How Are Medical Benefits Paid Under the Pennsylvania Workers’ Compensation Act?

Many injured workers believe or are told they that they must treat with a company doctor for the first 90 days after they are injured. In most cases, this is not true. For more information, just click here to read “Exploding the Myth of the 90 Day Rule” by Dan Siegel.

Generally speaking, an injured worker can go to the doctor of his or her choice for medical care, and, provided the care is for a part of the body your employer agrees was injured, the employer must pay for the medical care based upon a fee schedule set up by the legislature in Harrisburg. If there is a billing dispute, or your employer or its insurance company believes that the care was not reasonable, the employer/insurer must file seek a utilization review. Regardless, an injured worker is not responsible or obligated to pay for any medical care related to a work injury.

Be aware, however, that the Workers’ Compensation Act only provides medical coverage for your work related injuries or occupational disease, not for other medical conditions. For non-work related conditions, you must use your private insurance (such as Personal Choice or an HMO) or pay for the care out of your own pocket. The Workers’ Compensation Act does not protect or guarantee your right to receive medical care for injuries or condition not related to your on the job injury. If you have the choice, always keep your private medical insurance.

For more information about medical treatment under the Workers’ Compensation Act, click here to read the Poster/Notice prepared by the Bureau of Workers’ Compensation for employers in Pennsylvania to display.

If you would like to speak with Dan Siegel, call (610) 446-3457 or send an email, and Dan will respond promptly. All workers’ compensation matters are handled on a contingent fee basis, which means that you never pay a fee unless Dan Siegel gets you benefits or successfully prevents your employer from stopping your benefits. Give Dan Siegel a call at (610) 446-3457 or send an email.