If I Am Injured at Work, Can I Choose My Own Doctor in Pennsylvania?

Can You Stick With Your Preferred Physician or Medical Center?

One of the misconceptions many workers have is that the Pennsylvania Workers’ Compensation system requires a worker to undergo treatment for workplace injuries from a company-specified doctor only. However, this is not the whole truth.

The quick answer is “yes.” However, your employer may require you to subscribe to a “Panel Acknowledgement” at the time of hiring, which can be re-iterated immediately after your injury. With this, the employer may provide a list of at least 6 qualified physician names.

If these conditions are fulfilled, you will be required to seek treatment from a doctor on this list for the first 90 days following your injury. Once this time limit is over, you are free to choose your own doctor for additional treatment.

If the employer has not fulfilled the above-described conditions, you can choose your own doctor in Pennsylvania right after your injury.

Regardless of injury, your employer may also mandate a physical exam by a specified physician, once or twice a year.

How Extensive Is the List of Employer-Specified Medical Providers?

Typically, this list is extensive enough to cover your treatment for the first 90 days. It must include at least 3 doctors and a maximum of 4 health care providers. After your initial visit, you can choose to seek treatment from a single doctor or a combination of doctors and care centers specified on the list.

There is also additional provision for specialized situations. For example, if you require a chiropractor and there is none specified on the list, you can choose your own chiropractor.

Remember that these limitations apply only for the first 90 days. Subsequently, you can seek treatment from a physician of your choosing.

What Rules Apply in the Event of Surgery?

Following your injury, the panel acknowledgement mandates that you seek treatment from an employer-specified physician. If you have been advised to undergo invasive surgery by a physician on this panel, you are allowed to seek a second opinion from your own doctor or health care provider. However, any treatment required after the second opinion — including surgery — must once again be provided by the employer-specified panel. Again, this applies only for the first 90 days following an injury.

Your Own Doctor Knows Best

If your employer mandates treatment from a specified panel of doctors or healthcare providers, keep in mind that this panel is most likely hired by your employer’s insurance company. Furthermore, they may be unaware of your medical history. Yet their advice will be used to determine your “disability rating,” which in turn influences the workers’ compensation benefits you receive — including the amount covered in medical expenses and the amount offset by loss of wages.

For all these reasons, this panel may not always provide an impartial or informed decision regarding your disability status. It is best for you to take ownership and find ways to seek medical advice and treatment from your own doctor, who should have a thorough knowledge of your medical history and can advise the best way forward.

Does the Panel Determine When You Can Restart Work?

Yes, if you seek treatment from a doctor or healthcare provider specified on the panel. Regardless, it is rare for an employee to be placed into full-time work right away following a significant injury. Employers will typically protect themselves from liability by starting you off with “light-duty work.”

Your partial disability status is governed by a physician or healthcare provider from the panel, or on the basis of an IRE (impairment rating evaluation). This allows up to 9.6 years (500 weeks) of disability benefits, depending on the health of the injured employee. If your situation determines that you are unable to work full time, you may still be able to work part time on light-duty assignments and earn accordingly.

Contact an Experienced Workers’ Compensation Lawyer in PA

If you have suffered a work-related injury, it is best to seek legal advice from a knowledgeable Pennsylvania workers’ compensation attorney with decades of actual experience. They will help ensure that your legal rights are fully protected and do everything to get you your rightful compensation.