You are hurt at work. What do you do now? Keep in mind that not every injury is a sudden event, like injuring your low back picking up a box or falling down steps at work. Some injuries are harder to determine and understand, even for the person who is hurt. Things like repetitive stress injuries, such as carpal tunnel syndrome, tendinitis or bursitis, or chemical/smoke exposure, or even an illness, for example, COVID, can appear over a period of days or weeks.
Regardless of the type of injury, or how it happened, the first thing to do is report the injury. I cannot tell you how many times a client has told us that he or she did not report an injury immediately because “I didn’t think it was anything serious.” The fact is, all injuries should be reported immediately. It is far better to report something and then learn it is nothing serious than to fail to do so, and then discover it is worse than you initially suspected. A delayed reporting of an injury is often used by a workers’ compensation insurance insurer as a basis to deny the workers’ comp claim. Don’t make this mistake!
Once you have reported the injury, attention turns toward getting medical treatment. Many people think the employer, or the workers’ compensation insurer, controls what doctor the injured worker can see for a work injury. The truth is the employer, or the workers’ comp insurer, can limit the treatment options for a maximum of 90 days (and even then, certain steps have to have been met).
If the employer has a list of medical providers (called a “panel list”) posted in a prominent location (with additional requirements regarding what medical providers can appear on the list), AND the injured worker has signed an acknowledgment that he or she has seen the list BOTH BEFORE AND AFTER the work injury, only then is the workers’ compensation insurer able to deny payment for medical treatment with a provider not on the list. This, of course, depends on the work injury being “accepted” by the workers’ comp insurer. Note, too, that if a specialty is required which is not represented on the list, the injured worker may seek treatment off that “panel” listing. As noted above, even if the panel list is properly posted and acknowledged, access to medical treatment is only for a period of 90 days. After that 90 days, an injured worker in Pennsylvania can treat with whatever provider he or she desires.
Mentioned in the previous paragraph is whether a claim is “accepted.” The Pennsylvania Workers’ Compensation Act requires a workers’ compensation insurer to accept or deny a claim within 21 days of being notified of the injury. This entails issuing a document which can accept the case, Notice of Compensation Payable (NCP), Notice of Temporary Compensation Payable (NTCP or TNCP), or Agreement for Compensation, or a document which can deny a case (Notice of Denial, NCD). A TNCP or NTCP “accepts” the case for a maximum of 90 days, but allows the workers’ compensation insurer to revoke the TNCP or NTCP within that 90 days and still issue an NCD to deny the claim.
Obviously, things can get complicated and scary for the injured worker after a work injury. And, that’s what we are here for! Since our practice is limited to Pennsylvania workers’ compensation cases, we are well versed in the entire PA workers’ compensation system. If you have had a work injury, and you have questions, call us at 215-638-7500, or visit us on the internet at www.bnlegal.com, for a free, no obligation, consultation.