After suffering a workplace injury in Pennsylvania, you may be dealing with pain, uncertainty, and a mountain of paperwork. One pressing question keeps coming up: can I choose my own doctor after getting hurt at work in Pennsylvania, or must I use the doctor my employer chooses? The answer involves understanding Pennsylvania's 90-day panel physician rule and knowing your rights as an injured worker; something a skilled Pennsylvania workers' compensation attorney can help you navigate.
Key Takeaways
- If they meet specific legal requirements, Pennsylvania employers can require you to treat with their panel physicians for the first 90 days after a work injury.
- Your employer must post a list of at least six designated healthcare providers.
- After 90 days, you gain the right to see your own doctor at your employer's expense.
- Emergency situations, improper panel notices, and claim denials create exceptions to the 90-day rule.
- Understanding the steps to take after a workplace injury is essential to protecting both your health and your legal rights.
- Legal representation helps protect your medical treatment rights throughout your claim.
Understanding Pennsylvania's Panel Physician Rule
Pennsylvania's workers' compensation system operates under specific rules about medical treatment. If they meet specific conditions, the Pennsylvania Workers' Compensation Act grants employers the right to direct your medical care through a panel of designated physicians for 90 days following your work injury.
This 90-day period starts from your first visit to a panel physician, not from your injury date. During this time, if you want your medical treatment covered by workers' compensation, you must choose from your employer's posted list of providers.
Your Rights During the 90-Day Period
While employers have substantial control during the first 90 days, Pennsylvania law provides several important protections.
For the 90-day rule to be enforceable, your employer must do all of the following: Provide you with the list of approved doctors at the time of hiring; provide the list to you again after you are injured; and post the list in a common area at your workplace. If your employer does not do all three of these things, the 90-day restriction does not apply, and you can treat with a doctor of your choice immediately.
Key requirements for a valid panel include:
- At least six different healthcare providers
- Minimum of three physicians (not just chiropractors)
- Providers within a reasonable geographic distance
- Clear contact information for each provider
- Posting in an obvious workplace location
Without proper notice both before and after your injury, the 90-day restriction may not apply. This is one of several technical protections that experienced workers' compensation attorneys might use to help injured workers regain control of their medical treatment.
Emergency Treatment Exceptions
Emergency medical situations create an automatic exception to panel physician requirements. When you need immediate medical attention for a work injury, go directly to the nearest emergency room. After emergency treatment stabilizes your condition, your employer may direct follow-up care to panel physicians.
What Happens After 90 Days?
The 90-day mark represents a crucial turning point in your workers' compensation medical treatment. Once this period expires, you gain the right to see your own doctor for your work injury in PA. Your employer must continue paying for reasonable and necessary treatment related to your work injury.
Making the transition requires proper procedure. Notify your employer and their insurance company in writing about your doctor change. Include your new physician's contact information and keep copies for your records. During this stage, many injured workers also ask how long a workers’ compensation claim takes, since treatment changes can sometimes affect the timeline.
Common Employer Tactics and How to Respond
Employers and insurance companies sometimes use questionable tactics to maintain control over your medical treatment beyond 90 days. Some claim you must continue seeing panel physicians indefinitely. This assertion directly contradicts Pennsylvania law.
Insurance companies may delay approving treatment from your chosen physician or claim treatments aren't "reasonable and necessary." When you’re facing treatment denials or delays, several factors may strengthen your position:
- Clear documentation linking treatment to your work injury
- Support from your treating physician about medical necessity
- Consistent treatment history showing improvement
- Second opinions confirming your doctor's treatment plan
Knowing when to hire a Pennsylvania workers’ compensation lawyer can make all the difference in these disputes, and teaming up with a seasoned workers’ compensation lawyer strengthens your ability to effectively challenge these strategies.
Special Circumstances and Exceptions
Several situations create exceptions to standard panel physician rules in Pennsylvania. If your employer fails to properly post or maintain their panel physician list, you may be able to see your own doctor immediately. Employers may fail to meet notice requirements by posting fewer than six providers, using outdated information, or placing the list where workers can’t easily see it.
Additionally, the moment your employer issues a Notice of Compensation Denial on your case, you are no longer required to treat with the employer’s doctors. This is true even if 90 days have not passed since your injury.
When a panel physician refers you to a specialist, that specialist doesn't need to be on your employer's panel. Referrals for specialized treatment like surgery or advanced imaging typically fall outside panel restrictions.
Protecting Your Medical Rights
Successfully navigating Pennsylvania's workers' compensation medical treatment rules requires proactive steps. Review your employer's panel list before any injury occurs. Keep the following documentation throughout your treatment:
- Copies of all medical records and reports
- Written communications about doctor selection
- Photos of posted panel physician lists
- Bills and treatment authorization forms
This documentation becomes crucial if disputes arise or if you need to file a claim petition—what Pennsylvania calls challenging a denial. In these cases, knowing how to check the status of a workers’ comp claim helps you stay informed. Maintaining organized records strengthens your position in any proceedings.
FAQ for Can I See My Own Doctor After a Work Injury in PA
Can my employer fire me for wanting to see my own doctor after 90 days?
No, Pennsylvania law protects your right to choose your physician after the 90-day panel period. Terminating employment for exercising workers' compensation rights constitutes illegal retaliation.
What if there's no panel physician near my home?
Panel physicians must be geographically accessible. If all providers are unreasonably distant, this may invalidate the panel requirement, especially for workers with mobility limitations.
Do I need approval to change doctors after 90 days?
You don't need anyone's permission after 90 days. This right exists automatically under Pennsylvania law. However, properly notifying your employer helps avoid payment issues.
Can I get a second opinion during the 90-day period?
Yes, but your employer likely won't pay for consultations outside their panel during the first 90 days. Some workers pay for second opinions personally to verify diagnoses.
What if the panel doctor releases me to work but I'm still in pain?
This situation may require legal assistance. After 90 days, switching to your own doctor allows you to receive an independent evaluation. Document your ongoing symptoms carefully and consider seeking legal counsel to file a claim petition challenging any improper medical determinations.
Taking Control of Your Medical Treatment
Understanding your rights regarding medical treatment after a work injury in PA empowers you to make informed decisions about your care. While the 90-day panel physician rule creates temporary limitations, knowing the exceptions may help protect your health and claim.
Don't let confusion about medical treatment rules prevent you from getting the care you need. Contact Kaufman Workers' Compensation Law at (267) 626-2973 to discuss your specific situation. From our offices in Abington and Philadelphia, we help injured workers across Montgomery County and Southeastern Pennsylvania navigate complex medical treatment issues.
Jenifer Kaufman is a certified workers' compensation specialist in Pennsylvania—earning this credential in 2013, the very first year it became available, and renewing it in 2018. With our unique standby counsel service, you can have Jenifer Kaufman in your back pocket ready to help if problems arise, with no fee unless a claim petition becomes necessary. If you're navigating treatment problems or want peace of mind moving forward, we’ll help you pursue the full medical care you're entitled to under Pennsylvania law.