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Does PA Workers’ Comp Pay for Time Off to See Your Doctor?
If you’ve experienced a work-related injury, seeking immediate medical attention is crucial for your health and to support your workers’ compensation claim. Depending on your injury, you may have follow-up appointments for further assessments, treatment and physical therapy. These appointments cost time, mileage and money.
Both federal employment laws and Pennsylvania workers’ compensation laws influence whether you’ll need to cash in your paid time off (PTO) to cover these appointments. This guide will explain what medical appointment costs workers’ comp covers.
Laws Governing Workers’ Comp and Time Off for Doctors’ Appointments
The federal Fair Labor Standards Act (FLSA) regulation 29 CFR 785.43 requires employers to pay employees for time spent during work hours getting immediate necessary medical care after a work-related injury. This applies to any urgent medical care you need because of a work-related injury or that your employer instructs you to get.
The FLSA does not mandate your employer to pay for time spent on follow-up workers’ compensation medical appointments during work hours unless the employer tells you to attend these appointments. Likewise, Pennsylvania state laws leave PTO policies between employers and their workers.
The Pennsylvania Workers’ Compensation Act does not establish a requirement for your employer to pay you for hours spent getting ongoing medical care during your workday. It does establish compensation for necessary medical costs as well as lost wages during hours spent getting necessary medical care for a work-related injury. It also reinforces the employer’s duty to pay for the costs involved in an immediate medical examination after a work-related injury.
Workers’ Comp and Time Off for Doctors’ Appointments FAQ
The legal landscape outlined above can help answer the most common questions about medical appointments after a work-related injury.
1. Are Initial Workers’ Comp Appointments Paid by Employers?
Yes. If you are hurt doing your job, your employer should cover your time getting immediate medical attention from emergency room staff or a doctor. If they don’t, you can receive compensation for this time after filing a successful workers’ compensation claim. You should not have to use PTO for an urgent doctor’s appointment right after a work-related injury. If your employer pressures you to use your paid or unpaid leave for these hours, seek an attorney’s help.
2. Does Workers’ Comp Pay for Time Off for Ongoing Doctors’ Appointments?
Maybe. Your employer does not have to pay you to attend medical appointments during work hours once you return to work after your initial injury and appointment. The best solution is to schedule these appointments outside work hours. Speak to the doctor about available slots before or after your workday.
If the only time you can get a necessary medical appointment is during your workday and you lose paid hours, you may be able to get compensation through partial disability benefits. Consult an attorney to check how this could work in your situation and whether you can avoid using your PTO.
If these appointments happen while a severe work-related injury is keeping you out of the workplace for an extended time, a successful workers’ comp claim can help cover your lost wages.
3. Does Workers’ Comp Pay for Time Off for Physical Therapy?
Maybe. The same rules apply to physical therapy as to other kinds of appointments. If you’ve returned to work full-time or part-time, try to schedule these sessions outside work hours. If scheduling sessions outside of work hours is not possible, consult an attorney about getting workers’ compensation for lost wages while undergoing necessary physical therapy. If you can take unpaid leave and receive compensation for lost work hours, you may be able to save your PTO.
4. Will You Get Compensation for Mileage?
Sometimes. The Pennsylvania Workers’ Compensation Act requires employers to cover reasonable travel expenses for employees getting the required independent medical examination after a work-related injury. For subsequent treatment, you can usually only claim reimbursement for mileage if you must travel outside your local area to get necessary medical treatment not available close to home. For example, if you need to travel more than 100 miles for an appointment, you may be able to receive reimbursement.
5. Can You Get Compensation for Doctors’ Fees?
Yes. If you file a successful workers’ compensation claim, you can receive compensation for all necessary and reasonable medical expenses related to your work injury. These include:
- Service fees from doctors and other medical professionals.
- Reasonable surgical expenses.
- Necessary hospital treatment costs.
- Prescribed medications and supplies.
- Orthopedic devices.
6. Do You Have to See a Doctor?
Yes. Seeing a doctor right after a work-related injury occurs is necessary to address any urgent medical needs you may have and to document the nature and scope of your injury. Even if you think the injury is minor and will probably get better in a day or two, you should report the injury the day it occurs. If you feel medical treatment can wait for an afternoon or evening when you report it, that’s ok. But if you are not better the next day, you need to tell your employer and either see a doctor on their list, or, if they have no list, go to your own doctor to document the injury.
Your employer or their work comp insurance carrier may ask you to go to an independent medical evaluation. While you are required to attend, understand that it is not independent. They are choosing a doctor and may be getting an opinion that they want; not necessarily what is medically or factually accurate. If you are being asked to attend an independent medical evaluation, that is not a good thing and you should consult with an attorney BEFORE you go.
You should get a medical evaluation for your well-being and to support your compensation claim. Waiting too long after the injury to get medical attention will make your injury appear less serious to a court.
7. Can You Choose Your Doctor?
Yes, with some conditions. Your employer’s insurer has the right to list at least six health care providers for you to choose from. If they do this, you must choose one from the list, or they won’t be obligated to cover your fees. You can select any provider from that list. After 90 days, you can continue treatment with a provider of your choice. If they don’t provide a list, the choice is yours.
Contact Frommer D’Amico for Legal Support With Pennsylvania Workers’ Comp
If you’re a Pennsylvania employee and have experienced a work-related injury, a seasoned workers’ comp attorney can help you file for compensation and protect your PTO. For legal support that puts you first, reach out to John Frommer and Joe D’Amico. Your call is confidential.
These certified workers’ comp specialists assist employees throughout Pennsylvania in filing comp claims, supporting them with evidence and navigating appeals if necessary. If you’re unsure how to approach your medical appointments after an injury without sacrificing your hard-earned employee benefits, John or Joe can help you find the best way forward. Frommer D’Amico has won big payouts for PA workers in many industries and will invest this experience into fighting for you.
When you choose Frommer D’Amico’s personalized legal support with your workers’ comp case, you’ll save on fees and not pay a cent unless we win your payout. For a free consultation with a PA workers’ comp specialist, contact us today.
Joe D’Amico has more than 20 years of experience fighting for injured workers. He is Certified as an Expert in Pennsylvania Workers’ Compensation Law by the Supreme Court of Pennsylvania. Joe is one of the very few Pennsylvania workers’ compensation attorneys who have obtained a recovery in excess of $1.5 million for an injured worker.
Reviewed by Joe D’Amico.