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Can I choose my own doctor in a workers’ compensation case?

Pennsylvanians who are injured on the job or suffer an illness from their work have myriad concerns about their workers’ compensation case. Being approved for benefits can be a worrisome process. It will dictate how much of their wages they receive, the duration for which they can receive it, and how the medical treatment will be handled. Many injured workers have a certain medical professional in mind when seeking that treatment. It is important to understand how a health care provider is chosen and if there are options.

Under Pennsylvania workers’ compensation law regarding health care providers, the worker can choose his or her own doctor unless the claim is accepted and the workplace has a poster listing at least six providers or medical professionals to provide treatment. If that is the case, the worker must visit one of those listed providers when treatment begins. The treatment must last for 90 days.

Some workers suffer an injury that requires surgery. If this is recommended, the worker can get a second opinion. The employer or workers’ compensation insurance company must pay for it. Again, the treatment from the second opinion must be provided by a listed doctor. If the worker visits an unlisted medical provider, the employer or insurer may refuse to pay for it. However, if there is no list at the workplace or it is not done according to the rules, the worker can get treatment from any doctor. The employer must still be given information about the healthcare provider. There can also be monthly reports sent to the employer or insurer.

Even after the workers’ compensation benefits have been approved and the worker is receiving payment and treatment, the employer or insurer has the legal right to request that the worker see a medical professional it chooses to gauge progress. Should the employee refuse, there could be an order from a workers’ compensation judge compelling the worker to take part in the examination. If the worker still refuses, it can result in the benefits being suspended.

Being injured or becoming ill on the job is only one aspect of a workers’ compensation claim. The medical care is an integral part and many workers might function under the mistaken belief that they can see any doctor they want. Doing so can cause problems with the case. For this or any other issue from getting approved for benefits to receiving the maximum of what the worker is entitled to, legal help may be needed. Consulting with a law firm that handles workers’ compensation cases is the first step.