Pre-Designating a Physician

Workers' Compensation

Pre-Designating a Doctor

Employees have the option of pre-designating their personal physician as their treating physician in the event of a work-related injury/illness. The Pre-designation of Physician form must be filled out, signed by the doctor and submitted to the Human Resources Management department prior to a work-related injury/illness. The law defines "personal physician" as:

1.) The employee's regular licensed physician or surgeon;

2.) Who is the primary care physician and has previously directed the employee's treatment and retains the employee's medical records and medical history;

3.) And who agrees to be pre-designated.

Employees bear the responsibility of keeping their physician pre-designation current. If you choose to pre-designate, the form must be completed and signed by you and your personal physician. Please upload the completed form to our Secure dropbox or return to Human Resources Management, WH-A340.

If you have pre-designated a physician but are unable to drive or cannot arrange for timely transportation, Human Resources Management will only arrange transportation to our approved occupational clinics. This service is only provided on the first day of treatment. All subsequent transportation needs must be arranged by the employee.

Please upload Workers' Compensation form(s) and supporting documents to our HR Medical Related Supporting Document Submission secure Dropbox