While workers’ compensation is a nationwide protection granted to injured workers, how courts and officials handle workers’ comp cases is up to each state. As a result, workers' compensation laws vary depending on what part of the country you’re in. Despite this, you might be surprised to learn that nearly every state has its own version of “the 90-day rule” in workers’ compensation law.
However, what one state means by the “90-day rule” could differ wildly from what another state calls “the 90-day rule.” By and large, these rules are not related to any other state’s rules, but they all use 90 days as a period by which the rule takes effect.
For people unfamiliar with the law, it can be a little confusing.
The 90-Day Panel Physician Rule in Pennsylvania
Our state’s 90-day rule, for instance, deals with seeking medical care after a work injury.
In Pennsylvania, the 90-day rule states that injured workers must initially see "panel physicians”—a list of pre-approved doctors posted by the employer—within 90 days of their workplace injury to receive compensation. If they see a different doctor, workers' compensation won’t necessarily have to cover the cost. However, after the 90-day period, workers can see any licensed medical care provider of their choice, but ongoing care must be "necessary and related to the work injury.”
Other states have different rules regarding when and how long an injured worker can see a doctor of their choice. Some states may have a longer or shorter waiting period before an injured worker can see a non-panel physician, and others may have different requirements for ongoing care. You have a right to know the specific rules and regulations for workers' compensation in your state if you are injured on the job.
Other 90-Day Rules Across the Country
In other states, their own versions of the 90-day rule may have nothing to do with panel physicians. For instance, California’s 90-day rule has to do with insurance deadlines. Insurers have 14 days from the filing of a work injury claim to respond. Employers may delay a claim decision, but if they do, they have 90 days to review and respond to the claim. If 90 days pass without a response, the claim is considered automatically accepted, and all eligible costs are covered by workers' compensation. Meanwhile, other states have entirely different rules setting deadlines for insurers on workers' compensation cases.
See what we mean by confusing?
If you’re injured at work in Pennsylvania, you need a Pennsylvania workers' comp lawyer. When it comes to your future, you can’t afford to make any mistakes—especially given how tough workers’ comp law can be to navigate. The law firm of Handler, Henning & Rosenberg LLC, led by J. Jeffrey Watson, has the experience, skill, and know-how to get you what you need. Watson is certified as a specialist in the practice of workers' compensation law by the Pennsylvania Bar Association’s Workers' Compensation Law Section as authorized by the Pennsylvania Supreme Court. Don’t let an injury on the job prevent you from getting the compensation you deserve. Contact Handler, Henning & Rosenberg LLC for a consultation today.
FAQs
The 90-Day Panel Physician Rule in Pennsylvania
What is the 90 day rule for workers comp in PA? ›
Pennsylvania law is very specific in regard to the doctors you are allowed to obtain treatment from after being injured at work. Specifically, the Pennsylvania Workers' Compensation Act indicates that for the first 90 days after your work injury, you are required to treat with the company's panel doctor.
How long does an employer have to hold a job for someone on workers compensation PA? ›
An employer does not have to hold your job while you're on workers' compensation. If your company needs to hire someone to do the job in your place, it can replace you and offer you a suitable replacement job.
How long can you be out on workers' comp in PA? ›
This classification assumes that you are 49 percent or less disabled. It also assumes that you cannot recover from your illness or injury within 90 days and that you cannot resume your same job duties. You can collect partial lost wage benefits for a maximum of 500 weeks (approximately 9.6 years).
How is workers comp settlement calculated Pennsylvania? ›
In the typical workers' comp settlement, amounts originate from two-thirds of your average weekly pay and the 500 weeks that injured workers in Pennsylvania are eligible for benefits. If two-thirds of your average weekly pay was $500, then you'll multiply $500 by 500 weeks for a total of $250,000.
What is the 90 day rule for employees? ›
Definition. At its core, the 90-day rule requires employees to report their work-related injuries to their employer within 90 days of the occurrence. This prompt reporting ensures that the claim process can begin swiftly, allowing for timely medical treatment and financial compensation.
Can you be terminated while on workers comp in PA? ›
You are not fully protected against losing your job, even if you return to work on restrictions from your doctor. While nothing gives your employer the right to retaliatory termination, your employer may give you a reason beyond the workers' compensation claim.
Does my employer have to hold my job while on workers' comp in Pennsylvania? ›
Your employer is within its rights to terminate your employment after you filed a workers' comp claim or even while you are receiving benefits. There is no law requiring your employer to hold your position open while you are unable to work.
Can I lose my health insurance while on workers' comp in PA? ›
Unfortunately, if you have trouble paying for health insurance while on workers' comp in PA, your employer is not required to assist you. It's possible for you to lose coverage during your time off work.
Can I quit my job while on workers comp Pennsylvania? ›
Can I quit my job during a workers' comp claim? According to Pennsylvania laws, employees can typically quit a job at any time and for any reason unless they are bound by a contract.
Approximately two-thirds of the workers' salary for total disability (up to a maximum dollar amount provided by law) is paid for the time lost from work as a result of the work related disability, if the disability lasts longer than seven calendar days. There is no maximum payment period.
What is the workers compensation limit in PA? ›
(3) Workers compensation insurance with statutory benefits as required by Pennsylvania law; employers liability insurance with minimum limits of: $ 100,000 each accident for bodily injury by accident; $ 100,000 each employee for bodily injury by disease; and $ 500,000 policy limit for bodily injury by disease.
What is the longest you can be on workers' comp? ›
Some states limit the length of time an injured worker can receive temporary benefits. This range can be three to seven years. That said, there is not usually a limit on permanent disability benefits. However, some states do stop weekly benefits when employees reach the age of 65.
Does surgery increase workers' comp settlement in PA? ›
Under Pennsylvania law (77 P.S. § 531), workers' compensation insurance must pay for your medical expenses, including surgery. If your surgery is unsuccessful, the value of your claim will increase, as this means you are more likely to have a higher disability rating.
Which body part has the highest value in a workers' compensation claim? ›
Aside from losing a limb, workers' compensation cases that involve head injuries typically have the highest value in a claim and settle for the most amount of money.
Do you pay taxes on workers comp settlement in PA? ›
Workers' compensation benefits are generally tax-free under Pennsylvania law. They are not taxed like regular income.
What is the waiting period for workers' comp in PA? ›
Benefits for time lost from work are payable on the eighth day after injury. Once you have been off work 14 days, you receive retroactive payment for the first seven days.
Does my employer have to hold my job while on workers comp in Pennsylvania? ›
Your employer is within its rights to terminate your employment after you filed a workers' comp claim or even while you are receiving benefits. There is no law requiring your employer to hold your position open while you are unable to work.
What is the longest you can be on workers comp? ›
Some states limit the length of time an injured worker can receive temporary benefits. This range can be three to seven years. That said, there is not usually a limit on permanent disability benefits. However, some states do stop weekly benefits when employees reach the age of 65.
Can you quit your job while on workers comp in Pennsylvania? ›
If you are getting workers' compensation benefits in Pennsylvania, it doesn't mean you are locked into your employment. You can quit your job after suffering a work-related injury, and it shouldn't automatically disqualify you from workers' compensation benefits.
