05.30.2016

Medical Treatment and Workers Compensation Claims

Under the Pennsylvania Workers Compensation Act  (77 Pa. C.S.A. § 1-1031), in addition to wage-loss benefits, an injured worker is entitled to payment of reasonable surgical and medical expenses for treatment of their work injury. This includes hospital treatment and services, medical supplies, medication, orthopedic appliances and prosthetic devices. Medical benefits for injured Pennsylvania workers are generally paid without regard to length of disability or amount of cost. Pennsylvania Workers’ Compensation procedures are form-intensive, Powell Law can assist in meeting all necessary procedural requirements to successfully file your workers’ compensation claim.  Medical Treatment and Workers Compensation Claims

Currently, the Pennsylvania Workers’ Compensation Act requires an injured worker choose a doctor from a list of employer-mandated health-care providers. Employers must provide a list of at least six health-care professionals, at least three of whom must be doctors and no more than four of whom may be associated with a coordinated-care organization. After the employee chooses a provider from this list, he or she must continue to exclusively see and receive treatment from this doctor for 90 days from the date of first treatment.

If a doctor from the employer-mandated list recommends surgery or invasive treatment, the worker has the right to seek a second opinion from any doctor, not just a provider on this list. If the second doctor proposes a different treatment plan which the injured employee chooses to accept, the employee must receive this treatment from an employer-mandated provider who is on the list, but only for the period within the 90-day timeframe. After the 90 day period passes, the worker may receive treatment from the health-care provider of his or her choice.

Claim acceptance results in an obligation by the employer/insurer to continue paying workers’ compensation benefits for both wage loss and medical expenses until certain events occur.  Examples of these events that end the obligation to pay medical expenses are if the employee sufficiently recovers from the work injury to be able to return to some level of work, or if the employee dies from causes that are not injury-related.

Powell Law has litigated on behalf of employees seeking workers’ compensation benefits for 110 years. Your first consultation is free. Contact us online or call (570) 961-0777.

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