Dr. David DeFries

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Workers Comp Injury Doctor

Getting treated for a work related injury by the right doctor is important. Most injuries incurred while on the job do not result in debilitating conditions when treated correctly and as soon as possible. Delays in treatment may result in worsening of the condition which can lead to loss of mobility, increased degeneration and an overall decrease in the quality of life.

In Pennsylvania, Workers Comp claims are handled by the Department of Labor and Industry and there are specific steps for someone to follow who would like to file a claim. 
If medical care is needed, the agency advises the following:

"Employers are responsible for advising workers of their rights and duties under Section 306(f.1)(1)(i) of the Act. The written notice of these rights and duties is to be provided to the employee at the time of injury or as soon after the injury as is practicable.
 
In the event of a work-related illness or injury, you are entitled, if covered under the Act, to the payment of related reasonable surgical and medical services rendered by a physician or other health care provider.

Medicine, supplies, hospital treatment and services, orthopedic appliances and prostheses are also covered for as long as they are needed. (To assure payment of medical services, see Choice of Doctor.) Even if you have lost no time from work, health care costs for a work-related injury or illness are payable at the fee schedule rate. However, an employee may not be charged the difference between the health care provider's charge and the amount paid by the employer or its insurance carrier. In other words, there can be no balance billing to you."

Choosing your provider

 

"You are free to choose your own health care provider to treat your work injury unless the employer accepts your claim and has posted in your workplace a list of six or more physicians or health care providers. You are required to visit a provider on the list for initial treatment. You are to continue treatment with that provider or another on the list for a period of 90 days following the first visit. You may see any provider on the list; your employer may not require or direct you to any specific provider on the list"

It is important to understand this paragraph as far too often injured workers fail to get care due to false directions or a misunderstanding of their rights.

  • Your employer must have a posted list of providers ( panel providers). If there is no list or there is not a provider type on the list ( ie chiropractor, podiatrist, physical therapist)  you can elect to see whomever you choose.
  • Your employer cannot steer you or force you to one particular provider..it is your choice as long as they are on the panel if there is a list posted.
  • If there is a panel, you must use those providers for the first 90 days

​"If during the 90-day period you visit a provider(s) not on the list, your employer or your employer's insurance carrier may refuse to pay for such treatment. After the 90 days, and in situations where your employer has no posted list or an improper list, you may seek treatment with any physician or other health care provider you select"

 

 


 

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