Pennsylvania Workers’ Compensation Medical Treatment Guidelines
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Employers purchase workers’ compensation insurance to obtain financial protection against incidents and accidents that happen in the workplace. Every state but Texas requires private sector employers to participate in a state workers’ compensation program. Each state has created different requirements for participating in a workers’ comp program, but the process to apply for workers’ compensation benefits is similar among the 49 states that require employers to buy insurance for injured employees.
One of the differences among the states concerning workers’ compensation insurance involves how each state defines the guidelines for receiving medical treatment. For example, Colorado has implemented a few different guidelines than the guidelines implemented by Pennsylvania. If you sustained an injury or injuries at work in a city such as Pittsburgh, Scranton, Harrisburg, or Philadelphia, you should be familiar with the Pennsylvania workers’ compensation medical treatment guidelines.
Before you file a workers’ compensation claim in Pennsylvania, you should meet with an experienced workers' compensation attorney who specializes in helping clients file persuasive claims for financial assistance. At Morgan and Morgan, our team of workers’ compensation lawyers reviews the information handed over by a potential client, as well as explains the Pennsylvania workers’ compensation medical treatment guidelines. The way you go about receiving treatment for one or more injuries plays a significant role in determining whether your employer’s insurance company approves your claim.
Although employers are financially protected by workers’ compensation, this does not mean your employer’s insurance company will approve your claim for financial assistance. Schedule a free case evaluation today with one of the highly-rated workers’ compensation attorneys at Morgan and Morgan.
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What Are the Most Common Types of Workers’ Compensation Accidents?
With more than three decades of experience representing clients for workers’ comp cases, the experienced team of lawyers at Morgan and Morgan has handled just about every type of workplace accident. However, the following types of accidents represent the most common workplace accidents that lead to the filing of workers’ compensation claims.
From a receptionist continuously typing to a warehouse worker lifting both arms throughout the day to stock products, a repetitive motion injury such as carpal tunnel syndrome (CTS) can take years to develop. Repetitive motion injuries impact the hands, wrists, and arms more than any other area of the body, although you can develop CTS in the legs and shoulders as well. The pain starts as a dull ache and if left untreated, CTS can morph into an agonizingly painful workplace injury.
Unsafe Lifting Technique
Just about every type of occupation requires some degree of lifting. Even improperly lifting a light load off the floor of an office can tweak a muscle in the back. Although just about every employee undergoes safety training that includes a segment discussing how to lift with your legs, many workers forget the timeless advice and instead, lift heavy objects with their backs. Back injuries caused by improper lifting techniques are especially prevalent in warehouses and at construction sites.
Slip and Fall
Employees that work in the retail and hospitality industries are more likely to sustain an injury caused by a slip and fall. Grocery stores are a workplace accident waiting to happen in just about every aisle, as well as in the back of the store where inventory sits. Slick floors are the number one culprit for causing slips and falls.
Slip and fall accidents can produce serious injuries like head trauma and broken ribs.
What Is the Workers’ Compensation Process in Pennsylvania?
The workers’ compensation process in Pennsylvania follows many of the same steps required by 48 other states. Nonetheless, Pennsylvania has established a couple of unique rules that pertain to workers’ compensation in the Keystone State.
Report the Accident
Pennsylvania law gives employees 120 days to report a workplace accident that caused an illness or injury. The reason for the long period granted for reporting a workplace accident is that many illnesses take time to develop symptoms. For example, a worker who developed an illness because of prolonged exposure to toxic chemicals might not develop symptoms of the illness for several weeks after exposure to the toxic chemicals.
The key is to be proactive and contact a workers’ compensation attorney from Morgan and Morgan as soon as possible after a workplace accident. If you wait more than 120 days to report a workplace accident, your employer’s insurance company does not have to pay workers’ comp benefits.
Receive Medical Attention From an Approved Physician
If your employer posts a list of eligible physicians to see after a workplace accident, Pennsylvania law requires you to see one of the physicians on your employer’s list if you want your employer’s insurance company to approve compensation. You must visit one of the approved doctors within 90 days of sustaining an injury or developing an illness because of an accident at work.
One important note: If you sustained a serious injury caused by a workplace accident, you should seek medical treatment right away. A co-worker or a manager who witnessed the accident should inform your employer about the incident.
Employer Files a First Report of Occupational Injury Form
According to Pennsylvania law, your employer should file a First Report of Occupational Injury form to its insurance company, as well as to the Pennsylvania Bureau of Workers’ Compensation. Your employer’s insurance company has 21 days to approve or deny your claim, which covers the cost of medical bills and any lost wages associated with your missed time from work because of an illness or injury. To receive compensation for the first seven days of lost wages, you must have missed work and received medical care for at least 14 days.
Determining Employer Responsibility
If your employer accepts responsibility for your work-related illness or injury, you receive a Notice of Compensation Payable. Some claims in which an employer assumes responsibility for a workplace accident can get approved for temporary workers’ compensation payments that last for 90 days. If your employer denies responsibility for causing your illness or injury, then you receive a Notice of Compensation Denial.
Hiring one of the skilled litigators at Morgan and Morgan can help you navigate the Pennsylvania workers’ compensation process. Working with a workers’ comp lawyer also ensures you meet the Pennsylvania workers’ compensation medical treatment guidelines.
What Are the Medical Treatment Guidelines for Workers’ Comp Cases in PA?
The workers’ compensation process in Pennsylvania often confuses both employers and employees, particularly when it comes to the 90-day rule for visiting with a physician on an employer’s select list of approved healthcare providers. The heart of the confusion concerns seeking medical care from your own doctor and not a doctor listed on your employer’s list of approved physicians. Pennsylvania workers’ compensation law only impacts the insurance company’s obligation to pay for the treatment provided by a physician not listed on your employer’s panel.
Consult with your Morgan and Morgan attorney to ensure you receive the best treatment that is covered by workers’ compensation insurance.
Can I Get a Second Opinion on a Recommended Surgery?
If a physician from your employer’s panel of approved healthcare providers recommends surgery, you have the right to seek a second opinion from your own doctor. In addition, your employer must pay for the cost of receiving a second opinion.
What Happens if My Employer’s Insurance Company Denies My Claim?
Your Pennsylvania-licensed workers’ compensation lawyer will explain the appeal process if you decide that is the approach you want to take for receiving financial assistance. However, if your employer’s insurance company denies your workers’ compensation claim, Pennsylvania law requires your health insurance company to fill the financial void and pay for all healthcare costs related to your workplace accident.
Am I Eligible to Receive Compensation for the Cost of Prescription Medications?
Under Pennsylvania workers’ compensation statutes, your employer must pay for the costs of prescription medications if you demonstrate the medications are directly related to treating your illness or injury. If your employer’s insurance company determines the request for compensation to cover the costs associated with prescription medications is not valid, then the insurer has the right to withhold payments and submit the withholding reasons for a Utilization Review.
Discuss the Pennsylvania worker’ compensation medical treatment guidelines with your attorney from Morgan and Morgan.
Why Should I Choose Morgan and Morgan?
More than 30 years of experience handling workers’ compensation cases is just one reason why you should hire Morgan and Morgan to help you navigate the Pennsylvania claim process.
Workers’ Compensation Law Is One of Our Specialties
When your financial health is on the line because of a workplace accident, you cannot afford to hire an attorney who treats workers’ compensation law as a side practice to fill in the gap left by the lawyer’s true legal specialty. At Morgan and Morgan, our workers’ compensation attorneys practice workers’ comp law and nothing else.
Thorough Knowledge of Pennsylvania Workers’ Compensation Medical Treatment Guidelines
One small misstep during the claim process can cost you a considerable amount of money. By working with a litigator from Morgan and Morgan, you receive the type of legal support that ensures you comply with all Pennsylvania workers’ compensation medical treatment guidelines.
Represents Employees, Not Employers
Many lawyers provide legal support to both employers and employees for different cases. For example, a lawyer might represent a grocery store in a slip and fall case, and then a few weeks later represent a client who slipped and fell at another grocery store. Morgan and Morgan's attorneys work only for employees who sustained injuries or developed illnesses because of a workplace accident.
Represent You From Start to Finish
When you hire a workers’ compensation attorney from Morgan and Morgan, you can expect the lawyer to provide legal support from the day of the free case evaluation to the day when your employer approves your claim. Many attorneys meet with clients for a free case evaluation, only to disappear for the remainder of the case.
Superior Approval Rate
When it boils down to choosing the best legal representation for your workers’ compensation case, you want to hire a legal counselor who has compiled a high approval rate for claims. At Morgan and Morgan, we are the leaders in helping out clients get approved for workers’ compensation benefits.
Learn more about Pennsylvania workers’ compensation medical treatment guidelines by scheduling a free case evaluation with one of the experienced attorneys at Morgan and Morgan.