ADJ21567804 · July 20, 2026

The nurse practitioner's report was not signed by a physician and thus invalid as a release from care; a nurse practitioner cannot be designated as a primary treating physician under Labor Code section 3209.10; therefore, the applicant is entitled to designate a new primary treating physician and continue medical treatment.

From the decision · page 7Here, the report is not signed by anyone other than the nurse practitioner. Applicant provided unrebutted testimony that no physician other than the nurse practitioner and a physician

The October 16, 2025 report was authored solely by a nurse practitioner without physician supervision or co-signature.

Favours Applicant prevailed

This made the report invalid as a release from care under Labor Code section 3209.10, which requires a physician's involvement for such designation.

From the decision · page 7Here, the report is not signed by anyone other than the nurse practitioner. Applicant provided unrebutted testimony that no physician other than the nurse practitioner and a physician

Cal. Code Regs., tit. 8, § 9785(a)(1)

The primary treating physician must be a physician as defined by California regulations.

The designation of Concentra as the primary treating physician was invalid as it is an entity, not a physician.

From the decision · page 7selected by the employer, the employee pursuant to Article 2 (commencing with section 4600) of Chapter 2 of Part 2 of Division 4 of the Labor Code, or under the contract or procedures applicable to a Health Care Organization certified under section 4600.5 of the Labor Code, or in accordance with the physician selection procedures contained in the medical provider network pursuant to Labor Code section 4616.

Labor Code section 3209.10

A nurse practitioner may not be designated as a primary treating physician.

The nurse practitioner's report was invalid as it was not signed by a physician, and thus could not serve as a release from care.

From the decision · page 7(Lab. Code, § 3209.3 (a).) Section 3209.10 clarifies that practitioners not specifically designated as physicians in section 3209.3 may treat injured workers, but that such practitioners, including nurse practitioners may not be designated as a PTP. It states in relevant part: (a) Medical treatment of a work-related injury required to cure or relieve the effects of the injury may be provided by a state licensed physician assistant or nurse practitioner, acting under the review or supervision of a physician and surgeon pursuant to standardized procedures or protocols within their lawfully authorized scope of practice. The reviewing or supervising physician and surgeon of the physician assistant or nurse practitioner shall be deemed to be the treating physician. For the purposes of this section, “medical treatment” includes the authority of the nurse practitioner or physician assistant to authorize the patient to receive time off from work for a period not to exceed three calendar days if that authority is included in a standardized procedure or protocol approved by the supervising physician. The nurse practitioner or physician assistant may cosign the Doctor's First Report of Occupational Injury or Illness. The treating physician shall make any determination of temporary disability and shall sign the report.

Applicant testified that he was examined only by a nurse practitioner and a physician assistant, and never by a supervising physician during treatment at Concentra.

From the decision · page 3Applicant testified that he was examined at Concentra by the nurse practitioner as well as another gentleman that was a physician assistant. (Id. 3:21-22.) He confirmed that at the last evaluation he was able to perform all the testing and did not have discomfort. (Id. at 3:22-25.) He testified that “the appointment took from six to seven minutes. He was not seen by an actual doctor.” He never met a supervising doctor either that day or at any other point during treatment at Concentra. (Id. at 4:1-4.)