What is the Workers’ Compensation 90 day rule?

This is a very common question for victims of a workplace injury, we hear it all the time with our worker’s comp and personal injury clients. To be clear about what we’re talking about, we have to explain what the Worker’s Compensation 90 day rule is, and how it affects you and your workers’ compensation case in Pennsylvania. When we’re talking about the workers’ compensation 90 day rule, we’re talking about the section in the Pennsylvania Workers’ Compensation Act which states that for the first 90 days after your work injury, you are required to treat with the company’s / insurance company’s doctor.

So to answer the question “What is the workers’ compensation 90 day rule?” It’s the rule in the Pennsylvania Worker’s Compensation Act that says for the first 90 days after a workplace injury, you are required to get treated by the company’s “panel” doctor.

Workers’ Compensation 90 day rule in Pennsylvania

Pennsylvania law is very specific in regard to the doctors you are allowed to obtain treatment from after being injured at work. Specifically, the Pennsylvania Workers’ Compensation Act indicates that for the first 90 days after your work injury, you are required to treat with the company’s panel doctor. If you’ve been injured at work in PA you need to know about the workers’ compensation 90 day rule.

If you’re not aware of the workers’ compensation 90 day rule, and after a workplace injury you decide to get treated by another doctor who is not one of your company’s “panel” doctors, your employer may not be required to cover your medical bills. If you mess this up and your employer doesn’t have to cover your medical bills, you may have to cover your medical bills!

This can be a very costly mistake, so it’s important to know the rules, in this case the workers’ compensation 90 day rule. The workers’ compensation rules in Pennsylvania are very complex and can be intimidating for someone who’s been injured at work and is just starting to look into all of the rules and regulations of Pennsylvania’s Workers’ Compensation Act.

That’s why it’s important to consult an experienced workers’ compensation lawyer with a good track record of winning cases in Pennsylvania, like Attorney Joshua B. Goldberg, author of “The Essential Pennsylvania Workers’ Compensation Survival Guide”. Call today, set up your free consultation, and we’ll help you fully understand the workers’ compensation 90 day rule, and guide you through your workers’ comp case to the payout you deserve!

How do I find my company’s panel doctor?

So, now that we know what the Workers’ Compensation 90 day rule is in Pennsylvania, and that you have to use you company’s panel doctor for treatment within the first 90 days of a workplace injury, we can discuss what a panel doctor is and how to find your company’s panel doctor.

Most employers have a panel physician list, which is a list of doctors / organizations chosen by the company, where an injured worker can obtain medical treatment. All initial treatment (within 90 days of workplace injury) must go through these specific physicians. These doctors will control the treatments received for the first 90 days, this is important to remember.

According to Pennsylvania’s Workers’ Compensation 90 day rule, employers in PA should post a list of chosen “panel doctors” in a place that is easy for employees to see, and employees must be informed of and sign off on their obligation to see a doctor from this “panel” when hired. If you’re having a hard time finding your company’s list of panel doctors, ask your employer to show you their list of panel physicians.

What happens after 90 days?

After the initial 90 day period, you are permitted to treat with any doctor you choose. The Workers’ Compensation 90 day rule no longer applies to you. At that point, you would simply submit the insurance carrier information / claim number to the new physician of your choosing, so that the insurance company is properly billed for the treatment rendered to you after the 90 day mark.

What if I don’t follow the Workers’ Compensation 90 day rule?

You might be wondering “What if I don’t follow the workers’ compensation 90 day rule?” and you decide to go to your personal doctor right away after a workplace injury.

Technically, you are allowed to treat with any doctor you want after you are injured at work. However, the insurance company is under absolutely no obligation to pay for medical treatment received from your family doctor or any other physician that is not a panel doctor, if that treatment is obtained within the first 90 days.

In other words, you can choose to ignore the workers’ compensation 90 day rule and go to a different doctor, but the insurance company is not required to pay for that treatment if you are still within the first 90 days after your work injury. If you would like to obtain treatment from a different physician, you will be on your own to pay for this medical treatment. It is unlikely that your private health insurance would cover any medical bills in this regard, if the treatment is for a work-related injury.

Anytime your treated for a Work Injury in PA

No matter what doctor you choose to treat your workplace injury, or if you abide by PA’s Workers’ Compensation Act’s 90 day rule, there are a few things you should always remember when getting treatment in Pennsylvania. Always make sure to be very specific with your doctor as to:

• How you were injured
• Your symptoms
• Body parts injured
• Where the injury occurred
• What you were doing at work that lead to the injury
• etc.

You must provide a completely accurate description of your work accident and injuries sustained. If you do not, it could lead to a denial of your medical bills and ultimately impact your workers’ compensation case.

Should I consult a Workers’ Comp Lawyer about the Workers’ Compensation 90 day rule?

Since we’ve covered what the Pennsylvania Workers’ Compensation 90 day rule is in this blog post, you don’t really need to consult a PA workers’ compensation lawyer to explain what the workers’ compensation 90 day rule is, but if you’re researching the 90 day rule, and you’ve made it to the bottom of this article, you’re probably dealing with a workplace injury and you should 100% seek legal counsel.

Consulting an experienced workers’ compensation attorney in Pennsylvania will help you with your workers’ comp case more than any blog article ever could. Workers’ compensation cases are complicated, and any mistake can cost you dearly.

So please, before continuing your online research into Pennsylvania’s workers’ compensation 90 day rule, reach out to us. We’ll help you get a better understanding of where you stand in the eyes of Pennsylvania’s workers’ compensation act, we’ll fight to get you the compensation you deserve after being injured at work, and we offer free consultations for our workers’ compensation clients!

What are you waiting for? Call us today, or fill out one of our contact forms on this website, schedule your free consultation and start taking action toward getting the workers’ compensation settlement you deserve!