Direction to DoctorCan You Choose Your Own Doctor After a Work Injury in Pennsylvania?

If you were hurt on the job in Pennsylvania, someone probably told you that you have to see the company doctor for 90 days. That is sometimes true. It is often not. The difference comes down to paperwork your employer was required to complete, and many employers do not complete all of it.

Here is what the law actually requires, what you can do in the first 90 days, and what changes after that.

The Short Answer

Your employer can require you to treat with providers from a posted list, but only if the employer did three specific things correctly. If any one of them is missing, you are free to choose your own doctor from day one. Your employer is still responsible for the cost of your care.

Even when the list is valid, it expires after 90 days.

What the 90 Day Rule Actually Says

Under the Pennsylvania Workers' Compensation Act, an employer may set up a list of designated health care providers. The list has rules:

It must name at least six providers.

At least three of them must be physicians.

No more than two may be coordinated care organizations.

If the employer establishes that list properly and notifies you properly, you are required to treat with someone on it for 90 days. That clock starts on the date of your first visit to a listed provider, not on the date you were injured. That distinction matters. A delay in getting seen pushes the whole window back.

The Three Things Your Employer Must Do

For the 90-day requirement to apply to you, your employer must:

  1. Post the list of designated providers where you can see it.
  2. Give you written notice of your rights and duties under the Act.
  3. Have you sign an acknowledgment showing you were informed and understood.

That last step is the one employers miss most often. The notice is supposed to be given when you are hired and again right after an injury.

What Happens If Your Employer Missed a Step

Pennsylvania regulation is unusually direct here. If the employer fails to provide the notice and show evidence of it, that failure releases you from the duties in the notice. The employer still stays liable for the treatment you receive.

In plain terms: no valid notice means no 90-day restriction, and the bill is still theirs.

So, after a work injury, ask two questions and keep the answers:

Can I see the posted list of providers?

Can I see the acknowledgment form I signed?

If your employer cannot produce both, you may already be free to choose your own doctor. Bring whatever paperwork you have to your appointment. If you want a legal opinion on your specific situation, talk with a workers' compensation attorney.

Most offer free consultation.

What You Can Do During the First 90 Days

Even when the list is valid, you have more room than most people are told.

You can switch from one listed provider to another at any time. Nothing locks you to the first one you saw.

You can see a specialist that a listed provider refers you to, and that care is covered.

You can go anywhere for emergency care. Non-emergency care returns to the list for the rest of the 90 days.

You can see any doctor you want during the 90 days if you pay for it yourself.

If a listed provider recommends surgery, you have the right to a second opinion from a doctor you choose, and your employer pays for that opinion.

After 90 Days, the Choice Is Yours

Once 90 days have passed since your first visit, you may treat with any provider you want. Your employer still pays if the treatment is reasonable and necessary.

There is one deadline attached. You must notify your employer within five days of your first visit to the new provider. Put it into writing, send it in a way you can prove, and keep a copy.

Second Opinions Before Surgery

This right deserves its own section, because it is the one most worth using.

Say a provider on your employer's list tells you that you need an operation. Pennsylvania law lets you get another opinion from a doctor you choose. Your employer must pay for it.

Surgery is a decision you live with for years. Getting a second look before you agree to one is not being difficult. It is what the statute anticipates you will do.

Ask Where Your Imaging Is Going

Imaging drives decisions in work injury cases. An MRI report that describes ordinary age-related change instead of an acute tear can change what treatment gets approved.

You are allowed to ask questions about where your study is being done. Reasonable ones include these. Does the facility have a financial relationship with the insurer? How old is the scanner and what is its field strength? Will a fellowship trained musculoskeletal radiologist read it?

If the report does not match your symptoms or your physical exam, a second read by a musculoskeletal radiologist is a reasonable request. Findings do get missed, and a corrected read can change a treatment plan.

What to Bring to Your First Visit

The more you bring, the faster the visit goes.

The posted provider list, if you have a copy.

Any form you signed about your rights and duties.

Your incident or injury report.

Any imaging you have already had, on disc or through a patient portal.

The name and contact for your adjuster, and your attorney if you have one.

A written description of how the injury happened, while it is fresh.

Independent Orthopedic Care for Work Injuries in the Pittsburgh Area

Prisk Orthopaedics and Wellness is an independent practice in Monroeville. Dr. Victor Prisk is a board-certified orthopedic surgeon who holds surgical privileges at Allegheny Health Network and UPMC facilities.

‘Independent’ means no employer, insurer, or hospital system sets treatment targets here. We evaluate the injury and recommend what it needs. Sometimes that is therapy and time. Sometimes it is surgery. Either way you get the reasoning in plain language, along with written work restrictions specific enough to be useful to your employer.

Dr. Prisk treats work injuries throughout the musculoskeletal system, including the shoulder, elbow, hand, knee, neck, and back, along with his subspecialty focus in foot and ankle.

To schedule an evaluation, call 412-525-7692.

Frequently Asked Questions

Is the Pennsylvania workers' compensation 90-day rule real?

It is real, but it only binds you if your employer did everything the law requires. The employer must post a list of at least six designated providers, at least three of whom are physicians, provide written notice of your rights and duties, and obtain your written acknowledgment. If any piece is missing, the duty does not apply to you.

What would happen if my employer never had me sign anything?

Pennsylvania regulations state that an employer's failure to provide and make evidence the required notification relieves the employee of the duties in that notice, and the employer remains liable for the treatment provided. Ask to see the posted list and your signed acknowledgment and keep copies.

Can I switch between providers on my employer's list?

Yes. You may move from one designated provider to another during the 90-day period, and care from a specialist that a designated provider refers you to is covered.

Who pays for a second opinion on work injury surgery?

Your employer does. When a designated provider recommends invasive surgery, you may obtain an additional opinion from a provider of your choice, and the employer is responsible for the cost of that opinion.

How soon do I need to tell my employer I changed doctors?

Within five days of your first visit to a provider who is not on the employer's list, once the 90-day period has ended. Send it in writing and keep proof.

When do the 90 days start?

On the date of your first visit to a provider on the list, not the date of your injury.

This article is general information about Pennsylvania workers' compensation and is not legal advice or medical advice. Every claim and every injury is different. For advice about your situation, speak with a workers' compensation attorney and with a physician who has examined you.