Workers’ Compensation: Can I Choose My Physician?
When one is injured on the job, neither the employer nor the employer’s insurance carrier can specify a doctor to act as the treating physician. However, the injured worker is required to treat with a medical professional on the employer’s list of designated physicians (also referred to as a designated list of panel physicians) for 90 days. Per the Pennsylvania Workers’ Compensation Act, a list of designated healthcare providers must be posted in a workplace area that is easily accessible to employees. Moreover, immediately after the employer is notified of an employee’s workplace injury, the employer is required to provide written notice to the injured employee as to the use of a designated medical provider on the list. The employee will also be required to sign the notice indicating acknowledgement of needing to choose a physician from the list provided.
Note that exceptions to this rule do exist. An injured worker can be treated by a medical provider of their choice that is not on the list of physicians provided by the employer in the following situations:
- The designated list is deficient in some way (e.g., if the injured worker needs to see an orthopedic surgeon, and there is no medical professional specializing in that area identified on the list); or
- The employer did not provide written notification to the injured worker as to the fact that he or she was limited to choosing from the designated list.
Workers’ Compensation laws are complex, to say the least. It’s in the interest of any injured worker to contact a specialized attorney experienced in all matters related to the Workers’ Compensation system. The law firm of Krasno, Krasno & Onwudinjo has been practicing Workers’ Compensation law since 1936, and has eleven offices throughout the state of Pennsylvania.
Workers’ Compensation 90 Day Rule
The 90 Day Rule does not prohibit an injured worker from seeking medical treatment with a doctor of one’s own choosing, nor will seeing one’s own doctor jeopardize the case. The 90 Day Rule guarantees that medical treatment by a panel physician will be covered by Workers’ Compensation, whereas treatment by a non-panel physician may be denied. If the claim is covered by the employer’s insurance carrier, one is free to see any physician after the 90-day period.
Can My Employer Force Me to Have Surgery?
If a medical professional advises surgery and the worker refuses, workers’ compensation benefits can be suspended. If a doctor’s professional opinion is that surgery will improve one’s disability status and/or allow the return to work, the employer and insurance carrier will file a petition seeking to suspend benefits. A hearing will take place to make a determination.
What if the Workers’ Compensation Physician Misdiagnoses My Injury?
If a panel physician should deny that worker’s injury is work-related or misdiagnoses the severity of the injury, the worker should absolutely seek a second opinion. This is usually a provision of the workers’ compensation insurance carrier. If it is not an option, or if the second opinion is also wrong, the injured worker should contact an attorney for a free consultation. It is also advisable to seek medical treatment from one’s own physician. Initially, this may mean a greater out-of-pocket expense. However, it is important to keep in mind that the workers’ compensation hearing judge is required to consider all the medical opinions, not just the panel physician(s). If an independent physician has medical evidence that contradicts the panel physician(s), a judge may find in the injured worker’s favor.
An experienced workers’ compensation attorney can be a huge assistance throughout the claims process from. Having a specialized workers’ compensation attorney by your side makes a claimant far more difficult to dismiss and lends credence to the case.
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