Can I Choose My Workers’ Comp Doctor in Georgia?
If you’ve been injured on the job, you’re probably wondering, “Can I choose my workers’ comp doctor?”
As much as I would like to tell you that you are free to make an appointment with your primary care doctor you already know and trust, or see whichever doctor you want, I can’t lie to you.
You are given some choice, but not complete freedom.
Unless your primary care doctor is listed on your employer’s posted panel of physicians, or unless your employer failed to have a valid posted panel on the date of your accident, the answer is NO. Keep reading for a more detailed answer.
Can I Choose My Workers’ Comp Doctor? The Short Answer is Yes and No.
If you are injured on the job in the state of Georgia, you qualify for workers’ compensation. This includes care from a physician.
However, you can’t just go see any physician you want.
According to Georgia law, you must choose someone from your employer’s posted panel of physicians. In other words, you can’t choose just anyone, but you do get to choose whom you’d like to see from a narrow list of six doctors.
The key here is that you do get some choice.
You should never simply go to the physician your employer recommends (we’ll explain why later).
How the Panel of Physicians Works
Let’s break down the panel of physicians.
Georgia Code O.C.G.A. 34-9-201 (2010) states:
(1) The employer shall maintain a list of at least six physicians or professional associations or corporations of physicians who are reasonably accessible to the employees; provided, however, that the board may grant exceptions to the required size of the panel where it is demonstrated that more than four physicians or groups of physicians are not reasonably accessible. This list shall be known as the “Panel of Physicians.” At least one of the physicians must practice the specialty of orthopedic surgery. Not more than two industrial clinics shall be included on the panel. An employee may accept the services of a physician selected by the employer from the panel or may select another physician from the panel. The physicians selected under this subsection from the panel may arrange for any consultation, referral, and extraordinary or other specialized medical services as the nature of the injury shall require without prior authorization from the board; provided, however, that any medical practitioner providing services as arranged by a primary authorized treating physician under this subsection shall not be permitted to arrange for any additional referrals. The employee may make one change from one physician to another on the same panel without prior authorization of the board;
All this fancy legal language is basically saying employers must have a list of at least six physicians for employees to choose from should they need to see a doctor for workers’ compensation.
This list of physicians must be posted in a space where employees can clearly see it, such as a breakroom, on the day the injury occurred.
In the middle of all this language, it states, “An employee may accept the services of a physician selected by the employer from the panel or may select another physician from the panel.”
Once you have chosen a doctor from this list, this doctor is referred to as your authorized treating physician (ATP).
What If My Employer Doesn’t Have a Posted Panel of Physicians?
If there is not a posted panel of physicians visible on the day of your injury, this means you can choose a doctor of your own accord. And the insurance company still has to pay for it.
Why Does the Workers’ Comp Doctor Matter?
You may be wondering why I am putting so much emphasis on your ability to choose from a list of six physicians.
The answer is simple – you want to choose a doctor who cares about people rather than profit.
There are a good number of doctors who work with workers’ compensation insurance companies.
Sadly, some doctors whose names appear on the posted panel of physicians are more focused on getting money from the insurance company than on helping heal work injuries.
These authorized treating physicians are more focused on pleasing the insurance company than caring for your injuries.
For example, they will try to get you back to work sooner so that the insurance company doesn’t have to pay as much for your care.
They may claim your injuries aren’t as severe as they truly are or suggest no additional tests or scans are needed when they are.
They will do what the insurance adjusters suggest, rather than what is needed, to stay on the panel of physicians.
If your employer seems really adamant that you see a specific doctor on the list, this is a red flag. Your employer likely knows this doctor sends employees back to work sooner rather than later.
In addition, there are just some bad doctors.
Can I Choose My Workers’ Comp Doctor for a Specialty Appointment?
Let’s say your injury requires seeing a specialist, such as a neurologist or physical therapist.
These specialists will be referred by your authorized treating physician.
So, again, you don’t necessarily get to choose freely, but you can suggest your doctor refer you to a specific specialist if you already know one.
Georgia law gives your authorized treating physician control over your treatment plan, including referring you to specific specialists.
Workers’ compensation insurance should cover it as long as your ATP refers you.
What If I Don’t Like the Doctor?
There are times when a doctor just isn’t the right fit. For example, you might not get a good feeling from the doctor on your visits. Maybe he acts as if he doesn’t believe you, or he doesn’t seem organized.
No matter the reason, if you get a bad feeling about your authorized treating physician, you should look for another doctor.
The good news is that, in the state of Georgia, you are allowed to switch from one doctor on the posted panel to another one on the list.
The code states, “The employee may make one change from one physician to another on the same panel without prior authorization of the board.”
This is a one-time deal.
Can I Choose My Workers’ Comp Doctor for a Second Opinion?
You may find yourself needing a second opinion and may be wondering, “Can I choose my workers’ comp doctor for a second opinion?”
As long as you have received, or are receiving, income benefits, you have the right to an independent medical examination (IME). And you can choose the doctor who performs the IME.
O.C.G.A. 34-9-202(e) has strict criteria for who qualifies for an IME at their employer’s expense.
- You have an accepted compensable injury;
- You request the exam within 120 days after receiving income benefits;
- The IME takes place at a reasonable time and place, within this state or within 50 miles of the employee’s residence;
- The IME provider is a duly qualified physician or surgeon;
- You provide advance notice in writing to the employer or the insurer about going to get a second opinion; and
- The IME cannot include medical diagnostic tests that you already had since your injury unless they total less than $250 or unless you pay for the duplicate tests yourself.
[Related Read: Everything to Know about a Defense Independent Medical Exam]
Another option for receiving a second opinion is to ask your authorized treating physician to refer you for a second opinion.
Will Hiring a Workers’ Compensation Attorney Help with Finding a Doctor?
We wish you could trust your employer’s posted list of physicians, but, unfortunately, we’ve seen employees suffer at the hands of seedy doctors.
Let’s say your employer or the insurance company is pushing you to use a certain doctor. An experienced workers’ compensation attorney will see this for what it is – a red flag.
You want someone in your corner to put a stop to the employer’s pressure tactics. You have rights, and workers’ compensation attorneys know how to use them.
If you’ve been injured on the job, contact us today for a free, no-strings-attached consultation.
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