One question I frequently get from potential workers’ compensation clients is how long must I treat with a panel doctor/provider. The answer is, it depends. There are a few nuances about the treating with a panel doctor that could effect your case.
First, the general rule is simple. If your employer has a panel list of provider, the PA Workers Compensation statute requires you to treat with the panel provider for the first 90 days after your injury date. Does that mean you can’t see any doctor of your choice during that time period? No. It just means if you chose to go your own doctor or get a second opinion within the 90 days, the workers compensation insurance carrier can properly deny paying for that medical bill. However, you are permitted to treat with your own doctor at your own expense.
Second, your employer must have the panel listed posted somewhere on location where the employee is expected to see them. In most instances, it is likely an employee break room. Second, the employee must have signed an acknowledgement when hired AND right after the injury.
Another provision of the law regarding panel doctors that is not readily understood by injured workers is the fact that if a panel list exists, you are free to treat with whichever doctor you choose on that list. Your employer can not dictate which doctor you treat with on that list. If you are unhappy with a panel provider, you are free to select another doctor on the panel list.
It is equally important to understand that even if all obligations are met and you treat with the panel physicians/providers, on the 91st day after your injury date, you are then free to treat with whatever provider you wish and as long as the treatment is reasonable necessary, the insurance carrier must pay.
Finally, and a very important point as well, if you receive a Notice of Compensation Denial, in which your employer/insurance carrier is denying you workers’ compensation benefits, then the panel provision does not apply. If your injury is denied, you can treat from day one with a doctor of your choice.
These rules can be complex and confusing. If you have any questions or would like to consult with us regarding your work injury, simply give us a call at 717-632-4656 or toll free at 1-877-632-4656.
Mooney & Associates represents injured workers in South Central Pennsylvania including Franklin County, Cumberland County, Adams County, Dauphin County, York County, and Fulton County.