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When can an injured worker receive a second medical opinion?

On Behalf of | Oct 16, 2023 | Workers' Compensation

Ultimately, receiving proper treatment is crucial for keeping someone at work after they get hurt on the job. Thankfully, workers can usually count on Pennsylvania workers’ compensation benefits to help them afford proper treatment for a work-related medical condition. As such, an injured worker does not determine their own care plan. Instead, they must seek evaluation from a physician and then abide by that medical professional’s recommendations for treatment.

Workers’ compensation claims may involve trauma care immediately after someone gets hurt and a variety of different treatment options, including physical therapy, medication and surgery. Sometimes, the patient receiving treatment questions whether the recommended treatment plan is appropriate. As a result, they may understandably wonder whether workers’ compensation will cover the cost of a second opinion in Pennsylvania.

Patients facing surgery have special rights

Typically, a patient undergoing treatment should abide by a doctor’s recommendations. After all, a physician has training to understand what someone needs, and members of the public do not have the same knowledge or experience. Compliance with medical instructions will be crucial to protecting a worker’s eligibility for future benefits.

However, there are scenarios in which an individual can ask for a second opinion while relying on workers’ compensation to cover that expense. If the physician overseeing someone’s care specifically recommends surgery, then the patient has the right to request a second opinion within 90 days of the doctor reaching that conclusion.

If a patient disagrees with the need for physical therapy or other treatment, they technically have the right to seek a second opinion elsewhere. They cannot automatically assume that workers’ compensation will cover those costs. This can leave patients in a difficult position, as failing to comply with medical instructions might leave them ineligible for ongoing benefits.

Some patients may choose to pay out of pocket for a second opinion to ensure they can continue receiving the coverage and treatment they require while healing from a work-related medical condition. Learning more about the rules that apply to a Pennsylvania workers’ compensation claim may help employees better utilize their rights after a job injury. Seeking legal guidance is a good way to get started.