Choosing a Doctor After a Workplace Injury
The Pennsylvania workers’ compensation system is set up to provide payment of medical expenses and lost wages related to an on-the-job injury. In-order to start off the process, a worker must simply report the injury to his or her employer. The Pennsylvania workers’ compensation system is set up to provide payment of medical expenses and lost wages related to an on-the-job injury.
A worker does not need to sue his or her employer to prove that the employer is at fault or responsible for the injuries; a worker must simply report the injury to his or her employer to start off the workers’ compensation process.
One question that often arises however, related to on-the-job injuries, is whether a worker is free to choose his or her own doctor for treatment. It is not hard to understand why an injured person would prefer to see the family physician after an injury – the practice of medicine is built on trust with the patient as well as knowledge of the a person’s medical history. After a workplace injury, the last thing an injured employee may want to do is visit the office of a stranger and create a new medical history when his or her own doctor is already well aware of any existing medical conditions or concerns.
Conditions On The Right To Choose A Healthcare Professional
In Pennsylvania, seeking medical treatment after a workplace injury, is just not that simple. The PA Workers' Compensation Act allows employers to create a list of health care professionals from whom injured employees can seek treatment. In order for an injured worker to secure payment under the workers’ compensation system, he or she must see and be treated by a doctor chosen by the employer.
An employer must maintain a listing of approved medical professionals for injured workers. The employer’s list must contain:
• At least six approved healthcare professionals;
• Geographically accessible health care professionals;
• At least three physicians;
• The address, telephone number and specialty of each listed professional;
• No more than four medical professionals who are part of a coordinated care organization.
If there is no chiropractor or other professional with a necessary specialty on the employer’s list, the employee is free to choose his or her own.
If a doctor from the employer-approved listing recommends invasive treatment or surgery, the injured employee may seek a second opinion from a doctor of his or her choosing. If the second opinion recommends a different course of treatment and the injured worker chooses to follow that recommendation, he or she must again seek treatment from an approved health care professional on the employer’s list.
An injured employee must continue to seek treatment from an employer-designated health care professional for at least 90 days, if the injury warrants follow-up care. After 90 days, an injured employee is free to choose his or her own doctor for continued care related to the workplace injury.
Legislation was introduced in 2011 to extend the time period to 180 days but it has not yet been passed.
If you have questions about choosing your doctor after suffering a workplace injury or if your workers’ compensation claim has been improperly denied, a Philadelphia workers compensation lawyer can help you understand the process and secure appropriate benefits.
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Disclaimer: While every effort has been made to ensure the accuracy of this publication, it is not intended to provide legal advice as individual situations will differ and should be discussed with an expert and/or lawyer. For specific technical or legal advice on the information provided and related topics, please contact the author.