When you are injured in a workplace accident, your employer is required to provide you with the necessary medical care. Unfortunately, workers’ compensation claims have certain limitations—including restrictions on which doctor you can see for your treatment.
Receiving Emergency Medical Treatment
An employee with serious or life threatening injuries requiring immediate medical care may seek out treatment at the nearest emergency room. Workers’ compensation insurance is required to pay for the cost of any emergency care related to an on-the-job injury, including diagnostic testing and emergency surgical procedures.
Seeking Treatment From the Panel of Physicians
Once your condition has been stabilized or if your injuries did not require emergency medical care, your employer is supposed to provide you with a list of physicians. The list is called a panel of physicians and should include six or more doctors, with at least one orthopedic surgeon and at least one minority doctor and no more than two industrial clinics. In most cases, all providers should be within 50 miles of the job site.
The doctor that you choose from this panel is called an “authorized treating physician” (ATP). This doctor may provide you with medical treatment for up to 400 weeks following your accident (unless your claim is deemed catastrophic, in which case you will be entiled to medical benefits for the rest of your life). If your condition isn’t one that can be treated by your ATP, he or she may refer to you a specialist for further evaluation and treatment.
You will not need to pay any of the cost of your medical care, including any medications prescribed by your treating physicians, since all treatment from an ATP or referred specialist is fully covered under your workers’ compensation benefits. In addition, you are also entitled to be reimbursed for your mileage and other travel expenses.
Making a Change to Your Medical Care
If you are dissatisfied with the treatment you are receiving from your ATP, you are allowed to make a one-time change to another doctor on the panel of physicians without receiving prior approval. In certain situations, you are allowed to seek an opinion from a physician of your choosing as an independent medical examination (IME).
Using Your Own Health Insurance Benefits
You may think it would be better to use your own health insurance or pay out-of-pocket, and just have your regular family doctor handle your medical care. Unfortunately, choosing to do this could jeopardize your case. If you do not treat with a panel physician, your employer and its workers' compensation insurer do not have to follow the recommendations of the unauthorized physician, and most likely will refuse to pay you income benefits based on any disability documentation that you obtain from your family doctor.
If your claim is denied in whole or in part, or if your employer does not have a properly posted panel of physicians, you are technically able to choose your own doctor. However, this issue should be discussed in greater detail with your attorney.
Protecting Your Legal Rights
Georgia laws regarding workers’ compensation benefits can be quite complex. To protect yourself, you should strongly consider hiring an experienced attorney who can advocate for your right to benefits.
Rechtman & Spevak is dedicated to helping workers who’ve been hurt on the job receive the benefits they need to move forward with their lives. We’ve assisted employees of Home Depot, United Parcel Service, FedEx, Delta Airlines, Emory University/Emory Healthcare, Kroger, Publix, Northside Hospital, Piedmont Healthcare, Walmart, Lowes, Waffle House, Chick-fil-A, Randstad, and many other local businesses in resolving their workers’ compensation claims. Call today to schedule a free, no-obligation consultation.