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Medical Treatment Under The Pennsylvania Workers' Compensation Act

May 6, 2008
If you have been injured at work in Pennsylvania, you do not have to treat with a company or designated doctor unless a list of medical providers is given to you by your employer or its insurance company, according to the Pennsylvania Workers' Compensation Act. Looking at it the opposite way, you must treat with a company doctor (or at least with a designated facility), only if your employer or its insurance copmany has provided you with a list of at least six healthcare providers. Of course, it's not easy to know if the least is correct. That's why you should contact attorney Jack B. Katz, former chair of the Philadelphia Bar Association Workers' Compensation Section, who will review the information you have received and provide legal advice.

If a proper list of six places was not provided at your workplace, then you are immediately free to treat with a physician of your own choosing -no matter what the employer tells you or hands you. If a proper list is provided, then you need to treat with at least one of these providers for 90 days from the first date of treatment. If a specialist is needed and one is not on the posted list, a injured worker may treat with a doctor of his own choosing. The employer will be responsible for the bill. (This includes chiropractor, if needed, and none is posted.)

What does this all really mean? If an employee fails to treat with a designated provider for the first 90 days, the employer does not have to pay for the medical treatment received during that time only - that is all that the above means! It does not mean that the claim itself will be denied or that you will not receive any weekly benefits. In other words, don't automatically believe what your employer or its insurance company says. They may not be telling you the truth, or may not be telling you the whole truth.

Since the company can have control of treatment for 90 days -you may want -at least once - to choose to be examined by a doctor in whom you have confidence and who will look after your best interest. This is true even if you have to pay for the treatment yourself. If not, after the 90 days, you won't have a doctor who can fully document and confirm your injury to the insurance company, let alone start to cure you! (You should always notify your employer of the name and address of your treating physician within 5 days of you initial treatment.)

After 90 days, you absolutely should treat with your own doctors. The employer is then entitled only to periodic examinations but not to have you treat with their doctors. (The employer's or insurance company's doctors are not being paid by you and may be under pressure to get you back to work before you are really ready.)

Finally, if surgery is prescribed by a company-designated doctor, employees may get a second opinion by a doctor of their choice -paid for by the employer.

This handy Pennsylvania workers' compensation law tip is provided by the Philadelphia workers' compensation law office of Attorney Jack B. Katz, Law Offices of Jack B. Katz, 1213 Vine Street Philadelphia, PA 19107, www.jackbkatz.com, Email jbk@jackbkatz.com.
About the Author
Philadelphia workers compensation attorney Jack B. Katz, and the Law Offices of Jack B. Katz have been representing injured workers for more than two decades. Jack Katz concentrates his practice in workers compensation matters.
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