Q: Can you go to your primary doctor if your employer only gave you one health care provider for workers compensation?
My boyfriend is a mechanic that works for Firestone. He recently got his hand crushed underneath a tire machine. His employers only gave him one health care provider and he wants to get a second opinion on his injury. Is he able to go to his own primary doctor considering that his job only gave him one specific health care provider for workers compensation as a second opinion?
In order to control an injured worker's medical treatment the Employer is required to establish a list of designated physicians including at least 6 medical providers identifying specific positions. Said List of Designated Physicians must be posted at a readily accessible place at the worksite. In addition, the Employer is required to have the injured worker execute the Requisite Notice of Employee Rights and Obligations at or about the time the injury is reported. If neither or both did not occur the injured worker is free to treat with a physician of his own choosing in accordance with the Medical Cost Containment Regulations.
If your boyfriend has been advised that he is only able to treat with one physician, it is likely that his Employer has failed to comply with the aforementioned Regulations and he would be free to treat with his own physician. If, however, the Employer did comply with both pre-requisites your Boyfriend can still treat with his old position, however, the Workers Compensation Carrier would not be required to pay for said medical treatment.
Again, if your boyfriend's Employer did comply with both prerequisites they are only able to control medical treatment for 90 days, unless surgery has been recommended within said timeframe.
It is my recommendation that your boyfriend contact an Attorney who is a Board Certified Specialist in Pennsylvania Workers Compensation Law to discuss his rights and remedies for taking any action. The initial consultation will be Free of charge and most Attorneys accept Workers Compensation Claims on a Contingent Fee Basis.
Timothy Belt agrees with this answer
1 user found this answer helpful
A: I agree with attorney Jaffe that if your boyfriend's employer has not complied with the requirement that they maintain a list of panel doctor's and properly provide their injured worker with this panel that your boyfriend is free to treat with a medical provider of his choosing. I would simply add that even when the injured worker is legal correct in regard to their rights, that does not always mean that the employer or its workers' compensation carrier are going to make proper payment. That is why it is important that your boyfriend obtain a workers' compensation attorney as soon as possible to make sure that his rights are protected.
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