You never know what sort of medical treatments will be needed to cure or alleviate an injury. Will you need physical therapy after a back injury, or will surgery be required? This level of uncertainty can be a problem when workers’ compensation should be paying for everything.
In Georgia and other states, workers’ compensation benefits should pay for all necessary medical treatments related to the claimant’s work injury. Determining what is necessary can be a multistep process, depending on how the insurance company wants to handle the case. If a worker’s injury is accepted as a compensable claim, then the insurance company has more or less said that it is open to whatever treatments the primary care physician prescribes.
Treatments covered by workers’ compensation can include:
- Rehabilitative therapy
- Prescription medication
- Special medical equipment like prosthetics
- Psychological counseling
- Chiropractic care
- And more
But if the insurer accepts a case as “medical only,” then there will be some bumps on the path to recovery for the claimant.
Physician Panels for Medical-Only Claims
When an insurance company accepts a case as medical only, this means that it will not offer indemnity benefits like lost wages, and it is not broadly accepting all recommended medical treatments. At this point, the case should be reviewed by a panel of at least 6 physicians, including at least 1 orthopedic specialist, at least 1 minority physician, and no more than 2 industrial clinicians, as described in O.C.G.A. 34-9-201 in Georgia law. This panel of physicians will decide what treatments should be approved to provide the necessary care for the injured worker, which will omit any elective or optional care.
An injured worker in Georgia can choose their own doctor, though, if the employer or insurer fails to assemble the necessary members to create a panel of physicians. The chosen medical providers must accept payments through Georgia’s workers’ compensation schedule, which many do.
When choosing their own doctor, an injured employee can consider a:
- Family or general physician
- Physical therapist
- Specific, trusted medical professional
When this happens, the treatments available to the injured worker can vary depending on what type of doctor they chose to handle their medical care. It is highly advised that claimants work with experienced workers’ compensation attorneys, so they can be confident in any decisions they make regarding their case and treatments.