When you have been injured in your workplace or developed an illness because of a job-related activity, it is reasonable to want to be treated by your regular physician. Many studies have shown that a patient’s trust in their doctor plays a vital role in the healing process.
But in the case of a work-related injury or illness, the rules are a little different. Seeing your regular doctor is not quite as easy as when you have a cold or when you have hurt yourself around the house. The laws that govern workers’ compensation in Pennsylvania will require a few more steps before you can see your regular physician.
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What Do I Need to Do If I Suffer a Work-Related Injury?
If you suffer an injury directly related to the work that you do for your job, you should notify your employer immediately. Even if an accident happens and you don’t think that you are injured, you should still notify your employer of the incident. In many cases, injuries or symptoms do not appear for days or weeks after an accident occurs.
Under Pennsylvania law, you have 120 days from when the incident took place to tell your employer that you have a work-related injury. Make sure you know the right person to notify — just telling another employee that you think you hurt yourself does not fulfill this requirement.
The best reason to report the incident as soon as possible, however, is that it adds to the credibility of your claim. If you wait a month or two before reporting a work-related injury, your employer may try to argue that it did not happen on the job. Do not try to “tough it out” and see if things improve. Report any accident or potential accident immediately.
In the case of a work-related injury like carpal tunnel syndrome, which develops over time and does not take place immediately, report the injury to your employer as soon you are aware that you may have carpal tunnel — normally after a medical visit or when you are forced to miss time because of the injury.
Once you have reported the injury or the incident to your employer, you then have up to three years from the date of the injury to file a workers’ compensation claim in Pennsylvania.
When Can I See My Own Doctor?
If you have been injured in a work-related incident or developed an illness due to exposure to chemicals or another substance on the job, you should seek treatment as soon as possible even if the illness or the injury appears to be minor. If you need immediate medical care, go to the nearest emergency room.
Make sure you tell them that you were injured on the job. And remember:
- If your injury does not require immediate medical care, Pennsylvania law requires you to select a doctor from a list of up to six workers’ compensation physicians that your employer will provide to you. You must continue to visit this doctor for the first 90 days after you report your injury or illness to your employer.
- If you require surgery, you may use your own doctor at any time during the 90-day period.
- Following this 90-day period, you may use your own doctor for any treatment.
- If you do decide to use your own physician following the 90-day initial period, you need to provide your employer’s workers’ compensation insurance carrier with a week’s notice.
- Your own doctor, however, may not be able to treat your workplace-related injury or illness. If that is the case, he or she can recommend you to another physician or a specialist who can treat your condition. But you can change doctors if you wish.
- Once you see a physician for two consecutive visits, they are considered your primary care physician for any workers’ compensation claims.
What Are the Responsibilities of My Employer?
After you have notified your employer of a work-related accident or injury, he or she must:
- Provide you with a list of up to six workers’ compensation physicians. As noted above, you must use one of these physicians for the first 90 days to treat a work-related injury or illness.
- Your employer also needs to post this panel of physicians in a location where you and your fellow employees will see them, such as a break room.
- Your employer is required to make sure you acknowledge in writing that you are aware of this 90-day requirement.
- Some employers fail to gather this acknowledgment and will try to tell their employees that they need to see the workers’ compensation physician past the 90-day deadline. Once the claim has been accepted by the employer or their insurance carrier, however, the 90-day requirement begins. After this point, the employee is entitled to see whichever physician they choose.
- If your employer does not inform you of this requirement or provide you with a list of these workers’ compensation physicians, and you visit your own physician to treat your work-related injury or illness, the employer or their workers’ compensation insurance carrier are required to pay your medical bills.
What If My Doctor Is Not on the List of Doctors Chosen by My Employer?
If you are thinking of launching a workers’ compensation claim, you are required by law to use one of the physicians chosen by your employer. You may ask your own doctor for a second opinion, but it is very likely this medical bill will not be covered by workers’ compensation and you will have to pay for it out of your own pocket.
The visit, however, may be worth the expense, especially if you do not trust the doctor, you are required to visit under the law.
Why Should I Be Concerned About My Choice of Doctor?
Although the physicians chosen by your employer or their insurance companies to provide the first 90 days of treatment for a work-related injury are supposed to be objective, this is often not the case.
Often, these doctors are retired physicians who do nothing but treat workers’ compensation claims once they have ended their regular practices. Some care very much about doing a good job. Others, however, have strong financial ties to the insurance companies or to the employers who choose them. They are retained because of their likelihood of rejecting workers’ compensation claims. If they start to approve too many of these claims, the insurance carriers and employers might drop them from the recommended panel of doctors, resulting in a substantial financial loss.
Once the required 90-day period has passed, it is crucial for you to select a doctor that you know and trust. Even if that doctor does not have the necessary skills to treat your work-related injury or illness, he or she can recommend you to another doctor or specialist can.
If your doctor needs to recommend you to another doctor or specialist, ask them to help you find a doctor who has experience with workers’ compensation claims and who is articulate. This doctor will play a key role in whether your workers’ compensation claim is granted or denied. Along with diagnosing your condition and making decisions about treatment, if you are forced to pursue a claim, the Workers’ Compensation Commission relies on accurate doctors’ notes when making their decisions.
This doctor may also be required to testify during a hearing. It is therefore imperative that they can clearly explain why they believe your injury is eligible for workers’ compensation.
What Should I Tell the Physician That I Am Required to See During the Initial 90-Day Period?
Despite the availability of new, more modern medical technology, most doctors still rely on what their patients tell them about their symptoms, including the level of pain, their difficulties with movement and how the injury is affecting their life.
When that patient has a soft tissue injury — one that will not show up on an X-ray or an MRI — this is, even more, the case. Here are some points to remember:
1. Do Not Lie or Exaggerate
People sometimes feel the need to exaggerate their illnesses or injuries in order to be believable.
When the doctor asks you to describe the level of pain on a scale of 1 to 10, and you reply that it is at a level 10 all day long, it is not believable. You need to be able to tell the doctor what it is like throughout the day. Perhaps it is a 4 in the morning when you get up and then feels a little better, around a 2, at lunchtime. But then in the evening it intensifies and, just before you go to bed, it’s often around 9 or 10.
Describe your injuries completely and accurately.
2. Tell the Doctor About All of Your Symptoms or Conditions
Report everything to the doctor, including even minor aches and pains. Let the doctor decide what is related to your injury and what is not. Sometimes that minor ache or pain can indeed let the doctor know you have been injured.
3. Do Not Speculate About Your Injuries
Do not speculate on what your injuries might be. If the doctor asks you a question and you do not know the answer, say so. Never say that you think you have recovered if the doctor asks you that question. It is not up to you to determine when you have fully recovered.
Who Will Pay My Medical Bills?
When you are first injured, your employer or the employer’s insurance company will pay for the medical bills until they have decided whether to pay for your claim. This is why it is so important to tell your employer as soon as possible of any work-related accident or incident and then to file a workers’ compensation claim. No medical bills will be paid until you file a claim.
If your employer approves your workers’ compensation claim, they will continue to pay for all medical bills. Employers. However, will try almost anything to get an employee off workers’ compensation as soon as possible. This is another reason to have an experienced workers’ compensation attorney helping you.
If your employer or their insurance company denies your claim, you are forced to pay for your own medical bills until the Workers’ Compensation Commission holds a hearing. If the commission decides in your favor, you may then seek reimbursement from your employer and their insurance company.
It is often the case that, during a workers’ compensation appeal, a doctor will continue to see you and not ask for payment until after you have received the benefits to which you are entitled.
Can I Get a Lawyer If I Do Not Want My Work Doctor?
It is always a good idea to work with an experienced workers’ compensation attorney after a work-related injury. If you feel that the employer-appointed doctor is not being fair or is obviously tipping the scales in favor of the employer or the employer’s insurance company, an experienced workers’ compensation lawyer may be able to help you see a physician of your own choosing.
This is not the only reason, however, to work with an experienced workers’ compensation attorney. Your attorney can also help you gather the appropriate medical records that you might need and interview people who may have witnessed your injury or who can testify to the conditions that may have led to a workplace injury. Your attorney will make sure that all the required papers are filed on time and that you know about any hearings which you are required to attend.
The other benefit of hiring an experienced workers’ compensation attorney is that they won’t ask you for a penny upfront. All workers’ compensation claims are dealt with on a contingency basis, and the rules for what attorneys can or cannot be paid are largely set by the state.
Let KBG Injury Law Help You With Your Workers’ Compensation Claim
Preparing a workers’ compensation claim can be difficult and time-consuming. The process is made even harder when you are trying to accomplish all these various tasks and are still dealing with the after-effects of your injury.
At KBG Injury Law, our experienced workers’ compensation attorneys have the knowledge and the experience to help you with your claim. They will fight to make sure you receive all the benefits to which you are entitled. They will also make sure your employer does not try to force you to continue to see a workers’ compensation doctor when you are no longer required to do so.
We understand how important these claims are to our clients and their families. If you would like to know more about how we can help you with your workers’ compensation claim, call us at 1-800-509-1011 or visit our contact page and leave us your name and details. A member of our team will get back to you as soon as possible.