TREATING WITH A PENNSYLVANIA COMPANY DOCTOR

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Partner at The Boles Firm | Experience Matters

As noted in this article, an employer has the right to create a list of panel medical providers (commonly called "company doctors") with whom an employee must treat for a period of 90 days from the date of first visit.  Few employers comply with the legal requirements governing panel providers, and thus virtually all Pennsylvania employees are free to treat with a physician of their choice, even during the first 90 days.  As a practical matter, however, many medical providers will refuse to treat employees for a work injury during the period of 90 days following the injury for fear that they will not be paid.  If you are in this situation, under Pennsylvania law, your health insurance carrier is legally responsible to pay medical bills that have been denied by the workers' compensation carrier.  If you have concerns about whether it is wise to treat with your own medical provider rather than a company doctor, please call us. If you want to learn about the experiences of people who have treated with Pennsylvania company doctors or post a review of your medical treatment, see my library page, "Reviews of Pennsylvania Company Doctors."

To ensure they receive steady streams of injured workers, company doctors develop cozy relationships with employers and insurance companies who refer them patients.  The doctor who was so nice to you for the first 60 days of medical treatment may suddenly pronounce that you are fully recovered and can return to work without restrictions.  You may protest that you still have serious pain, but the doctor may attribute that pain to a preexisting degenerative condition.  Your protests that you never had pain before the work injury will fall on deaf ears.

So how do you maximize the chance that the company doctor is going to support you?  Unfortunately, there are no guarantees that anything you do will make a difference, at least with some panel providers.  In general, however, physical therapy centers and medical specialists such as orthopedic surgeons on company lists tend to be more objective and less employer-oriented than medical facilities devoted exclusively to the treatment of patients referred to them by employers or insurance companies.  Typical occupational medical centers that rely upon referrals by employers or insurers include WorkNet Occupational Medicine, Concentra, WorkHealth, and  WorkCompvidence. These medical facilities tend to favor insurance company interests, as can be seen by reviewing some of the Yelp reviews for Concentra Medical Center in Plymouth Meeting. Because you have the right to choose from the providers on the company list, refuse to treat with any occupational health facility and insist on a specialist.

It is important to document your symptoms.  While you treat with a company doctor, write notes after each examination by the company doctor, including a description of all your symptoms.

I once had a case in which I represented a woman who treated with a well-known occupational health facility at her employer's direction.  She complained of back pain extending down the back of her leg into her foot, which is consistent with a serious spinal nerve injury.  Medical records from the occupational health physician repeatedly noted that my client denied any symptoms of any kind down either of her legs.  When I explained to her that the medical records did not support her claim that she described leg pain from the date the injury occurred, she started crying.  "I told them every time I saw them, Mr. Boles," she told me. The doctors who recorded that she did not complain of leg pain also referred her to a physical therapy facility.  I told her that we would order the physical therapy records.  Sure enough, the physical therapy records showed that every time that she went to physical therapy, the therapist documented that she complained of leg pain. The records of the occupational health physicians, therefore, were false with respect to the most important symptom she had.

Nonetheless, even though there are unscrupulous occupational health physicians who will not truthfully record your complaints of findings on physical examination, it is best to follow the advice that I provided in my article, "Handling the Independent Medical Evaluation" when dealing with a company doctor.  If you follow that advice, you will maximize the chance that the company doctor will support you.

The smartest thing you can do, however, is not to treat with one of these occupational health facilities at all.  Pennsylvania law requires that a list of panel physicians have no less than three physicians on the list.  On balance, it is better to treat with a physician than an occupational health facility.

If anyone reading this article is trying to figure out how to deal with a physician or medical provider on an employer list, call us at 877-959-1811 and fax the list of panel physicians to 215-827-5616 and we will tell you which of the medical providers on the list has the best reputation for integrity.