Regardless of how you got hurt at work or what kind of work-acquired medical condition you developed, you can likely count on workers’ compensation benefits to help support you. Even newly-hired or part-time employees will generally qualify for benefits if they can tie their medical issues to their employment.
In Pennsylvania, workers’ compensation can provide temporary and even permanent disability benefits when someone requires time off from work because of the medical condition they acquired on the job. They can also receive full medical coverage for their treatment.
However, there are many rules that govern medical care during a worker’s compensation claim. Those rules determine how long you can receive benefits, what doctors can treat you and what kind of treatments you will receive. If you disagree with the recommendations of the doctor overseeing your care, do you have the right to ask for a second opinion?
When can you get a second opinion?
Technically, you always have the option of paying out of pocket or using your health insurance to see a different medical professional for a second opinion. Unfortunately, if you want workers’ compensation to pay for the appointment, there is only one scenario in which coverage for a second opinion is automatic.
If the doctor overseeing your treatment recommends surgery, you can request a second opinion through the workers’ compensation program. This rule largely exists to help people seek out the least-invasive and most cost-effective treatment options given their conditions. If the second opinion does not involve surgery, the patient may be able to opt for an alternative treatment plan.
Otherwise, those hoping to obtain a second opinion or propose alternate treatments may need to cover the cost for that themselves, at least initially.
Making sense of medical benefits isn’t easy
In theory, workers’ compensation will pay 100% of your approved healthcare costs, but only for necessary treatment and only until you achieve maximum medical improvement for your condition. Especially when you have a lengthy road to rehabilitation ahead of you, it is important to understand what kind of benefits coverage you can expect to receive from workers’ compensation.
Securing professional help during your initial claim or any appeal you have to pursue will increase your chances of successfully obtaining workers’ compensation benefits.