Can You Go to Urgent Care or ER for Workers’ Comp?

You shouldn’t have to worry about where you go for emergency treatment after a severe workplace injury. In Pennsylvania, that’s not an issue, thankfully. Under state law, the answer to “Can you go to the ER on workers’ comp?” is an unequivocal yes. Your employer might still give you trouble, though, so it’s smart to talk to a Pennsylvania workers’ compensation attorney about your situation.

Will Workers’ Comp Cover the Cost of an Urgent Care or ER Visit?

Workers’ compensation in Pennsylvania pays for reasonable and necessary medical care when you suffer a work injury. Your benefits include coverage for emergency room treatments. If your injury is catastrophic or life-threatening, you can go directly to the ER without prior approval. Your employer’s insurer must cover the cost of an ER visit if the treatment relates to your work injury. You should also tell the hospital that your injury happened at work and notify your employer as soon as possible.

Workers’ comp benefits may also cover urgent care visits when an injury is less severe but still needs prompt attention, such as a sprain, minor laceration, or simple fracture. Unlike emergencies, though, urgent care sometimes falls under Pennsylvania’s 90-day panel provider rule. If your employer has posted a list of at least six approved providers and explained this rule to you in writing, you must see one of those providers for the first 90 days after your injury. If no list exists, you may choose your own doctor or urgent care clinic, and workers’ compensation should still cover the costs.

Some Injuries That May Need ER or Urgent Care Treatment

Some work-related injuries that may require an ER visit or treatment at an urgent care facility include:

• Severe bone fractures or dislocations that require immediate stabilization
• Deep cuts or heavy bleeding that basic first aid cannot manage
• Head injuries that cause loss of consciousness, confusion, or dizziness
• Chest pain or difficulty breathing that begins after a workplace incident
• Burns from chemicals, electricity, or heat that extend beyond minor skin damage
• Sprains, strains, or joint injuries that cause sudden swelling and limit movement
• Eye injuries from foreign objects, chemicals, or sudden physical trauma

How the Workers’ Comp Process Works at Urgent Care

When you visit urgent care for a work-related injury in Pennsylvania, the process starts like any other medical visit: you check in and describe how the injury happened. Be sure to tell the provider that the injury occurred at work. That way, the clinic bills your employer’s workers’ compensation insurer instead of your health insurance.

If your employer has posted a list of approved providers, you must use one of those clinics during the first 90 days after your injury for coverage to apply. The urgent care staff will document your condition, provide treatment, and create a medical record that becomes part of your claim. You should not receive personal invoices for approved care related to your injury.

FAQS

Pennsylvania workers’ comp cases are complicated, and it’s natural to have questions about your benefits or the legal process. Here are the answers to some common questions we receive about these claims:

Do I Need My Employer’s Permission to Go to the ER or to Urgent Care?

You do not need your employer’s permission to go to the emergency room after a serious work injury in Pennsylvania. If the situation threatens your health or safety, you can seek care right away, and workers’ compensation should cover the cost as long as the treatment relates to your injury.

The rules may differ for urgent care visits. If your injury is not life-threatening, your employer may require you to use a clinic on their posted list of approved providers during the first 90 days after your injury. If no list exists or your employer has not given you proper notice, you can choose your urgent care clinic without prior approval.

Should I Go Back to the ER or Urgent Care for Follow-Up Care?

You should only return to the emergency room for follow-up care if your condition turns into another emergency. ERs exist to stabilize serious or life-threatening injuries, not to provide ongoing treatment. Once you leave after your initial visit, workers’ compensation insurers usually expect you to continue care through an approved provider or specialist.

Urgent care can handle some of your follow-up needs, such as checking on stitches or a simple fracture, but it is usually not the best option for long-term treatment. If your employer has a posted list of panel providers, you may need to see one of them within the first 90 days. Seeing a provider from that list helps your providers coordinate your care, and you’ll know that your employer’s insurance should cover your medical bills.

When To Seek Legal Assistance with Your Workers’ Comp Claim

You may want legal help with your workers’ compensation claim if you have problems with your medical coverage or wage-replacement benefits. If your employer’s insurer denies payment for your ER or urgent care visit, or they argue that your treatment was unnecessary, a lawyer can challenge that decision. You should also seek legal guidance if your employer disputes that your injury happened at work or pressures you to return before you have fully healed.

Timing also matters in these cases. The sooner you talk to a lawyer after an issue arises, the easier it is for them to protect your claim and secure the care you need. Lawyers who focus on workers’ compensation understand how to deal with insurance adjusters and employers, and they can explain your options when the system feels difficult to manage.

Contact the Workers’ Comp Lawyers at Calhoon and Kaminsky for Help

At Calhoon and Kaminsky P.C., we only handle workers’ compensation cases, and that singular focus has given us unmatched experience and insight. We’ve recovered over $221 million for injured workers, and we don’t charge any attorney fees unless we secure compensation for you. Call now or complete our contact form for a free consultation.