Pennsylvania Workers Compensation Doctor

Pennsylvania Workers Compensation Doctor

When it comes to your general health, the individual you choose to be your doctor is a very personal decision. The doctor is not just a plug and play technician for your body. No, your doctor is much more to you; their patient. He or she is a highly trained, caring and compassionate professional that you have grown to know over the years. Your doctor understands much more about your medical history, they understand your life history! There is a good chance this same person treated your mother and father as well as your siblings or your own children. A good quality doctor cares not just for you and your family but for the community they serve. They have become your medical confidant and the person you trust the most with your most intimate concerns. This bond is deep and therefore, it is understandable that when you are injured at work, you usually prefer to see you own doctor. However, in Pennsylvania you are not always able to do so based on the guidelines of the PA Workers Compensation System. The employer may require you to treat for the first 90 days with a panel doctor. However, you should be aware that there are specific rules that must be strictly followed by your employer/insurance carrier if they are to control your care following work injury for the first 90 days in Pennsylvania. If they don’t follow the guidelines specifically, then you ARE able to see your own doctor!

Employees are required to treat with an employer’s panel doctor if (and only if) ALL of the following conditions are met:

  1. The employer is required to notify employee of a properly posted panel and have obtained your WRITTEN acknowledgement (via your signature) of that panel. This is required at Time of Hire and immediately after injury or a soon as possible after injury. Therefore, the employer needs your signed acknowledgement (2x) twice and must be able to produce those documents. If you did not sign a posted panel notice since your injury occurred, then you are not obligated to treat with the company’s doctor. YOU CAN GO ANYWHERE YOU WANT FOR YOUR CARE!
  2. For it to be a PROPERLY posted panel it must contain the following:
    1. Must have at LEAST six (6) healthcare providers on the list.
    2. At least three (3) must be physicians.
    3. At least one (1) must be a chiropractor.
    4. No more than four (4) of the providers may be coordinated care organizations (CCOs).
    5. The names, addresses, phone numbers and medical specialty of all designated providers must be included on the list.
    6. Providers must be geographically accessible and have specialties that are appropriate based on your medical problem.
    7. Employer must specify on the list if any of the designated healthcare providers are employed, owned or controlled by your employer or its workers compensation insurance company.

NOTE: Your employer’s list of designated healthcare providers must meet ALL of the above requirements. If the list does not meet all of the requirements, you do not have to choose a provider from the list. Instead, you have the right to seek medical treatment with any healthcare provider of your choice. If your employer did not do ALL the above, then you can go anywhere you want for your care and see the doctor of YOUR choice!

This information is provided by the PA Bureau of Workers’ Compensation Helpline Information Center.

If your employer followed all of the above guidelines then you may have to see a panel provider for the first 90 days after your work injury. However, the guidelines are complex and there are certain circumstances that you should be aware of:

  1. During the 90 days, you may select any of the choices provided. If any of the panel doctors recommend physical therapy, you may bring that prescription to The Injury Care Center for physical therapy care. If your doctor refers you to a non-panel provider, the insurance carrier is obligated to pay for that treatment.
  2. If you are seeing one of the employer’s panel providers and they recommend surgery, then you have the right to obtain a second opinion by a physician of your choice.
  3. You always maintain the right to still consult your family doctor for any medical condition and seek his/her advice. The employer is not obligated to pay for that visit if it is solely related to your work injury but your family doctor has the right to understand and assist you in all healthcare matters. Most times, it is helpful that your family doctor is aware of your condition from day 1, so they can advise you medically…. there is NO restriction on telling your family doctor on what is going on with your health.
  4. If there is no chiropractor listed on the company panel and your condition falls within the scope of chiropractic, you may see a chiropractor of your choosing. The Injury Care Center has multiple healthcare providers including chiropractors, medical doctors and physical therapists.
  5. After 90 days from the date of your injury…You are free to treat with any healthcare provider of your choosing. If you are not fully recovered in that timeframe, then it would be best to seek medical care with the doctor that you have grown to trust over the years. Again, you are OK with seeing your doctor at that time.

 

Therefore, the Pennsylvania Workers Compensation System is complex and has many specific rules that must be followed and we at the Injury Care Center, are specialist in caring for those hard-working individuals who may have unfortunately sustained injury during the course of doing their job. We pride ourselves on treating you the same way we treat our own family members and will provide you the Care You Deserve for The Injury You Didn’t!

If you were injured on the job and just want some honest medical advice, please give us a call.

 

Author: Thomas Kiger, P.T.

www.injurycarecenter.net

 

If you would like us to evaluate your injury, please call: 877-444-2422.

 

Or Visit a location near you:

 

Injury Care Center
901 W. Ashland Avenue
Glenolden, Pa 19036
Phone: 610-461-6522

Injury Care Center
1502 Upland Street
Chester, Pa 19013
484-816-0661

Injury Care Center
3300 Grant Avenue
Suite #20
Philadelphia, PA 19114
215-647-9601