7; Crees v. California State Board of Medical Examiners, (1963) 213 Cal.App.2d 195).
The misunderstanding arises from the fact that, although a chiropractor can be pre-designated for a change of physician under section 4601, a chiropractor cannot be pre-designated to treat for the effects of a work injury from the date of injury under section 4600. The date of injury pre-designation is limited to medical doctors.
It has been argued that Rule 9783.1 is authority for the right of an injured worker to pre-designate a chiropractor in contravention of the mandate of section 4600(d)(2)(A). Rule 9783.1 is nothing more than a sample form and applicable only to the situation where the issue is a change of physician. More importantly, a regulation cannot confer statutory authority and no regulation adopted is valid or effective unless consistent and not in conflict with the statute and reasonably necessary to effectuate the purpose of the statute. (Gov. Code section 11342.2.)
The practical importance of understanding the difference between a date of injury pre-designation and a change of physician pre-designation is where an employer has not established a medical provider network but retains control of medical treatment for the first 30 days.