What to Know about Urgent Care and Workers’ Compensation
If you’ve been injured on the job, one of the first decisions you must make is where to seek medical attention: emergency room, urgent care, or your primary care doctor.
No matter what the injury is, one thing is clear – you should seek medical attention as soon as possible.
You also need to let your employer know you are seeking medical care and clearly state it’s because of an injury that happened on the job.
If you don’t, you are prolonging your healing and potentially putting yourself at risk of hurting yourself further.
Here’s the good news. In the state of Georgia, if an employer has three or more employees, he or she is required to have workers’ compensation insurance.
This means that your medical treatment should be covered by Georgia’s workers’ compensation.
There are some things you can and cannot do when it comes to receiving workers’ compensation benefits in the state of Georgia.
For instance, one of these requirements is getting treatment from an approved panel of physicians. You cannot choose any doctor you want.
But is it okay to go to urgent care or the emergency room if you need immediate treatment?
We’re going to break down this confusing part of workers’ compensation today.
Urgent Care Versus Emergency Room
The first thing to understand is that certain injuries require immediate attention.
If you suffer an extreme injury, such as a severed limb, you will likely go to the emergency room at a hospital for immediate treatment.
Should this type of extreme injury occur, you may not have time or the wherewithal to tell your employer what has happened until after you have received emergency treatment.
Under workers’ compensation law in Georgia, you do not have to wait to speak to your boss for emergency treatment.
If you have a serious injury on the job and need to go to the emergency room, you are entitled to immediate medical treatment.
Please note that we are specifically talking about serious injuries.
If you head to the emergency room for a sprained wrist from a fall at work three days after you fell, it won’t be as easy to request workers’ compensation benefits or reimbursement for that medical bill.
The basic rule is that the emergency room should only be utilized for life-threatening emergencies that occur on the clock.
If you experience a non-life-threatening injury, such as a sprain, you do not need to go to the emergency room.
In non-life-threatening cases, you will need to tell your employer you have been injured and need to see a doctor to ensure you receive workers’ compensation benefits.
Technically, you are required to visit a doctor from a list of physicians that your employer has displayed in a central location.
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.
But what you may discover is that some of the doctors that appear on the posted panel of physicians work at urgent care centers that specialize in occupational health (i.e., professional associations or corporations of physicians).
[Related Read: Can I Choose My Workers’ Comp Doctor in Georgia?]
Why Employers Push Urgent Care
Here’s where it gets tricky.
Urgent care treatment centers exist to alleviate the number of people who go to the emergency room.
They specialize in treating non-life-threatening injuries and illnesses.
However, many of today’s urgent care treatment centers also work hand in hand with workers’ compensation insurance companies and employers. (Looking at you, Concentra, Caduceus, and Nova!)
Their entire goal is fast treatment to get employees back to work as soon as possible and save employers and insurance companies money.
Just consider some of the following direct quotes from urgent care facilities around the U.S.:
- “Why Choose Physicians Immediate Care? Physicians Immediate Care helps your employees get back to full duty as quickly and easily as possible. […] Physicians Immediate Care will help you contain your costs, avoiding things such as unnecessary ER trips. […] We’ll keep you informed every step of the way so you know the specific status of each employee.” [source]
- “They are accustomed to seeing high volumes of patients. This allows them to become highly skilled at case discernment so they may be more apt to notice if a worker is exhibiting inappropriate behavior in relation to the injury.”
[source] - “CareWell’s urgent care centers keep employee injuries and workers’ comp from bleeding your business dry. […] Whether it’s bone breaks, stress fractures, joint pain, sore backs or anything in between, CareWell’s experienced staff will get your employees out of pain and in a comprehensive recovery program to get them back on their feet as soon as possible.” [source]
- “If employees get hurt on the job, we’ll be ready to quickly treat their injuries and get them back to work.” [source]
I hope you notice these urgent care treatment centers are speaking directly to EMPLOYERS – not injured employees.
When you are injured and a doctor says you are unable to work, that puts stress on your employer.
They want you back to full-duty work as soon as possible.
If you read the above quotes, this is what many urgent care facilities strive to provide for employers.
Moreover, workers’ compensation insurance companies do not want to spend one penny more than they have to.
Urgent care treatment centers work better financially for insurance companies because urgent care centers don’t have all the additional testing tools, such as MRIs.
What to Do after the Initial Visit
Let’s say you did find yourself at the emergency room or in urgent care after an accident on the job.
The big thing is to make sure you stress to those treating you that this is a work-related injury.
If you did not inform your employer before heading to the emergency room or urgent care, make sure you inform them as soon as possible.
In the state of Georgia, you have 30 days to notify your employer.
Watch Top 5 Workers’ Comp Mistakes to Avoid.
In most cases, workers’ compensation should cover your initial visit.
However, this does not mean you should continue follow-up appointments with emergency room doctors or urgent care physicians.
Remember, the doctor you are required to see under Georgia workers’ compensation law must be listed on the posted panel of physicians.
If you need follow-up care, you must see one of these six doctors to ensure you receive workers’ compensation benefits.
That’s not the only reason.
We discussed how urgent care facilities work closely with doctors and workers’ compensation insurance companies.
If the authorized treating physician you choose to see works at one of these urgent care centers, you are putting your care and workers’ compensation benefits at risk.
The doctor will be more focused on getting you back to work as soon as possible rather than on full and complete healing.
How a Workers’ Compensation Attorney Can Help
An experienced workers’ compensation attorney is familiar with urgent care centers that tend to side with insurance companies.
Your attorney can warn you of these places and recommend a more patient-friendly doctor from your employer’s posted panel of physicians.
Additionally, workers’ compensation attorneys know how to navigate the complicated system of worker’s comp medical treatment and will fight for you to get the treatment you need and justly deserve.
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