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Exploding the Myth
Of the 90 Day Rule
By Daniel J. Siegel, Esquire
(c) 2006, Daniel J. Siegel
The constant mantra that injured workers must treat with a “company doctor” for 90 days is a myth, and it’s time to put it to rest. All too often, I hear that the “law” requires an injured worker to treat with a “company doctor” for 90 days when, in reality, this “rule” applies to virtually to no one. I hope this “Practice Tip” puts this myth to rest – for good.
Treatment with a “company doctor” is governed by Section 306(f.1)(1)(i), whose relevant provision says:
Provided an employer establishes a list of at least six designated health care providers, no more than four of whom may be a coordinated care organization and no fewer than three of whom shall be physicians, the employe shall be required to visit one of the physicians or other health care providers so designated and shall continue to visit the same or another designated physician or health care provider for a period of ninety (90) days from the date of the first visit: Provided, however, That the employer shall not include on the list a physician or other health care provider who is employed, owned or controlled by the employer or the employer’s insurer unless employment, ownership or control is disclosed on the list. . . . Should the employe not comply with the foregoing, the employer will be relieved from liability for the payment for the services rendered during such applicable period. It shall be the duty of the employer to provide a clearly written notification of the employe’s rights and duties under this section to the employe. The employer shall further ensure that the employe has been informed and that he understands these rights and duties. This duty shall be evidenced only by the employe’s written acknowledgment of having been informed and having understood his rights and duties. Any failure of the employer to provide and evidence such notification shall relieve the employe from any notification duty owed, notwithstanding any provision of this act to the contrary, and the employer shall remain liable for all rendered treatment. Subsequent treatment may be provided by any health care provider of the employe’s own choice. (emphasis supplied)
In the decade or so since the legislature enacted this provision, I have never met an injured worker whose employer complied with it. Consequently, and much to the dismay of employers and insurers, if the employer hasn’t provided the employee with requisite written notification, and obtained the employee’s signature, and provided the list complies with all of the other requirements of Section 306(f.1), an injured worker does not have to treat with a company doctor.
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