Workers’ Compensation Medical Treatment

By: Douglas A. Williams

If you have been injured at work it’s possible that your employer or its workers’ compensation insurance carrier have instructed you to treat with one particular doctor. Many injured workers believe that they must treat with the doctor to whom they are sent. However, this is not the case.

The Pennsylvania Workers’ Compensation Act permits an employer to maintain a list of panel of physician. Each list must contain at least six (6) different medical providers. It is true that, if your employer maintains such a list, the workers’ compensation insurance carrier only has to pay for treatment provided by those doctors – at least during the first 90 days after the first date of treatment for the injury. But, what employers and insurance carriers rarely tell injured workers is that the worker has the right to choose the doctor (or doctors) who will provide treatment. So, if your employer tries to tell you that you must see one particular doctor, ask your employer to see the list of panel physicians – and then choose whichever doctor with whom you want to treat.

It’s also important to remember that you have the right to switch from one doctor to another if you desire. Thus, if you’ve chosen to treat with one doctor on the list of panel physicians and you are not pleased with that doctor, you have the right to begin treating with a different doctor. In fact, you can treat with all of the doctors on the list of panel physicians if you wish. As long as you are treating with one of the doctors on that list, the insurance carrier must pay for the treatment.

Finally, you should also be aware that, if you’re employer doesn’t maintain a list of panel doctors, you are free to treat with any doctor of your choosing. Moreover, if you wish to see a specialist – such as an orthopedic surgeon, neurologist, etc. – you are not required to get a referral from your family doctor as is often the case with health insurance plans. Rather, you may simply call the doctor, make the appointment, and the insurance carrier will have to pay for the treatment as long as the treatment was necessitated by the work-related injury and is reasonable and necessary.



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