Can You See Your Own Doctor for a Workers’ Comp Claim in Pennsylvania?

Workplace accidents are an unfortunate but everyday part of life in Pennsylvania. When a worker is injured, they might wonder if they can see their own doctor to treat their injuries.

Whether you can see your own doctor will depend on your employer. If you employer provides a list of doctors that you were aware of, you will need to be examined by one of the doctors on the list. If your employer does not provide a panel of approved doctors, you can visit a doctor of your choosing.

Call our experienced Pennsylvania Workers’ Compensation attorneys at Lerner, Steinberg & Associates today at (215) 355-6400 for a free case consultation.

Can I See My Own Doctor After Filing a Workers’ Compensation Claim in Pennsylvania?

In certain situations, you could jeopardize your claim if you see your own doctor to treat your workplace injuries. However, it might be possible to choose your own doctor if your employer fails to meet certain requirements. Our attorneys can help you determine the right healthcare provider to see so you can receive your benefits.

When You Must See an Employer-Selected Doctor

In Pennsylvania, most employers are required to carry Workers’ Compensation insurance in the event an employee is injured in a work-related accident. After being injured, your injuries should be reported immediately to your employer, but you will typically have 21 days to report. Your employer will report your injuries to the insurance company to begin the benefits process. While they are not required to, many employers will provide a list of doctors they have contracted with who the injured worker can choose from. If your employer accepts your claim and provides a list of at least six designated doctors, you will need to see one of the doctors from the list to treat your injuries.

You must be notified in writing that you must seek medical care from one of the listed doctors. Usually, you will be notified when you are hired and asked to sign an acknowledgment that you have been made aware of the list. If these conditions are met, you must see one of your employer’s doctors if you wish to receive compensation to cover you while you recover.

Suppose your employer accepts your Workers’ Compensation claim but does not provide a list of doctors or never gave notice. In that case, you will be permitted to see a doctor of your choosing without affecting your Workers’ Compensation benefits.

When You Can See Your Own Doctor

When an employer provides a list of doctors to an injured worker, they can choose whichever doctor they prefer on the list. An employer cannot force you to see any one particular doctor from the list. Your employer also cannot stop you if you want to switch to a different doctor on the list after having already been treated by one. However, injured workers are only limited to their employer’s list for the first 90 days following their first doctor’s visit. After the 90 days are up, you are free to treat with any doctor you choose.

If your employer does not meet the conditions listed above, you can also go to your own doctor. You will still receive compensation for your medical expenses and lost wages from your employer’s Workers’ Compensation insurance provider. However, you should be aware that your employer might try to deny your claim by arguing that your treatment was not reasonable or necessary or that it was not related to work. The insurance company could also decide to deny your benefits in the first 90 days, even after you started receiving compensation. Our Philadelphia Workers’ Compensation attorneys can help you find the right doctor and protect your rights if you suspect unfair treatment at any point in the process.

What Determinations Will the Doctor Make in My Pennsylvania Workers’ Compensation Claim?

When you see a doctor for workplace related injuries, they will evaluate you to determine your level of disability for your Workers’ Compensation claim. Depending on your injuries, your doctor will conclude whether you suffered partial disability or total disability. This will determine how long you will receive benefits.

Total Disability Status

Total disability status applies to injured workers who are found to be totally disabled and unable to work. While out of work, you will receive your income, but at 2/3 the rate. However, your employer or the insurance company can require you to undergo a medical exam after 104 weeks to determine if they are at least 35% injured. If they are not at least 35% injured, the injured worker will be switched to partial disability status.

Partial Disability Status

The benefits for partial disability status can be paid for up to 500 weeks. In these situations, injured workers can return to work but usually in a reduced role or doing a completely different job. If your injuries worsen, you can reapply for total disability benefits. Our Bucks County Workers’ Compensation attorneys can help you determine if your injuries were properly evaluated by the doctor that treated you.

Can I Get a Second Opinion from My Own Doctor in My Workers’ Compensation Claim in Pennsylvania?

It is understandable that you would want a second opinion from your own doctor if you are being treated by a doctor your employer approved. While you cannot get a second opinion for all the treatment you receive, you can get one if your employer’s doctor recommends surgery or other invasive medical procedures. Further, your employer’s insurance is required to cover the visit to obtain a second opinion. If the second opinion confirms the recommendations made by the first, you must get the procedure done by the employer’s panel doctor. If the first 90 days have passed since your initial doctor’s visit, you can get a second opinion from your own doctor. Our Berks County Workers’ Compensation attorneys can help you get another opinion if you are unsure about your initial diagnosis.

Our Pennsylvania Workers’ Compensation Attorneys Can Help

For a free case review, contact our Montgomery County Workers’ Compensation attorneys at Lerner, Steinberg & Associates at (215) 355-6400.