When a work-related injury occurs, the process of an injured worker receiving medical treatment begins. What’s the next step regarding medical treatment? It is commonly misunderstood by many Pennsylvanians whether an injured worker in our state may choose his or her own doctor for treatment of workplace injuries. Many believe that treatment must be obtained from a doctor chosen by an employer or its insurance carrier. This simply isn’t true.

In truth, the Pennsylvania Workers’ Compensation Act (the “Act”) does provide employers with some input in establishing the health care provider with which an injured worker may seek treatment.

The Act gives employers the right to establish a “panel list” of designated health care providers which it must properly post at the workplace. There are specific guidelines for these types of lists. Providers, as defined in the Act, include more than just physicians. When the panel list is properly posted, injured workers must seek medical treatment with one of the designated providers for 90 days from the date of the first medical visit.

At the time of hiring, an employer should provide a new employee with written notice of her rights and duties, which the employee must acknowledge by signature. This written notice must be signed not only at the time of hire, but when the list is revised and at the time an injury occurs.

Specific guidelines under the rules and regulations of the Act also require that:

  • The panel list contains at least six providers; three of the six must be physicians.
  • The panel list contains the name, address, telephone number and specialty of each provider included on the list.
  • If a particular specialty is not on the list and the specialty care is reasonable and necessary for the treatment of the work injury, an employee may treat with a health care provider of choice.
  • An employer may not direct or require the employee to seek treatment with any specific provider on the list.
  • An employee may switch designated providers at any time.
  • Listed providers must be geographically accessible to an injured worker.
  • Listed providers must perform specialties appropriate for the anticipated, work-related injuries or medical conditions of the employee.
  • If an employer’s list of designated providers fails to comply with the Act and its underlying regulations, the employee has the right to treat with a provider of choice

In sum, from the day of the injury and for ninety (90) days from the first visit, a worker must seek treatment with a health care provider from a “panel list” properly posted at his place of employment and established by his employer. The worker may choose any provider from the list and, after the ninety-day period passes, choose any provider available to the general public.