Treating with the Employer’s Physicians and the Panel List
What you need to Know!
Often one of the initial questions we receive from a client is whether they have to receive treatment from the employer’s doctor following a work accident. The easy answer is…it depends.
Section 306(f.1)(1)(i) of the Pennsylvania Worker’s Compensation Act provides that the employer must provide to the employee a clearly written notification of the employee’s rights and duties (including the obligation to treat with a designated healthcare provider for the first ninety (90) days following a work accident) and shall ensure that the employee has been informed and understands these rights and duties, which is evidenced only by the employee’s written acknowledgment. Section 127.755(a) of the Bureau Regulations establishes a similar directive to the employer, that if a list of designated providers is established, the employer shall provide a clearly written notice to an injured worker of their rights and duties under Section 306(f.1)(1)(i) of the Act. The Bureau Regulations then requires an additional level of notice. Section 127.55(c) provides that notice must be given to the injured worker at the time of hire and at the time of injury, or as soon thereafter as possible under the circumstances. Similar to the Act, the Bureau Regulations provide that an employer must obtain written verification when the injured worker is informed of their rights and duties.
The best way to proceed when the client asks the aforementioned question, after saying “it depends”, is to find out whether the injured worker signed a document whereby they acknowledged their obligation to treat with a physician designated by the employer for the first ninety (90) days following a work accident. If so, then the injured worker must treat consistent with the panel list if the injured worker expects medical treatment to be paid by the worker’s compensation insurance carrier for the first ninety (90) days after a work accident. The injured worker always has the option of treating off the panel list of physicians and pay for their own treatment for the first ninety (90) days, but this course of action is not very practical or realistic. In addition, by not treating with the employer’s panel list of physicians, particularly if the claim is accepted through the issuance of a Notice of Temporary Compensation Payable, the injured worker raises the prospect in our opinion of having the claim immediately stopped and denied.
Jonathan B. Koutcher, Esquire
Email Jon: [email protected]