After suffering an injury at work, you might wonder if there are any rules regarding medical treatment. In the state of Georgia, workers’ compensation covers medical treatment that is reasonable and related to the work injury. However, it is crucial to understand the rules you must follow for your medical care to be covered under workers’ compensation.
Workers’ Compensation Lawyers in Georgia
Attorney Beth Gearhart is one of the leading lawyers in the area of workers’ compensation in Georgia. If you have recently been injured at work, Attorney Beth Gearhart and her team can help.
We can help you with all aspects of your workers’ compensation case, including obtaining necessary medical treatment to be paid for through workers’ compensation. Contact our office today to find out more about what our team can do to help you navigate the legal aspects of your workers’ compensation claim.
How Do I Know What Doctor to Choose for My Workers’ Compensation Case?
Injured workers in Georgia must choose a treating physician on a list approved by their employer to ensure the medical treatment will be paid for through workers’ compensation. Your employer is obligated to post information regarding acceptable medical providers. The Georgia State Board of Workers’ Compensation requires every employer to have a legal-sized document published in a conspicuous area in a location where employees are working.
Your employer can fulfill this obligation in one of two ways. First, your employer can choose to post a list identifying a minimum of six different doctors, called a panel of physicians.
The other option for your employer is to post the name of a Workers’ Compensation Managed Care Organization that has been certified. Additionally, your employer is obligated to provide you with notice of the eligible medical service providers, as well as post a toll-free 24-hour phone number for the managed care organization. If your employer uses this option, you can call the number to speak with a managed care representative who can help you schedule an appointment with an eligible medical provider of your choice.
What Are the Requirements for the Doctors Chosen for the Panel by my Employer?
There are some requirements for the panel of physicians that your employer chooses. If these requirements are not met, then the listed panel could be deemed invalid.
One of the requirements is that the panel of doctors chosen by your employer must include at least one orthopedic physician. The panel must also include a minority physician.
Additionally, although your employer can certainly list multiple physicians from one practice, the additional physicians from the same practice do not count toward the minimum requirement of six doctors. In this scenario, your employer will also need to list five other physicians from different practices.
Another way that your employer can meet the requirements of having a valid panel is to list six different physician practice groups. With this option, injured workers would have their choice of any doctor within each of the six practice groups. This option is one way for employers to give their employees many different options for treaters but still ensure that the panel is limited to practice groups that they trust to provide adequate medical care.
What Should I Do About Medical Treatment if My Employer Does Not Have a Panel List Posted?
Employers in Georgia are required by law to either post a panel list of approved treating physicians for workers’ compensation injuries or to post information regarding their chosen Workers’ Compensation Managed Care Organization. However, if your employer failed to post the required panel list or the name of a Workers’ Compensation Managed Care Organization, you are entitled to choose your own treating physician.
In addition, the panel list posted by your employer must be valid. This means that the panel must meet all of the legal requirements. If it is not a valid panel, then you also have the option to choose your own treating physician for the medical care that is necessary to recover from your injury.
If your employer does not post a panel list or a Workers’ Compensation Managed Care Organization, or if the panel is invalid, your medical treatment should still be paid for by workers’ compensation. In cases in which these requirements are not met, and an injured worker chooses their own doctor for treatment, the bills should still be submitted to their employer and paid through workers’ compensation.
You should not be obligated to pay for any medical bills that you receive from your treating physician. If you do receive bills and are asked to pay them yourself, you should inform your workers’ compensation attorney so that they can help resolve the issue. If you do not have a lawyer for your workers’ compensation case, you should strongly consider hiring one to help resolve any issues regarding the payment of medical bills.
What Are My Options for Medical Care in an Emergency?
It is important to note that in emergency situations, such as immediately after a work accident, you are able to get emergency medical care at the nearest emergency treatment hospital or facility. However, once the emergency is over, you must seek treatment from an approved medical provider designated by your employer.
If I Don’t Agree with My Chosen Doctor, Can I Get a Second Opinion?
Yes, you are entitled to make one change to another approved treating physician of your choice. You have the option to change to a different doctor either on the panel list of physicians provided by your employer, or if your employer uses a Workers’ Compensation Managed Care Organization, you can switch once to a different doctor within that group. If you choose to make one change to a different approved physician, you do not have to get the approval of your employer.
Additionally, it is possible to make another physician change after you have already made your first change. This time, however, you must get the approval of your employer to do so. Otherwise, you take the risk of not having your medical bills paid through workers’ compensation.
If your doctor choice is unauthorized—your employer is not obligated to pay for your medical bills. A Georgia workers’ compensation attorney can help you ensure that you are following the requirements on your end to continue to receive workers’ compensation benefits.