One of the misconceptions many workers have is that the Pennsylvania Workers’ Compensation system requires a worker to undergo treatment for workplace injuries from a company specified doctor only. However, this is not the whole truth.
Can you stick with your preferred physician/medical-center?
The quick answer is ‘yes’. However, your employer may require you to subscribe to a “Panel Acknowledgement” at the time of hiring, which can be re-iterated immediately after your injury. With this, the employer may provide a list of at least 6 qualified physician names.
If these conditions are fulfilled, you will be required to seek treatment from a doctor from this list for the first 90 days post your injury. Once this time limit is over, you are free to choose your own doctor for additional treatment.
If the employer has not fulfilled the above-described conditions, you can choose your own doctor in Pennsylvania right after your injury.
Regardless of injury, your employer may also mandate the need for a physical exam by a specified physician, once or twice a year.
How extensive is the list of employer-specified medical providers?
Typically, this list is extensive enough to cover your treatment for the first 90 days.
This list must include at least 3 doctors, and a maximum of 4 health care providers. After your initial visit, you can choose to seek treatment from a single doctor, or a combination of doctors/care centers specified on the list.
There is also additional provision made for specialized cases. For example, if you require a chiropractor and there is none specified in the list, you can choose your own chiropractor.
Again, remember that these limitations apply only for the first 90 days. Subsequently, you can seek treatment from a physician of your choosing.
What rules apply in case of surgery?
Following your injury, panel acknowledgement mandates that you seek treatment from an employer-specified physician.
Now consider that you have been advised on invasive surgery, from a physician in this panel. In this case, you are allowed to seek a second opinion from your own doctor/health care provider.
However, do note that any treatment required post the second opinion (including surgery), must once again be provided by the employer-specified panel. Again, this only applies for the first 90 days following an injury.
Your Own Doctor Knows Best
If your employer mandates treatment from a specified panel of doctors/healthcare providers, remember that this panel is most likely hired by your employer’s insurance company.
Furthermore, they may be unaware of your medical history. Yet, their advice will be considered to determine your “disability rating”, which in turn will influence the workers compensation benefits you receive from the employer. (This includes the amount covered in medical expenses, and the amount offset by loss in wages.)
For all these reasons, this panel may not always provide an impartial or informed decision regarding your disability status. Hence, it is best for you to take ownership, and find ways to seek medical advice and treatment from your own doctor.
Your doctor should have a thorough knowledge about your medical history, and accordingly advise the best way forward.
Does the panel determine when you can restart work?
Yes, if you seek treatment from a doctor/ healthcare provider specified in the panel.
Regardless, it is rare for an employee to be put into full-time work right away, following a significant injury. Employers will typically protect themselves from liability, starting you off with “light-duty work”.
Here, do note that your partial disability status is governed by a physician/ healthcare provider from the panel or on the basis of IRE (impairment rating evaluation). This allows up to 9.6 years (500 weeks) of disability benefits, depending on the health of the injured employee.
If your situation determines that you are unable to work full time, you may still be able to work part time on light-duty work and earn accordingly.
Contact an Experienced Workers’ Compensation Lawyer in PA
If you have suffered a work-related injury, it is best to seek legal advice from a knowledgeable Pennsylvania workers’ compensation attorney with decades of actual experience. They will help ensure that your legal rights are fully protected and do everything to get you your rightful compensation.