Does My Employer Control My Medical Treatment?
If you are injured on the job, one pressing question you may have is, “Does my employer control my medical treatment?”
Workers sometimes hesitate to report work injuries because they believe the answer is yes.
But it’s not. Believing this myth often causes workers to suffer and not receive the medical treatment and benefits they are entitled to.
In the state of Georgia, any employer with three or more employees must have workers’ compensation insurance.
Workers’ compensation is designed to cover the costs of medical treatment and lost wages.
Unfortunately, some people misinterpret this and think that, because workers’ compensation covers the costs of medical treatment, their employer controls their medical treatment.
Does my employer control my medical treatment? No!
Your employer has very little say regarding your medical treatment – especially if you choose your own doctor.
Ultimately, your authorized treating physician controls your medical treatment.
Insurance companies may sway some doctors, so it is critical to choose a patient-friendly doctor, if possible.
Since I often get asked, “Does my employer control my medical treatment?”, I am going to take you through the answer step by step.
Choose from a Posted Panel of Physicians
You get to choose your own doctor; however, you must choose a doctor from your employer’s posted panel of physicians. That is the only real “control” your employer has with regard to your medical treatment.
GA Code § 34-9-201 (2020) states:
“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 shall 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.”
This is a fancy way to say employers need to have a list of at least six physicians for employees to choose from should they suffer a work-related injury.
This panel of physicians should be posted in a place that is clear and easy for employees to see – such as the breakroom.
The paragraph above also 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.”
It is this phrase that gives the employee – not the employer – control over choosing their doctor.
Should you allow your employer to choose your physician, you are giving them much more control than they should have.
However, you can take back control and choose your own physician from this posted panel of physicians.
IMPORTANT – If your employer did not have a valid, posted panel of physicians in place on the date of your accident, you and your lawyer get to pick ANY doctor you want to be your authorized treating physician ‒ and the insurance company must pay for it.
[Related Read: Can I Choose My Workers’ Comp Doctor In Georgia?]
Medical Treatment: The Role of the Authorized Treating Physician
Once you choose a doctor from this posted panel, this physician is referred to as your authorized treating physician.
This doctor is ultimately the person in charge of your medical treatment.
So, the question, “Does my employer control my medical treatment?” is answered, “No, but your authorized treating physician does.”
Your authorized treating physician is the person who controls the type of treatment you receive and determines your ability to work.
It is this doctor that will provide the workers’ compensation insurance company with information regarding how long you’ll be out of work and what type of work you are currently able to do (i.e., light-duty or full-duty).
This is why it is so important for employees to choose their doctor and not simply go to the doctor their employer recommends.
Issues That Arise with Workers’ Compensation Medical Treatment
You may wonder why it is so important to choose your own doctor for medical treatment when it comes to workers’ compensation.
The answer is simple.
Sadly, many physicians care more about staying in the good graces of insurance companies than healing patients.
Physicians know they are on the panel of physicians for workers’ compensation insurance for a reason. They are kept on these panels so that they will release employees back to work as quickly and cheaply as possible.
As a result, some of these physicians will focus more on pleasing insurance companies and employers than treating an injury seriously.
For example, they may feel as if they have to recommend a full-duty release before you are truly healed enough for full-duty work because they know employers want employees back at work and insurance companies don’t want to keep paying for lost wages or treatment.
Instead, you want to see the doctor who seems the most focused on patient care.
[Related Read: 10 Ways Authorized Treating Physicians Mess Up Your Georgia Workers’ Comp Claim]
Rules for When Work-Related Injuries Require More Than One Doctor
Depending on your type of injury, you may have to see more than one doctor, such as a specialist.
In this case, your authorized treating physician has control over whom you see.
This is where it gets tricky.
If the authorized treating physician does not provide the name of a specialist, the workers’ compensation insurance company will pick for you.
This is a bad idea.
Instead, have a specialist in mind and ask your authorized treating physician to recommend this specific specialist.
If the authorized treating physician recommends him or her, you will be able to visit this specialist.
Injured Employees Have the Option to Change Doctors
Buried within the legal code is this line:
“The employee may make one change from one physician to another on the same panel without prior authorization of the board.”
This is good news.
Let’s say you mistakenly went to the doctor your employer recommended and you get the feeling they aren’t in it for the right reasons.
You are allowed to change physicians.
Additionally, you have the right to an independent medical examination (IME), and you can choose the doctor who performs the IME.
Choose Your Own Pharmacy
Does my employer control my medical treatment? Nope.
Your employer and the insurance company also don’t have any say over which pharmacy you use for workers’ compensation.
You can stick to your regular pharmacy or choose an online pharmacy that caters to injured employees.
Insurance companies want to try to force you to use their budget pharmacies or companies with which they have contracts, but you can decide where to get your prescriptions filled.
Make sure your attending physician doesn’t mess up by having prescriptions filled at a pharmacy you didn’t choose.
Choose Who Is in the Room
You also get control over who is in your exam room.
For example, nurse case managers will try to force their way into your exam room. These individuals actually work for insurance companies.
If you allow them in your exam room, they can use anything you say against you. Something as simple as “I feel okay, I guess” can be used to deny your workers’ compensation benefits or put you back at full duty prematurely.
You have control over whom you speak to and allow in your examination.
Choose Your Workers’ Compensation Attorney
It’s important to work with a workers’ compensation attorney as soon as you suffer an injury on the job.
An experienced workers’ compensation attorney will help you choose a new authorized treating physician, report ongoing injury symptoms, and schedule an independent medical exam.
Workers’ compensation attorneys know the ways crooked employers, insurance companies, and doctors work together to push employees back to work too quickly.
DeMedeiros Injury Law has been in the business long enough to know which doctors are most interested in helping their patients and those who are more interested in their paychecks, so give us a call before you find yourself in a jam.
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