You are entitled to certain benefits under the Pennsylvania workers compensation program. These benefits include payment of any and all medical bills arising from your injuries. However, there may be limitations and restrictions regarding what doctor you may see and what treatment you may receive in order to have those bills paid. Under Pennsylvania law, if your employer has posted a list of doctors where you work, you will need to go to a doctor on that list to receive your first 90 days of treatment from a work-related injury. If you do not go to a doctor on a posted list, then your employer may be justified in not paying your bills. If, however, there is no posted list, or if more than 90 days have passed since treatment began for your injury, you may then begin going to any doctor that you choose who is a qualified and licensed physician in Pennsylvania.
When you go to a physician - your own or one chosen by the company - there are other requirements regarding getting the bills paid through workers compensation. First, the treatment must generally be reasonable. Highly experimental treatments, or those that are not necessary or not likely to work, are not going to be reimbursed in most cases. When you request payment for medical bills, the healthcare provider usually needs to submit details to the insurer about the treatment and why it was necessary in order to be reimbursed.
If your employer's insurer isn't paying reasonable bills, any disputes on fees can be heard by the Pennsylvania Workers Compensation Board. These disputes are governed under section 127 of the workers compensation laws. An application for fee review, along with details about the unpaid claim, may be submitted to the Workers Comp board within 90 days of billing or within 30 days of receiving notice that the payment is disputed. A lawyer may also be able to assist you in getting workers compensation claims paid for in a timely manner.