Do you have a say in your care during a workers’ comp claim?

| Jul 13, 2021 | Workers' Compensation

Understanding how workers’ compensation insurance functions is important. You don’t want to have to look up the details while receiving first aid after an accident on the job. Knowing how the program works and your rights as an injured worker will protect you after you get hurt on the job.

One of the first questions workers have about their benefits after an incident is about the medical care they receive. Can an injured worker pick their own doctor, or does their employer get to choose who treats a claimant when someone needs workers’ compensation medical benefits in Pennsylvania? 

Your employer can have a list, but you have the final say

Pennsylvania does not allow an employer to dictate that workers see a specific medical professional. Instead, they allow employers to provide a list of at least six suggested health care providers for injured workers. They can also send you to a specific doctor for an examination.

If your employer has such a list posted, you will need to defer to it when selecting the doctor for your initial examination and care. Checking with human resources about whether the company has a list before you seek medical treatment is likely a good decision.

If they do have a list and you pick a doctor not listed, the workers’ compensation insurance company might refuse to pay for the treatment. If your company doesn’t post and maintain a list, then you may have the option to pick your own doctor.

Those who need long-term care have more options

Most workers’ compensation claims only result in a few days of care or several treatments. In rare circumstances, workers will need care that lasts for months.

If you have to undergo treatment for more than 90 days, you will have the option of selecting your own physician after the 90th day of care, provided that they comply with all the rules about workers’ compensation care, like providing your employer and the insurance company with monthly updates on your progress. You also have the right to request a second opinion when a doctor recommends invasive surgery.

Understanding the basics of the medical coverage available to you can I help you more easily navigate a workers’ compensation claim if you get hurt on the job.

 

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