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Who chooses doctors in Pennsylvania work comp cases?

On Behalf of | Dec 4, 2012 | Firm News

The delivery of healthcare services in America is often quite complicated. Even for people with insurance, choosing a doctor can be affected by whether a given provider is within your insurance network.

Similar factors are involved in Pennsylvania workers’ compensation cases. Pennsylvania employers generally have a right to identify a list of authorized healthcare service providers. If you are injured at work, that list is the point of departure for seeking a medical provider to provide care.

The delivery of healthcare services in America is often quite complicated. Even for people with insurance, choosing a doctor can be affected by whether a given provider is within your insurance network.

Similar factors are involved in Pennsylvania workers’ compensation cases. Pennsylvania employers generally have a right to identify a list of authorized healthcare service providers. If you are injured at work, that list is the point of departure for seeking a medical provider to provide care.

Keep in mind, however, that the law also establishes several basic rights for injured workers. For one thing, employers must designate the list of authorized providers in advance and post it publicly.

Employers must also provide written notice to employees of what requirements are when obtaining medical care. This notice must come at the time of hire and be signed by the employee. An employee’s signature is also required if there are any changes in these requirements – and again when injury occurs.

The employers list has certain requirements as well. It must include at least six medical providers, and at least three of those must be physicians.

What happens if treatment of a particular work injury requires a medical specialist? In that case, Pennsylvania case law makes clear that an employee must be allowed to see a provider of his or her choice.

It should also be noted that just because the employer establishes a list of authorized providers, that doesn’t mean the employer can require the employer to see any particular one of those. The injured worker gets to choose which provider to see on that list.

Source: “Physicians List Defined,” Pennsylvania Department of Labor and Industry

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