Workers’ compensation is designed to provide wage-loss benefits and reimbursement for reasonable medical care for any employee who is injured on the job. Your employer shall provide payment for reasonable surgical and medical services, services rendered by physicians or other health care providers, medicines and supplies, as and when needed.
Your employer, in compliance with the Workers’ Compensation Act, has posted a list of at least six medical providers from which you are to select. You are to obtain treatment from one of the providers of your choice for 90 days from the date of your first treatment.
If during the initial 90-day period you wish to change medical providers, you must once again re-visit your employer’s physician list and select a new physician. If you do not seek treatment from a provider on the approved physician list for the initial 90 days following your first visit, your employer will not have to pay for the services rendered.
If one of the listed providers recommends invasive surgery, you are entitled to a second opinion from a physician of your choice. Should your physician’s opinion differ and you choose that opinion, the panel physician will abide by the same for 90 days.
After the initial 90-day period, if additional or continued treatment is needed, you may now choose to go to another physician or health care provider of your choice. Should you decide to change providers, you must first notify your employer within five days of your first visit with your new provider. Failure to notify your employer will relieve your employer of the responsibility for the payment of the services rendered if such services are determined to have been unreasonable or unnecessary.
Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.