Workers' Compensation

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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 [PDF] 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. Return the completed form 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 Western Medical Group in Torrance. This service is only provided on the first day of treatment. All subsequent transportation needs must be arranged by the employee.

Western Medical Group
21081 Western Ave., #150
Torrance, CA 90501
(310) 782-3333
Clinic Hours: 24hrs, 7 days a week

This physician pre-designation form is also available in the Forms section of the Guidelines, Procedures and Forms page.