Injured Workers’ Rights to Medical Treatment in PA

Just the other day, an injured worker called us, complaining that their employer refused to send them to a “workers’ compensation doctor.”  It seems that there is more confusion in this area than in many within the complicated world of Pennsylvania workers’ compensation.

While medical treatment for the work injury is one of the benefits available to an injured worker under the Pennsylvania Workers’ Compensation Act (Act), this is not necessarily treatment with a doctor with any connection to the employer or the employer’s workers’ comp insurance carrier.  In fact, the ability to direct and control medical treatment is a BENEFIT to the employer, and a DETRIMENT to the injured worker.  As such, this control is only available if an employer complies with specific steps.

Under the Act, an employer may only be responsible for payment to a medical provider on a “panel posting” within the first 90 days of treatment.  Such a “panel posting” must be prominently displayed in the work place.   To be a valid “panel posting,” the posting must contain at least six providers, at least three of which are physicians (the remainder could be therapy facilities or other healthcare providers who are not doctors). No more than four of the six on the posting may be from the same practice.  The employer must have the injured worker sign an acknowledgement, both at the time of hire and as soon as practical after the injury, that the injured worker is aware of the panel posting. All of these requirements can be found in Section 306(f.1)(1)(i) of the Act.

As a practical matter, very few employers actually achieve all of these requirements.  Also, as noted above, even if the employer complies with all of these requirements, and therefore has a valid panel posting, this only applies for the first 90 days of treatment.  After the first 90 days of treatment pass, an injured worker may treat with a medical provider of his or her choice.

Also, it is important to note what happens if the injured worker treats with a medical provider not on a valid panel posting during those first 90 days.  Literally, nothing.  While the workers’ compensation insurance carrier may not be obligated to pay for treatment with that provider during those 90 days, that does NOT impact whether there is a valid workers’ compensation claim.

As with many things in the PA workers’ compensation system, decisions made by an injured worker should be made with complete knowledge of his or her rights under the Act.  We are always happy to meet with any injured worker to make sure the injured worker learns their rights and obligations under the Act.  Call or e-mail us for a free consultation, with no obligation at all.  You can reach us at 215-638-7500, or by e-mailing us at gneiman@bnlegal.com