Pennsylvania Workers Comp Questions

[jeslinks10]

Hello,
I fell at work in november 2010. I notified employer same day but an accident report was not completed. I started hurting a few weeks later. I worked through it while managing pain with OTC medication. I also saw a chiropractor 1 time in December and 1 time in January. Pain continued to get worse. In February 2011 I notified my employer that I should probably go to the WC doctor to get checked out. Doctor says cervical strain, started physical therapy treatment 3 times a week. This did not work. Pain continued to get worse and finally I am diagnosed with cervical disc problems. I will get a 2nd MRI next week and also continue with conservative treatment for now.

Questions:
After I went to the WC doctor I was placed on limited duty. This has resulted in me making less money. I am a truck driver and get paid by the load. I am continuing to work through this on limited duty. Will I be able to collect partial workers compensation benefits although I did not miss any full days of work?

Will the chiropractor visits in December and January affect my workers compensation benefits in any way?

Thanks for your time and responses!

[1171]

the answer is yes to both.
a positive prior injury or medical condition requires that the treating doctor account for the current symptoms and establish liability for any subsequent industrial injury.

[jeslinks10]

OK. I saw the chiropractor for the current injury. I did not realize it was as serious as it seems to be. I thought an adjustment would help.
That shouldn't be a problem, right?

[1171]

the treatment rules allow employer to limit your choice of doctors to those on the list
more information here
http://www.portal.state.pa.us/portal/ser...e=2#doctor

[jeslinks10]

Yes, I am aware of those rules. The accident report was not filed until February 2011. I went to the chiropractor on my own, prior to the accident report being filed, in an attempt to get relief from the pain from the work injury I suffered in November 2010.
Now that an accident report has been filed, I am wondering if the chiropractor visits will cause a problem or not?


I appreciate your responses. Thank You.

[1171]

since you indicated they were for the industrial injury and you paid for them yourself they shouldn't be a problem.
a worker can provide treatment at his own expense at any time.

[jmf973]

As long as your chiro is relating your adjustments to your injury in November there shouldn't be a problem. The only issue you may run into with the treatment is if your employer has a panel in place then you are required to treat with a panel physician. If the chiro is not on the panel the WC carrier is not required to pay for it. They can if they choose to.

Now in regards to the panel (if there is one in place) your employer is required to have you sign the form twice (once when it's put into place or if it changes at all and then a second time when you are injured). If they did NOT do this then the panel is invalid. If you call a physician on the list and they are out of business or don't take work comp then the panel is invalid and you are free to choose your treating physician. If they have a panel in place and it's a valid panel then you are required to treat with the panel doctor for 90 days and then if you choose to you can change. If your employer does not have a panel in place you are free to choose where you treat. If the panel is invalid they can not have a new one put into place and require you to treat with it. It would only be valid for injuries that happen after the panel is put into place.

Also, wc carriers are not allowed to pre auth treatment in PA however when they receive the med notes they can deny the bills if they deem the treatment is not appropriate.

If you have limited duty and are working less hours, working at a lesser pay, or they can't accommodate at all then you should be due some TTD/TPD benefits and I would strongly let your adjuster know so they can review for payments.

(03-05-2011 10:55 AM)jeslinks10 Wrote:  Hello,
I fell at work in november 2010. I notified employer same day but an accident report was not completed. I started hurting a few weeks later. I worked through it while managing pain with OTC medication. I also saw a chiropractor 1 time in December and 1 time in January. Pain continued to get worse. In February 2011 I notified my employer that I should probably go to the WC doctor to get checked out. Doctor says cervical strain, started physical therapy treatment 3 times a week. This did not work. Pain continued to get worse and finally I am diagnosed with cervical disc problems. I will get a 2nd MRI next week and also continue with conservative treatment for now.

Questions:
After I went to the WC doctor I was placed on limited duty. This has resulted in me making less money. I am a truck driver and get paid by the load. I am continuing to work through this on limited duty. Will I be able to collect partial workers compensation benefits although I did not miss any full days of work?

Will the chiropractor visits in December and January affect my workers compensation benefits in any way?

Thanks for your time and responses!

[jeslinks10]

I appreciate the responses. Thanks!
It sounds like I should not have any problems.

[Timothy Belt]

You are entitled to 2/3 of the difference between your time of injury average weekly wage and your actual earnings after the injury so long as your loss of earnings is related to the work injury. I would also agree with the prior posts that if you were not provided with proper notice of the provider panel, you are free to treat with whoever you want, and the IC is responsible for payment. I would suggest that if you have not already done so, that you talk to a lawyer as soon as possible since it does not sound like your employer is living up to their obligations.

(03-06-2011 12:44 PM)jeslinks10 Wrote:  I appreciate the responses. Thanks!
It sounds like I should not have any problems.

[Aldis]

First of all I wish you to get well soon....I think you have to take complete rest instead of doing work in low scale...that will make you fully recovered, The you will be able to do your work as before the injury.