Can I choose my healthcare provider if I am injured at work?

Pennsylvania workers’ compensation law allows employers to provide a list of health care providers that injured workers must use to chose their doctor. However, injured workers must use one of these designated health care providers only if certain conditions are met and only for the first 90 days after an injury.

According to the Pennsylvania Department of Labor & Industry:

• The employer must provide written notice of the employee’s rights and duties. The employer must sign the notice when he or she is hired, when changes are made to the list and if the employer becomes injured.
• At least six providers must be on the list. Three of the providers must be physicians. Your employer cannot direct you to use a specific provider from the list.
• An injured worker who needs specialized care that cannot be provided by someone on the list may choose a health care provider who can provide the necessary care.

The bottom line: Unless a list of at least six medical providers is posted and the worker signed documents before and after your injury that deal with understanding your rights to medical care, the worker does not have to use a doctor on the list.

Even if a worker is required to treat with a doctor on the list, he or she is entitled to a second opinion. If the doctor providing the second opinion recommends another treatment, the worker may treat with that doctor after 90 days.

These rules are complex, and employers want to control health care costs. If you have questions about your medical care, an experienced workers’ compensation attorney can provide a full explanation of your rights regarding medical care in a workers’ compensation case.

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