What is a “panel of physicians” and what medical treatment am I entitled to?

Ramos-Law-Firm

An employer is required to post a list of physicians showing injured employees physician with whom the Employer or insurance company has pre-approved for treatment. This list of often referred to as the “Panel of Physicians.” The Employer may maintain a traditional panel of physicians that shall consist of at least six (6) non-associated physicians. However, Employers are allowed to have more than six physicians on this panel. The minimum panel shall include an orthopedic physician, and no more than two physicians shall be from industrial clinics. This panel shall include a minority physician, where feasible. Most employers have this “traditional panel.”

In some circumstances, Employers may maintain a list of physicians known as the “conformed panel of physicians”, which shall include a minimum of ten (10) physicians or professional associations. The physicians and groups listed on the panel shall be counted as a separate choice from the others listed only if they are not associated with other physicians or groups on the panel. This panel includes the same physicians required in the traditional panel, plus a chiropractor and a general surgeon.

Finally, Employers may contract with a Workers’ Compensation Managed Care Organization (WCMCO) certified by the Board. A “WCMCO” provides for the delivery and management of treatment to injured employees with a complex network of physicians. The WCMCO sets its own rules and regulations for treating the Employees.

The injured employee may select any physician on the panel and may make one change to another physician on the panel without approval of the Employer. Additional changes require approval of the Board or agreement of the parties. If the case is accepted under workers’ compensation, the employee will be able to treat and costs will be paid by the Employer/Insurer. This includes prescription medications, specialist visits, and therapy. Additionally, the injured worker may be entitled to transportation or mileage reimbursement.

If you have been injured on the job and are confused about your rights to medical care, please feel free to contact our office.