Why Can’t I See My Own Doctor?

September 25, 2019

A common question our Philadelphia workers’ compensation lawyers receive is, “Why can’t I see my own doctor?” The answer is that workers are not prohibited from seeing their own doctor, but they may be required to initially see a doctor of their employer’s choosing for the first 90 days. The laws on this vary by state, therefore workers should seek legal advice from a local, qualified attorney.

Pennsylvania Rule on Company Doctors for Workers’ Comp Injuries

In Pennsylvania, the general rule is that employees must choose from a list of designated physicians provided by their employers when seeking medical treatment for their work injuries during the first 90 days. They must see one of those doctors (or any combination thereof) for at least the first 90 days following their workplace injury. Those who seek treatment from their own doctor during this time should be aware that they may not receive workers’ compensation for doctors’ visits or any medications/treatments received.

Every work injury case is unique and may have circumstances that fall outside of the “typical” workers’ compensation claim. Extenuating circumstances include:

  • Chiropractors: If a chiropractor is not listed, workers may choose their own.
  • Second Opinions: Workers may seek a second opinion from their own doctors at their own expense, unless surgery is recommended – in which case, a second opinion by a doctor of the employee’s choosing is usually covered by workers’ compensation.

When Can You Choose Your Own Workers’ Compensation Doctor?

After the 90 days have passed, workers may see a doctor of their own choosing, provided they give a one-week notice to the workers’ compensation insurance carrier. However, if an employer does not provide a list of panel doctors, the employee may see his or her own doctor from the start.

The Pennsylvania Workers’ Compensation Act (the Act) outlines some rules and regulations pertaining to the designated physicians list, including that the:

  • Employer must provide written notice to employees
  • Notice must be signed by employees at the time of hire, when changes to the list are made, and at the time of injury
  • List must include at least six providers, no more than four of which must be coordinated care organizations and no less than three of which may be physicians
  • Information for each provider must be listed, including their name, address (geographically accessible to the employee), telephone number, and specialty
  • Employers may not direct employees to any specific provider, but rather must allow employees to make their own decisions
  • Listed providers must practice in areas related to the employee’s anticipated medical issues

According to the Act, if an employer does not provide a list of designated providers or the list does not comport with the requirements, the employee may see a doctor of his or her choice. Pennsylvania employees should be sure to follow the rules regarding seeing a doctor for work-related injuries to ensure they receive all the workers’ compensation benefits to which they are entitled.

Reading Workers’ Compensation Lawyers at Larry Pitt & Associates, P.C. Help Workers Understand Their Rights

If you were injured at work, you may be entitled to various types of workers’ compensation benefits. However, there are certain rules you must follow to remain eligible. Contact a Reading workers’ compensation lawyer at Larry Pitt & Associates, P.C. to discuss your case and legal options. We represent clients in Philadelphia and throughout the state. For a free consultation, please complete our online contact form or call us at 888-PITT-LAW today.

We assist injured workers across Pennsylvania, including the areas of Berks CountyBucks CountyChester CountyDelaware CountyMontgomery County, and Philadelphia County, as well as the communities of AbingtonAmblerArdmoreBala CynwydBensalemClifton HeightsCrum Lynne, DarbyDowningtownDoylestownDrexel HillEssington, FolcroftGlenoldenHaverfordHavertownHolmesKutztown, Lansdowne, Media, Merion StationMorton, Narberth, Norristown, NorwoodPhiladelphiaProspect Park, QuakertownReadingRoxboroughSharon HillUpper Darby, West Chester and Wynnewood.

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