Under the Pennsylvania Worker's Compensation rules, when an employee is injured at work, you must report your injury to your supervisor as soon as possible. Your company has a right to provide you a list of at least 6 designated healthcare providers. It is against the Pennsylvania regulations for the company to direct you to a single provider, as an injured employee you have a right to choose from a lease 6 provided providers on the company list. When an injury occurs, and the company refers you to the hospital, occupational center or company doctor it is important upon presentation to that facility that you do the following:
- Report all the areas of injury. Many times, a company doctor may concentrate on one area of an injury. Failing to document all areas of injury can become very problematic later on in the future.
- If you are not struck in the head by an object, have a full which you strike our head against the ground or other objects around you, or in a vehicle accident in which you may strike your head against objects within the car or violently shaken you could have sustained a concussion/mild to moderate traumatic brain injury.
- Symptoms for traumatic brain injury are as follows:
- Neck pain with radiating tingling, numbness, weakness or unusual sensations radiating to your fingers.
- Blurred vision
- Double vision
- Vomiting or regurgitation
- Trouble with balance
- Ringing in the ears
- Loss of smell or taste
- Run your hands on the side of your face including the forehead, cheek and chin at the same time each side to see if one side feels numb.
- Short-term memory loss (forgetting her keys, wallet, or not sure there are the direction that you are traveling in), long-term memory loss (forget the name of a loved one like your children or spouse).
- Trouble falling asleep or staying asleep throughout the night
- Difficulty counting money, adding or subtracting numbers
- Difficulty with concentration, thinking through problems, difficulty with reading and understanding the material
- Anxiety, depression, fear of returning to the site where the injury occurred.
- If you suffered from neck pain or upper back pain do you have any tingling, numbness, weakness, radiating or shooting pain that travels to your fingers. You may have difficulty holding onto a cup of coffee, or have difficulty picking up very small items like a paperclip or pins. Can you have a loved one the inside and outside of your arms, forearms and all your fingers at the same time to both hands. Do you feel numbness, tingling or unusual sensations to one part of the arms, forearms or hands compared to the other side?
- Do you suffer from upper and middle back pain or chest pain and if you scratch the front part of your chest and along the ribs on both sides at the same time there is one side film number than the other side?
- If you suffer from low back pain are you experiencing any tingling, numbness, weakness, radiating or shooting pain that travels to your groin, or radiating down your legs to your feet and toes. Do feel like you are losing your balance? There is swelling to your feet and toes, or is it just numb. Can you scratch both sides of your thighs, legs, feet and toes and have the same sensation equally between the left and right lower extremity?
- Can you raise both shoulders over your head without difficulty?
- Can you perform a squat without needing assistance getting up and does this cause hip pain, knee pain, leg weakness, or pain to the foot and ankle?
- Do notice any swelling or discoloration to any parts of your body especially your arms and hands or legs and feet.
- Do you notice any abdominal pain or are there any black and blue marks noted on the abdominal area, chest area or throughout the extremities?
If you experience any of the following signs or symptoms, you must report all of these findings to the company doctor especially on the first visit. That first visit is extremely important for the future of your treatment. If the doctor, nurse practitioner or physician assistant failed to document any of the symptoms that you are experiencing, the insurance carrier will not pay for treatment to that area if you do not make sure that the doctor has documented that area. I strongly advise you to ask for a copy of your first visit records by the company doctor and read them before you leave the facility to make sure everything has been appropriately documented.
If any documentation or reported symptoms or injuries are not noted on the initial visit, I would strongly recommend that you tell your employer and seek a second opinion from the designated list of providers immediately. Remember documentation is extremely important in protecting your injured body parts.
The Pennsylvania workers' compensation RULES:
The Pennsylvania workers' compensation system protects employees and employers. Employees receive medical treatment and are compensated for lost wages associated with work-related injuries and disease, and employers provide for the cost of such coverage while being protected from direct lawsuits by employees. Workers' compensation coverage is mandatory for most employers under Pennsylvania law. 1 This means that your employer cannot be sued for any injuries you sustained in a work-related injury. At the same time the employer's insurance company will cover you for any medical treatment (that is deemed medically reasonable and necessary) and pay for your salary while out of work or in a modified duty.
Employers are responsible for the injured employees’ medical bills. When you are injured, you employer must provide you with a written notice of these rights and duties at the time of injury or as soon after the injury as is practicable.2
An injured employee has to treat with a "company doctor" for 90 days from the first visit. But the following rules must me meet:
- At the time of injury your employer has to provide you a list of at least six designated health care providers within your geographical location and the company cannot direct you to a specific provider.
- You employer provides written notification of your rights and duties.
- And has your written acknowledgment that you have been informed of these rights and duties.
- If an employer fails with the above you can receive treatment from any doctor or provider of your choice.
After 90 days of the first visit with a company doctor, you can receive treatment from any doctor or provider of your choice.
Choice of Health Care 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.
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. You must notify your employer of the provider you have selected. During treatment, the employer or the employer's insurance carrier is entitled to receive monthly reports from your physician or provider.
If the company doctor discharges you before 90 days and you continue to experience pain or symptoms related to the work-related injury you are allowed to seek treatment from any other provider.
Once you begin receiving WC benefits, the employer/insurer has the right to ask you to see a doctor of their choice for examination. If you refuse, the employer is entitled to request an order from the WC judge requiring you to attend an examination. Failure to then attend may result in a suspension of your benefits.2