California Medical Provider Network (MPN) - CorVel Corporation

The new CA MPN has been approved by the California Department of Industrial Relations Division of Workers' Compensation's administrative director to treat workers injured on the job. Experience has shown that medical outcomes for injured workers can be maximized by allowing employees a choice of provider(s) in an approved medical provider network.

Benefits of the CA MPN are:

  • Earlier return to work – state documented
  • Lower medical costs – state documented
  • Reduced litigation through internal dispute resolution process
  • Access to care within 24 hours
  • Limited provider change once in program
  • Limits initial provider selection. Employee risks suspension of compensation benefits if treatment received from a non-network physician
  • No ceiling on control of care, as long as specialty is certified
  • Network discounts
  • Utilization Review is mandated

Access to provider lookup is available online at www.corvel.com/ppo-lookup/

You can also download CorVel's PPO Lookup App here: http://www.corvel.com/mobile-apps/ppo-lookup-app/

Login: MitSum      Password: Mitsui2015

- If your company is not currently participating in the MPN we sincerely request you immediately begin the program in order to take advantage of this opportunity to control workers' compensation cost and at the same time provide quality medical care to your injured workers.

What needs to be done to begin the MPN?

POST at each work site:

  • MPN provider panel
  • DWC-7 which includes MPN specific information
  • Pre-designation of Personal Physician form

What needs to be done to transfer from one MPN to another MPN?

CA MPN End of Coverage and Implementation Notice must be distributed:

  • To all injured workers when changing from an existing MPN to another MPN within 60 days.
  • To all employees when changing from an existing MPN to another MPN if more than 60 days have lapsed since ceasing use of a prior MPN.

POST at each work site:

  • MPN provider panel
  • DWC-7 which includes MPN specific information
  • Pre-designation of Personal Physician form

MSIG will provide the Complete Employee Information notice (0056 Mitsui Sumitomo Ins of America or 2039 Mitsui Sumitomo Ins USA) to the employee once the injury has been reported to MSIG. This will serve to educate the employees regarding the MPN and advise them how they can access the MPN network.

CorVel Corporation may be contacted via:

The MSIG claim office in Los Angeles, California can assist you with any questions. Please direct your inquiries to Greg Averetta. He can be reached via:

MSIG sincerely thanks you for your participation and cooperation in this vital program.


Please click on the links to the following forms that are available for your use:

Standard Claims and MPN Materials:

Report a Claim: Workers' Compensation Claim Form (DWC 1) & Notice of Potential Eligibility

Post at Workplace: Notice to Employees—Injuries Caused by Work (DWC 7): 0056 2039

Provide at Time of Injury: Complete Employee Information notice - 0056 Mitsui Sumitomo Ins of America - 05: (English & Spanish versions)

Provide at Time of Injury: Complete Employee Information notice - 2039 Mitsui Sumitomo Ins USA - 06: (English & Spanish versions)

Make Available as Requested: Pre-designation of Personal Physician (English & Spanish versions)

Optional Kaiser MPN Documents

Post at Workplace: Notice to Employees—Injuries Caused by Work (DWC 7): 2389 2390

Provide at Time of Injury: Complete Employee Information notice - 2389 Mitsui Sumitomo Ins of America - 05: (English & Spanish versions)

Provide at Time of Injury: Complete Employee Information notice - 2390 Mitsui Sumitomo Ins USA - 06: (English & Spanish versions)

MITSUI SUMITOMO INSURANCE®