Legal Question in Workers Comp in Pennsylvania

Re: i need treatment

First of all, you need representation. Your question raises several issues. The insurance company is responsible for paying for reasonable necessary and causally related medical care. The key is the nature of the accepted injury. If they have not accepted the RSD condition as compensable, they will not pay for the treatment. Assuming that they have recognized it as compensable, they do not have to pre-authorize the treatment. You get the treatment and have the physician bill the carrier. If it is denied, your health insurance must pay the bill.

With regard to your lack of work, you need to have a doctor authorize your disability. if the insurance company does not agree, you must file a petition in court to have your wage loss benefits instituted.

Please call me or my partner, Jim Monaghan to discuss this further.

Re: i need treatment

It is tough to answer as I do not know if your injury is more than 90 days ago but there is no reason you cannot set up the appointment and make sure that doctor gets approval for the treatment from carrier so you are not on the hook. If you miss time from work, you would also get paid for that lost time.