Can You Choose or Change Your Doctor on a Washington L&I Claim?

By Benjamin McCay, DC, CCSP

Published October 6, 2026

The provider who manages your Washington L&I claim can affect much more than the treatment you receive. Your Attending Provider may also address work restrictions, complete claim-related forms, coordinate referrals, and help guide your return to work. For that reason, having a provider who can appropriately manage your injury and communicate effectively with you can be an important part of the claim.

Workers are sometimes unsure how much choice they have, particularly if their employer initially directed them to an occupational medicine clinic or if they later decide that another provider would be a better fit. Questions can also arise about whether L&I or a self-insured employer can refuse a requested change.

Washington's workers' compensation system has specific rules governing provider choice and transfers of care. This article explains how those rules work, when you may choose or change your Attending Provider, and what options are available if a transfer request is denied.

Who Chooses Your Doctor After a Work Injury?

For your initial evaluation after a work injury, you may choose a qualified health care provider. Depending on the injury, that might be a physician, osteopathic physician, chiropractor, advanced registered nurse practitioner, physician assistant, or another provider authorized to treat injured workers.

Many workers initially go wherever they can be seen quickly, such as an emergency department, urgent care center, occupational medicine clinic, family physician, or chiropractor. Going to that provider for the first visit does not mean that you have permanently chosen that person to manage your L&I claim. A provider outside the L&I Medical Provider Network may see you for the initial office or emergency visit, but if additional treatment is needed, ongoing care in Washington must be provided by a network provider.

Your employer may recommend a particular clinic or company doctor, and many employers have established relationships with occupational medicine clinics. You may choose to use that clinic, but L&I specifically states that you have the right to choose your own doctor. Your employer cannot require you to use its preferred provider.

You also have the right to decide who, if anyone, accompanies you during a medical visit. L&I specifically states that a worker may decline to have a company nurse or other employer representative accompany them to the hospital, doctor's office, or another medical visit.

What Is an Attending Provider?

The Attending Provider, often abbreviated AP, is the primary provider responsible for managing the medical portion of your workers' compensation claim. The Attending Provider typically:

• Evaluates and manages the work-related condition.
• Develops or coordinates the treatment plan.
• Reports your progress to the claim manager.
• Addresses your ability to work and any necessary restrictions.
• Completes forms such as the Activity Prescription Form (APF).
• Refers you to specialists or other treatment providers when appropriate.
• Helps coordinate your eventual return to work.

The Attending Provider does not necessarily perform every treatment you receive. You might have an occupational medicine physician serving as the AP while also receiving physical therapy, chiropractic care, massage therapy, injections, or consultation with an orthopedic or neurosurgical specialist. Seeing another provider therefore does not automatically mean that you are changing your Attending Provider.

Can You Change Your Attending Provider?

Yes. If you initially establish care with one Attending Provider and later decide that another provider would be a better fit, you may request a transfer of care.

For ongoing treatment in Washington, the new Attending Provider must participate in the L&I Medical Provider Network and be qualified to treat the accepted injury or occupational disease. Under WAC 296-20-065, a transfer from one network provider to another must be approved by L&I or the self-insurer handling the claim.

Although a transfer is “subject to approval,” that does not give the claim manager or self-insurer unrestricted authority to prevent a worker from changing providers. The same rule specifically recognizes the worker's free choice of treating provider and states that, except under the circumstances identified in the rule, “no reasonable request for transfer to a network provider will be denied.” If a transfer is denied, the worker must be told why.

The timing of a transfer can matter. WAC 296-20-065 states that transfers normally will be allowed after the existing Attending Provider has had sufficient time to complete necessary diagnostic studies, establish an appropriate treatment plan, and evaluate whether that treatment is working. The rule also allows L&I or a self-insurer to require a change of provider in certain circumstances, such as when specialized treatment is needed outside the current provider's qualifications or scope of practice, the provider is not qualified to treat all accepted conditions, the provider is not complying with L&I requirements, or reasonable progress toward return to work is not occurring in a time-loss case.

How Do You Change Your Attending Provider?

Changing your Attending Provider is often fairly simple. Once the new provider agrees to take over the claim and the worker agrees to the transfer, clinic staff can often handle much of the process with L&I or the self-insurer. The worker does not necessarily need to complete the paperwork personally.

For a State Fund claim, the change can be reported through L&I's online Transfer of Care service, or a Transfer of Care form (F245-037-000) can be submitted. A transfer request may be submitted online by either the worker or the provider. If the paper form is used, the worker signs it to authorize the transfer.

Before transferring care, it is a good idea to confirm that the new provider:

1. Participates in the L&I Medical Provider Network.
2. Is qualified to treat the work-related condition.
3. Is accepting L&I patients.
4. Is willing to become the Attending Provider.

What About a Self-Insured Claim?

The same general provider-choice rules apply to workers whose employers are self-insured, but the administrative process is different. Instead of L&I directly managing the day-to-day claim, the self-insured employer or its third-party administrator, often called a TPA, performs many of the claim-management functions.

If you change Attending Providers on a self-insured claim, L&I provides a separate Transfer of Attending Provider Form for Self-Insured Workers (F207-114-000). The completed form is returned to the employer or TPA rather than directly to L&I.

The fact that the employer or TPA administers the claim does not eliminate the worker's rights under Washington workers' compensation law. If a transfer request is denied, there are additional options for having that decision reviewed.

Do You Have to Change Your AP to See Another Provider?

Usually not. Your Attending Provider can refer you to specialists or other treatment providers while continuing to manage the claim. For example, a worker with a lumbar disc injury might have an occupational medicine physician serving as the Attending Provider while also seeing a physical therapist, chiropractor, physiatrist, orthopedic surgeon, or neurosurgeon.

The specialist or other treatment provider addresses a particular aspect of the injury while the AP continues coordinating the overall claim. If your current Attending Provider is appropriately managing your work restrictions, referrals, and claim documentation, there may be no reason to transfer the claim simply because you need another type of treatment or specialist consultation, as your AP can usually make or coordinate the necessary referral.

The same principle applies to a second opinion. Obtaining another opinion does not by itself transfer responsibility for the claim to the consulting provider. L&I's worker guidance states that a worker may obtain a second medical opinion with claim-manager approval. When an Attending Provider refers a worker for a second-opinion consultation, however, L&I's provider guidance states that prior authorization is generally not required, although the Attending Provider should notify the claim manager.

Can a Chiropractor Be Your Attending Provider?

Yes. Washington L&I recognizes doctors of chiropractic as Attending Providers for injured workers with accepted musculoskeletal conditions involving the spine or extremities. A chiropractor serving as the AP can manage the claim within chiropractic scope of practice, including evaluating the worker, addressing work restrictions, coordinating appropriate care, and making referrals when necessary.

Receiving chiropractic treatment does not mean that you need to transfer your claim to the chiropractor. At Advanced Chiropractic, we often work collaboratively with an existing Attending Provider, particularly when that provider is already coordinating the worker's overall medical care, work restrictions, referrals, and claim documentation. Chiropractic treatment can be provided as part of that care without changing who serves as the AP. When possible, this is our preferred approach because it respects the existing provider-patient relationship, allows us to work collaboratively with the current Attending Provider, and avoids unnecessarily disrupting who is coordinating the worker's overall care.

In other cases, transferring the Attending Provider role to a chiropractor may be appropriate, particularly when the primary accepted condition is musculoskeletal and falls within chiropractic scope of practice. A transfer may reflect the worker's preference, the nature of the injury, convenience or continuity of care, or which provider is best positioned to coordinate the claim. A transfer does not necessarily indicate a problem with the care provided by the previous Attending Provider.

When Might Changing Your Attending Provider Make Sense?

There are many legitimate reasons a worker may want to change Attending Providers, and a transfer does not necessarily mean there was a problem with the previous provider. The worker may prefer a provider closer to home or work, need a provider whose scope of practice is better suited to the condition, or want a particular provider to coordinate the overall claim. Other reasons may include difficulty obtaining appointments, communication problems, delays in necessary referrals or diagnostic studies, or a change in the worker's condition that makes another type of provider more appropriate.

Changing Attending Providers does not reset the claim or change decisions that have already been made. A new AP may request additional diagnoses, treatment, referrals, or other action when medically appropriate, but becoming the new AP does not by itself add a condition to the claim, overturn a treatment denial, authorize a procedure, or change a previous L&I decision. The new provider continues working within the existing claim and Washington workers' compensation rules.

Changing Attending Providers is generally most useful when a change in overall claim management is needed. If the worker simply needs another medical opinion, a consultation may be sufficient without changing who serves as the AP.

What Should You Do If a Transfer Is Denied?

First, find out why the transfer was denied. Under WAC 296-20-065, the worker must be advised when and why a transfer request is denied. Sometimes the issue may be relatively straightforward, such as a problem with the proposed provider's network status or a need for additional information.

For a State Fund claim, contact the L&I claim manager and ask specifically why the transfer was not approved.

For a self-insured claim, first contact the employer or TPA handling the claim and ask that the decision be reconsidered. If the disagreement cannot be resolved, you may ask L&I's Self-Insurance Program to intervene or contact the Office of the Ombuds for Injured Workers of Self-Insured Employers for assistance. The Ombuds Office is an independent advocate for injured workers and can provide information, help address concerns, and investigate complaints involving self-insured claims. A decision by a self-insured employer or its TPA is therefore not necessarily the final determination of what Washington workers' compensation law allows.

Keep copies of any written denial, correspondence, transfer forms, and other relevant documents in case the issue requires further review.

The Bottom Line

Washington workers have the right to choose the provider who treats their work injury. For ongoing treatment in Washington, that provider must participate in the L&I Medical Provider Network, and a worker may request a transfer to another qualified network provider if a change of Attending Provider is needed.

Transfers require approval by L&I or the self-insurer, but that requirement is not a broad veto over the worker's choice. Washington rules specifically recognize the worker's free choice of treating provider and state that reasonable requests for transfer should not be denied except under the circumstances identified in the rule. You also do not need to change Attending Providers simply to see a specialist or receive another type of treatment; when the existing AP is managing the claim appropriately, referrals and collaborative care can often provide the additional care you need without transferring the claim.