Workers’ Compensation & Emergency Room Visits
Let’s talk about the general rule first since there is a lot of confusion about this. If the employer has a posted list of doctors and has made the injured worker aware of their legal obligations in this area; the injured worker is required to treat with one of the panel doctors for the first 90 days of treatment.
Note that the “panel doctor” rule goes to payment, not treatment. An injured worker can treat with any doctor they want to from day one; however, it won’t be paid for by the Workers’ Compensation Insurance unless and until the “90 day” rule for treatment has been satisfied and the Workers’ Comp claim is accepted by means of a Notice of Compensation Payable.
Many doctors are confused by this and will wrongly tell an injured worker that they can’t be treated by a independent doctor until after the 90 days. This is wrong; the injured worker can treat with both a panel and a non- panel doctor as long as they have another way of paying the non-panel doctor during the first 90 days.
An emergency is an exception to the “90 day” rule. If an injured worker can’t wait for a panel doctor and the injury is serious; he or she can treat at the ER and it will be paid for by Workers’ Comp as long as the Workers’ Comp claim has been accepted by means of a Notice of Compensation Payable. Once the emergency subsides; however, the injured worker has to back to a panel provider during the first 90 days, if the injured worker wants the bill to be paid for by Workers’ Comp.
It is obvious that a patient needs emergency care during a medical emergency. Sometimes; an injured worker will seek ER care after the “90 day” rule where symptoms such as pain need immediate attention and can’t wait. It can be difficult to get ER visits paid for in this situation, if they aren’t reasonable or necessary and there are other cheaper options available. The ER should be a treatment should be of last result. Also, from a lawyers point of view; ER doctors won’t be much help in a Workers’ Comp case since they move frequently and aren’t trained or interested in the causal connection between a work injury and the current medical problem.
Contact PA Workers’ Compensation Lawyers
If you have any questions or concerns about your ER treatment for a Pennsylvania Workers’ Compensation injury, fill out our online form or call the attorneys at Calhoon and Kaminsky P.C., at (717) 695-4722 for a free consultation and a free case review.
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For more than 20 years, our attorneys have been helping injured workers navigate the complex Pennsylvania workers’ compensation system. We empower workers with the information and the representation they need to make the best decisions for themselves and their families’ future.
