The rules governing which doctors you can see when you are on workers’ compensation may seem confusing. There are restrictions on what your employer will pay for when you get injured on the job.
Most people don’t realize that you can receive treatment from a physician who is not on the list of approved doctors provided by your employer’s insurance company. However, if you choose to do this, you may have to pay for the expense out of pocket. Even if you do not treat with a panel physician, you may not have to pay if your employer failed to properly notify you of the list of panel providers. Most workers prefer for workers’ compensation to take care of their expenses, so they may stick with the approved treatment list.
Yet sometimes a problem can’t wait. If you notice a sudden change in your condition, you feel intense pain or you experience another alarming symptom, you may want to visit the emergency room (ER) to get treatment. This most often happens at night or on the weekend, when your general practitioner or treating doctor may not hold office hours. But going to the ER for a work-related injury may not always be covered by workers’ compensation.
Does Workers’ Comp Pay for an Emergency Room Visit?
Can you go to the ER under workers’ compensation? If you have a serious problem that requires immediate medical attention within the first 90 days after an injury, then workers’ compensation should cover an ER visit, as long as you meet certain conditions:
- The treatment has been OKed by your employer or workers’ comp, or the claim has been approved by means of a Notice of Compensation Payable
- You have to visit a panel provider within the first 90 days of the injury if the ER visit took place during those 90-days
If you go to the ER after the initial 90-day period, workers’ compensation may not cover the cost. When there are other options available for treatment, you should seek those out first rather than visiting the ER. The ER should be the very last step when on workers’ compensation for more than 90 days. However, our attorneys have commonly been able to get ER treatment paid for by the workers’ comp carrier.
Your lawyer in your workers’ compensation case may note that an ER doctor will not make an effective witness should your case be contested. These physicians often change locations, and they treat so many patients each day, they may not remember the details of your case clearly. They also do not have the training to recognize the causal effects of workplace circumstances.
Consult a Lawyer About Going to the ER for a Work-Related Injury
It’s always better to play it safe during a workers’ compensation case. If you are not sure if you should do something, contact your lawyer to discuss your situation. They can advise you on the best course of action.
Are you looking for an attorney for your case? Frommer D’Amico only handles workers’ compensation and represents workers. We also charge low fees, so you can feel good about choosing us. Contact us today at 717-400-1000 or get in touch online.
John Frommer has been litigating Pennsylvania workers’ compensation and personal injury cases for more than 30 years. Since 1997 he has been an Adjunct Instructor of Trial Advocacy at The Dickinson School of Law at Penn State. He was named to the Order of the Barristers and named as a Pennsylvania Super Lawyer for Workers’ Compensation.
Reviewed by John Frommer.