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.
IN CASE OF WORK-RELATED INJURY OR DISEASE
It is your responsibility to immediately report the injury to your supervisor.
If you suffer a work-related injury, Travelers Insurance will pay for reasonable surgical and medical services, medicines, supplies, orthopedic appliances, and prostheses, including training in their use. In accordance with the Pennsylvania Workers' Compensation Act, and to ensure that your medical treatment will be paid for by Travelers Insurance, you must select from one of the physicians or other health care providers in the approved list below.
You must continue to visit one of these physicians or other health care providers listed below, if you need treatment, for 90 days from the date of your first visit. After this 90-day period, if you still need treatment, you may choose to go to another physician or other health care provider for treatment. If this situation should arise, let your employer and your Travelers Insurance claims representative know within five days of the first visit.
All physicians and other health care providers must file reports within 10 days after your first visit and at least once a month for as long as treatment continues in order for payment to be considered.
If one of the physicians or other health care providers listed in the approved physician list below refers you to another physician, or health care provider your employer or its insurer will pay the reasonable bills for these services.
If you’re faced with an immediate medical emergency, you may secure initial assistance from a hospital, physician or other health care provider of your choice. You must then seek subsequent treatment from a physician or other health care provider listed in the approved list for at least the first 90 days from the date of your first treatment.