In the state of Pennsylvania, those filing workers’ compensation claims must follow certain rules. For instance, if the employer has a preferred provider list, the injured worker must see one of those doctors for the first three months to receive medical benefits. Known as IME or independent medical exams, these visits start the paper trail necessary for a workers’ comp claim. Read on to learn more about independent medical exams.
IMEs and Employers
An employer’s insurance company pays for an IME, as well as the doctor performing the exam. However, these company doctors may tell a person that they can go back to work and they’re no longer injured. At any time during treatment, a worker has the right to decline to have an insurance rep present during a medical exam.
Workers also have the legal right to request a second opinion, for which the employer’s insurer will pay if the company doctor has already recommended invasive or extensive surgery. An employer may request that an injured worker see the company physician every six months while they’re receiving benefits. However, if problems arise, workers’ compensation attorneys in Luzerne County, PA may be able to help.
After the 90-Day Period and When There’s No Preferred Provider List
After the initial 90 days, an injured employee can go to their own doctor, chiropractor or another medical professional, as long as they notify the insurer within five days of the change. If the employer does not have a preferred provider list, the worker has the right to choose their own doctor and have their bills paid from the beginning.
When the Company Physician Clears the Employee to Return to Work
If the company’s doctor gives their permission for the worker to resume their duties, there are two options:
- Agreeing with the doctor and returning to work.
- Disagreeing with the physician. If the employee doesn’t go back to work, the employer may file a petition to suspend, modify or terminate their benefits. In such a case, it’s necessary to go before a workers’ comp judge.
Filing for and receiving workers’ comp benefits is a lengthy and complicated process. To get through it efficiently, consider working with workers’ compensation attorneys in Luzerne County, PA. Call The Law Office of Robert D. Elias to request a consultation. You can also follow them on Twitter.