Choosing a Doctor in Workers’ Compensation Claims

Being injured on the job can be frightening. The Pennsylvania workers’ compensation system provides insurance coverage for injured workers. You can receive medical treatment for injuries and benefits for loss of income.

However, you must follow the rules for obtaining medical treatment to receive workers’ comp benefits. For example, there are strict rules for choosing a doctor in a workers’ compensation case. You need to follow these rules for workers’ comp to cover your medical bills.

How Do I Choose a Doctor for a Workers’ Compensation Case in Pennsylvania?

First, you must determine if your employer has designated doctors approved to treat workplace injuries (physicians list). You must use an approved doctor if the following conditions apply:

  • Your employer accepted your workers’ compensation claim;
  • Your employer posted a notice at your place of employment in a place that is available to employees listing at least six medical professionals approved to provide treatment for work injuries;
  • Your employer notified you in writing that you must receive treatment from one of their designated physicians or healthcare providers; and,
  • You signed a statement acknowledging the list of approved providers when you were hired and after you reported the on-the-job injury.

If the above conditions are true, the employer and workers’ comp insurance company do not have to pay medical bills you incur from providers other than those on the list. You can choose a doctor not on the list, but you may be responsible for paying those bills during the first 90 days of treatment. 

However, your employer cannot force you to go to a specific doctor on the list. Instead, you can choose any doctor on your employer’s list of approved healthcare providers. You may also switch from one provider to another provider on the list. 

Can I Choose My Own Doctor for a Workers’ Compensation Claim in Pennsylvania?

If your employer does not provide a list of approved healthcare providers, you can choose any doctor to treat your work injuries. Also, if you sustain an injury that requires emergency treatment, you can go to the nearest hospital or emergency treatment center for care. After being released from emergency care, you would need to choose a doctor from the approved list.

Pennsylvania workers’ comp laws only require you to choose an approved doctor for the first 90 days after your first visit for a work injury. After the 90 days expires, you can seek treatment for the injury or illness from any medical provider.

Can I Get a Second Opinion for a Work Injury?

Sometimes, a worker may question an approved physician’s medical opinion or treatment plan. If that is the case, you can seek a second opinion. However, if the second opinion confirms the treatment plan by the approved doctor, an approved doctor must perform the treatment for the first 90 days.

After 90 days have expired, you can choose a doctor to perform the treatment. That said, failing to seek treatment because you do not like an approved doctor could cause problems for your claim. Suppose your condition worsens because you intentionally delayed treatment. In that case, the workers’ comp insurance may deny your claim or deny the portion of your claim related to bills and expenses caused by the intentional delay in care.

If you have concerns about an approved doctor for your workers’ comp case, you might want to schedule an appointment with another approved doctor on the list. If your concerns persist, you should discuss your case with a Harrisburg workers’ comp attorney to determine your legal rights and options regarding care and benefits. 

How Long Do I Have To Report a Work Injury or File a Workers’ Comp Claim?

You have just 120 days from the injury date to file a workers’ compensation claim. You have three years to file a claim petition and appeal a decision if your employer or the workers’ comp insurance company denies your claim. The three-year deadline begins on the date of injury.

However, you should not wait to report a work injury. Report the injury or accident to your employer as soon as possible. Seek medical care immediately to document the injury. 

Most injured workers are entitled to receive benefits that include payment of medical bills and disability benefits (loss of income). However, you might also be able to receive benefits for disfigurement and specific loss.

Some work accidents might result in a personal injury claim against a third party. If so, you have just two years to file a third-party claim. If you are unsure whether you have a claim, you can talk with a Harrisburg workers’ compensation lawyer about your case during a free consultation.

If you’ve been injured in a workers’ compensation, please contact Marzzacco Niven & Associates at the nearest location to schedule a free consultation today:

Harrisburg Law Office
945 East Park Drive, Suite 103 Harrisburg, PA 17111
(717) 231-1640

York Law Office
2550 Kingston Road, Suite 210A York, PA 17401
(717) 995-8998

Wyomissing Law Office
833 N. Park Road, Suite 103, Room A Wyomissing, PA 19610
(717) 388-2325

Chambersburg Law Office
79 St. Paul Drive, Suite 1 Chambersburg, PA 17201
(717) 388-2378

Carlisle Law Office
354 Alexander Springs Road Carlisle, PA 17015
(717) 995-8732

Carbondale Law Office
30 Lincoln Avenue, Suite 101 Carbondale, PA 18407
(717) 995-8810

Lancaster Law Office
2173 Embassy Drive, Ste 123, Lancaster Pa 17603
(717) 616-2954

Lebanon Law Office
937 Willow Street, Suite D Lebanon, PA 17042-1140
(717) 995-8963