For most of us, you start your day thinking about your job tasks and deadlines. The thought that you may have a worker’s compensation accident does not typically cross your mind. However, statistically, you are likely to have a work accident sometime during your work career. The statistics grow stronger if you work in a physical job and use machinery.
Step 1: Notify Your Employer in Writing
When a work accident occurs, certain steps must be taken immediately. First, the employee must notify the employer. The Pennsylvania Workers Compensation Act requires notice to be provided within 120 days. However, the employee should report the injury as soon as possible. Written notices such as text messages and emails are paramount to verbal phone calls. Under Pennsylvania law, the workers compensation carrier has 21 days to issue the proper documentation. The carrier may issue a NTCP (Notice of Temporary Compensation Payable), NCP (Notice of Compensation Payable), or a Denial. An NTCP or an NCP means the compensation carrier has temporarily accepted the claim, and benefits will continue for some time. If the employee receives a denial, he/she should contact an attorney immediately, as no benefits will be forthcoming.
Step 2: Obtain Treatment with a Panel Provider
Under Pennsylvania Law, the employer must post a list of “Panel Providers” in an area of the employer’s premises that is visible to all employees. As an injured employee, you must be treated with a “Panel Provider” for the first 90 days after your accident. The Workers Compensation carrier is not required to pay medical bills for any provider who is not on the list, excluding emergency care. During medical treatment with the Panel Provider, the injured employee will generally be given restrictions. All medical treatment with a Panel Provider is paid for by the compensation carrier. If an employee receives a medical bill or a co-pay bill, the employee should contact the compensation adjuster or an attorney immediately.
Step 3: Exercise Your Right to Choose Your Own Doctor After 90 Days
Every injured employee must know that under Pennsylvania Law, they have the right to select their own doctor after 90 days. Panel Providers may not provide an accurate diagnosis and often can be dismissive of an injured employee’s complaints. The process for switching from a Panel Doctor to a Doctor of your choice is as simple as making an appointment with the new Pennsylvania Doctor and providing proof that you have an open claim. The new doctor should have a thorough understanding of your physical job requirements so that they can provide restrictions that will avoid further injury.
Step 4: Use Your Restrictions As Your Life Line
Whether the employee is treated with a Panel Doctor or their own Doctor (after 90 days), the doctor will provide restrictions. The restrictions should be in writing. As the injured employee, it is vital that you adhere to the restrictions. The Injured Employee should provide a copy of the restrictions to the employer. If the employer provides work within the restrictions, the injured employee is obligated to return to work. If the employee receives a valid job offer or return to work within his/her restrictions and does not return to work, the Compensation Carrier can suspend money benefits, and the employee will jeopardize his/her right to benefits. If the employer does not have work within the restrictions provided, the workers compensation carrier will continue to pay weekly money benefits.
The foregoing is an overly simplified overview of the Pennsylvania Workers Compensation System from the employee’s perspective. Please feel free to contact me at broemersma@wwgrlaw.com for any additional information.
