Legal Question in Workers Comp in Pennsylvania

If your employer posts a list of six or more "panel physicians" then you are required to go to your choice of those doctors for 90 days. Therafter you can see whomever you wish. please call my office if you would like to discuss this further. The number is 610-279-4300.

Some employers do not seek to control or limit your choice of who you treat with for your work injury. Others attempt to control this choice, but can attempt to control your choice only during the first ninety (90) days of treatment. Many employers and insurance companies seek doctors who are willing to cooperate with their wishes in return for a steady flow of patients. As a result, too often your health interests become secondary, proper testing is not prescribed to curb costs, you are misdiagnosed and are pressured to return to work when you are not able to physically tolerate the job duties. If you are subjected to this despicable mistreatment, do not treat with the company doctors unless you financially have to; get away from them as soon as possible. Failure to treat with the company doctor is not a valid reason to deny a wage loss claim. In addition, too often, employers use the ninety (90) day treatment period in conjunction with the issuance of a Temporary Notice of Compensation Payable to cease paying wage loss benefits. This additional control does not apply when a regular Notice of Compensation Payable is issued.

For those employers seeking to control your choices, Pennsylvania law requires the employer to provide several minimum safeguards to protect you. If the employer provides a list of doctors it wishes for an employee to treat with for the first ninety (90) days, the employer must:

1) Provide a list of at least six (6) health care providers. At least three (3) must be physicians, and no more than two may be coordinated care organizations;

2) Not include on the list any health care provider who is employed, owned, or �controlled� by the employer or carrier unless that information is disclosed; and

3) Provide you with and have you sign a written �Acknowledgment of Rights and Duties� relating to treatment for a work injury both before and after the work injury and that you are NOT required to treat with only one specific provider. Without these two signed documents, you can treat with whomever you want and the carrier must pay if the treatment is found to be work related. However, if you were presented with the Acknowledgment before and after the injury and refused to sign, it will be treated as if you did sign the Acknowledgment.

If the employer�s provider prescribes surgery, you are entitled to a second opinion with a doctor of your own choosing within or outside the panel list. In all cases, even when surgery is not recommended, you are always free to switch among providers on the list. If the list does not include a specialist (ex. chiropractor) you desire to treat with, you are free to treat with that specialist outside of the list, and the carrier must pay if the treatment is found to be work related.

If there is no panel list, you may treat with a doctor of your choosing, and the workers� compensation carrier must pay for the work related treatment. If the employer followed all of the rules regarding the Acknowledgement of Rights and the posting of the list, you may treat with your own doctor at your own expense. If the employer fails to abide by any of the above requirements, the workers� compensation carrier is responsible for payment of your work related treatment during the first ninety (90) days wherever you choose to treat. Regardless of whether or not your employer followed the rules for posting and implementing a panel list of physicians, after ninety (90) days, the workers� compensation carrier is responsible for all reasonable and necessary treatment related to your injury wherever you choose to obtain the treatment. Your treatment options are not even limited to this country.