subject: Medical Care Under Worker Comp Who Chooses My Doctor? [print this page] Under Georgia law, the workers compensation statute indicates that your employer is supposed to have a posted panel of physicians which is located in an easy, accessible place for all of the employees. Posted panels, for example, are often located in kitchen/dining areas or conference rooms, etc. Also, your employer (or your supervisor or human resources person) should be able to read it to you if you are asking about it from home once youve already been injured. The bottom line about the posted panel is that it should be posted and clearly visible, there should be at least six physicians on it, and you should be able to select a physician off of that list when it comes time to get medical treatment following a work injury.
Some additional details about the posted panel: one of the doctors should always be an orthopedist, which is a doctor who deals with back, leg, neck, and/or shoulder injuries (bones, muscles, discs, etc.). The other doctors should be separate entities. One of those facilities can be an emergency room. Now, once you do see that panel, you are allowed to select any doctor from that panel, even if your employer tells you that you must go see a particular one on it or even, say, a doctor who is not on it. Under workers comp law, you have a right to choose off the panel, so do not be fooled into thinking your choices are limited to one or two doctors.
Some employers do not have the panel up, and this is obviously a problem. In that case, you really are technically allowed to go see whatever doctor you want to see about your injury. Unfortunately, though, that creates some issues, because the insurance company may actually have a panel which they may supply you with a day or two later and argue you now need to switch and go to the doctor that they are providing to you.
Its always better at that point in time, quite frankly, to call an attorney to find out whether to seek care with your own personal physician (if theres no valid panel) whether to wait it out for a day or two and then select from a list thats subsequently provided to you. If your injury is severe, of course, you will not have the luxury of waiting, and you will want to go to the emergency room ASAP. But the good news is that ER visits are covered under workers comp, even if the particular ER you visit isnt on the panel.
But the reason I stress the importance of contacting an attorney is because you dont want to wind up with a bunch of medical bills landing in your lap by making a hasty decision about medical treatment. If you dont understand the law, that could be a very, very big issue for you later on when youre staring at thousands of dollars worth of unpaid medical bills. Contact an attorney as soon as you possibly can in order to avoid this.
Switching doctors
If there is a panel of physicians and you seek out care with one of the doctors on the panel, you do have the right to switch to a different doctor on the panel if you are not happy with the treatment given to you by the first doctor. You get one free switch. Your employer may try to say you cant switch like that, but the law says you can. Just another reason why knowing the law is so important when in a workers comp case.
The other thing that we have been successful in doing at our law firm is making sure our clients get the most appropriate and best medical care for their given situation. For example, lets say you have a spine injury and you go to an orthopedist on the list who turns out to be a specialist in knees. Well, the insurance company might say that you have to stick with that doctor, but we might come in and help advocate on your behalf so that you go to a more appropriate doctor for your injury. We argue that the doctor you are seeing does not specialize in that particular body part that you may have injured. Then, we speak with the insurance company and get them to let you switch to a different specialist, whether it be a neurosurgeon, an orthopedist who specializes in the spine, etc.
The other way that weve been able to get different doctors available is to get our clients to know how to ask the doctor the right questions and perhaps get a referral from your current treating doctor to a specialist in the particular field of your injury. It makes the process of authorization down the road much easier when your current treating doctor refers you on to a new doctor who really does specialize in treating the particular injury you have sustained.
Finally, if you are unhappy with all the care you have received, we as your attorney can also request a change in physicians with the State Board of Workers Compensation.
Lets say, for example, youre simply not happy with the doctor youre seeing. The insurance company insists, however, that you see that doctor. Well, if we are not able to negotiate or agree on another doctor with the insurance company, we will then file a request with the State Board and ask for a mediation session wherein we sit down and discuss the potential to switch doctors. If that doesnt come to a successful outcome, we can ask for a hearing, at which time we will ask a judge to make a decision, after an evidentiary hearing, on all of the records that we place in evidence to determine if a new physician is necessary. So, there are many, many ways that we can, in fact, get a different doctor for you if you are not satisfied with your care and treatment, which many times is the case.
But imagine not having an attorney to help you through this process. You may simply have no way to take advantage of the rights you have under Georgia Workers Comp laws. Medical treatment is nothing to jeopardize, so call an attorney today!
