Workers’ Compensation Health Care Provider Panels

May 21, 2007

The PA Workers’ Compensation Act gives employers the right to establish a list of designated health care providers. When the list is properly posted, injured workers must seek treatment for the work injury or illness with one of the designated providers for 90 days from the date of the first visit. There are some specific guidelines provided in the rules and regulations[Subchapter D, Sections 127.751 through 127.755 of the rules and regulations found on page 237 of the Workers’ Compensation Act] for these lists:

  • The employer must provide a clearly written notice to employee of the employee’s rights and duties.
  • The notice must be signed by the employee at the time of hire, whenever changes are made in the list and at the time of injury.
  • The list must contain at least six providers; three of the six providers must be physicians.
  • Providers as defined in the Act are more than just physicians (includes chiropractors) .
  • Each provider’s name, address, telephone number and specialty must be included on the list.
  • If a particular specialty is not on the list and the specialty care is reasonable and necessary for treatment of the work injury, the employee will be allowed to treat with a health care provider of his or her choosing.
  • The employer may not direct the employee to any specific provider on the list.
  • The employee may switch from one designated provider to another designated provider.
  • Listed providers must be geographically accessible.
  • Listed providers must contain specialties appropriate for the anticipated work-related medical problems of the employee.
  • If employer’s list of designated providers fails to comport with the Act and the regulations, the employee has the right to treat with a provider of his or her choice.