In order to provide injured employees with access to the MPN, employers must:
Direct all injured employees to a medical provider within the California MPN Website. This site will help locate network providers specializing in Workers Compensation with a strong focus on returning injured employees back to work.
Post the California State DWC-7 Form and a panel listing of MPN providers that are in the employees' area. Create a panel of medical providers via the California MPN Website (click “Provider Panel” tab) or email your request to PPOPanelRequest@cna.com.
If you choose to email your request, please include:
- Name of insured.
- Address of insured (including zip code).
- List any specific physicians that should be included in the panel.
- Contact person.
- If the panel can be sent electronically, include an email address.
- If the panel should be sent by hard copy, include mailing address.
Timeframe for Completing Panel Submissions:
- Up to 10 panel requests will be provided within 24 to 48 hours of the request.
- Between 10 and 40 panel requests will be provided within five business days of the request.
- For more than 40 requests, the Operations team will provide an estimated time of completion.)
The Employee Notification (Spanish version) should be given to an injured employee at the time of injury.
Send a Change of MPN Notice (Spanish version) to all injured employees if there is a change in the MPN.
Send all employees a MPN Cessation/Termination Notice (Spanish version) if the MPN is no longer being used.