Seeking Medical Treatment After a Work Injury in Pennsylvania
In their list of Frequently Asked Questions, the Pennsylvania Department of Labor and Industry makes clear that whether an employee has a choice of health care provider depends upon whether their employer has accepted their claim and posted in the workplace a list of providers. According to the Workers’ Compensation Act, Pennsylvania law requires that employers post a listing of health care providers that are not necessarily doctors, and the listing must meet certain requirements. Provided the employer has met this requirement, treatment may be covered for the first 90 days.
A “proper” listing of health care providers, also deemed a “panel posting,” must have at least six providers. Of the total providers, at least three must be doctors, with their identifying name, address, contact info, and specialty stated. Providers listed must be in the nearby vicinity, accessible to injured employees. Additionally, the specifics regarding the list state that it must be prominently displayed, and the employer must have the worker’s signature that they were made aware of the list at the time they were hired or after their injury.
Workers’ compensation insurance carriers are only required to pay for treatment with listed health care providers for the first 90 days of treatment. Injured workers are entitled to choose any health care provider listed on the panel, and the employer cannot direct them to a specific provider. Provided that the treatment chosen by an employee is reasonable, necessary, and related to the work injury, the workers’ compensation insurance carrier will potentially cover payment for treatment in a specialty not listed on the panel.
When employees seek treatment from a doctor not listed on the panel, the workers’ compensation insurance carrier may not provide coverage for treatment. If 90 days have passed since the injury, or if the employer did not post a proper panel posting, workers may seek treatment with any physician they like. Employers should be notified of this selection, and during the period of receiving treatment, the workers’ compensation insurance carrier is entitled to receive monthly reports from the treating provider.
After an injured worker begins to receive workers’ compensation benefits from an employer or insurer, they do have the right to request that the worker see the doctor of their choice to be examined. If a worker refuses, the employer has the right to request that a workers’ compensation judge require an examination. Workers who fail to attend this mandated examination may find their benefits have been suspended.
Injured workers seeking treatment may need to give their health care providers information concerning their claim. For example, information that the worker may have received from their insurance carrier can be provided to the medical professional by making a copy of a letter or form.
The workers’ compensation attorneys at Needle Law Firm represent injured workers and their families throughout Pennsylvania. If you are seeking medical treatment, we can provide assistance in selecting a provider and ensuring that you have a strong chance of reimbursement for your claim. If you or someone close to you has suffered an injury at work, you may be able to recover benefits, lost wages, and medical costs. To schedule a free consultation with a skilled attorney, call (570) 344-1266 or reach us online.
More Blog Posts:
What Happens to My Pennsylvania Workers’ Compensation Benefits if I’m Laid Off or Terminated While Receiving Benefits? Pennsylvania Accident Lawyer Blog, February 9, 2017
Refusing Surgery and Treating Conservatively: Can Injured Workers Lose or Forfeit Their Right to Pennsylvania Workers’ Compensation? Pennsylvania Accident Lawyer Blog, December 26, 2016