When you're injured on the job in Georgia, navigating the workers' compensation system can be confusing and daunting. One key component of the Georgia workers' compensation system is the Panel of Physicians. In this article, we will explore what the Panel of Physicians is and why it's essential in Georgia workers' compensation claims.
What is a Panel of Physicians?
The Panel of Physicians is a group of healthcare providers designated by your employer or their workers' compensation insurance company to provide medical treatment to employees injured on the job. The panel must include at least six physicians, with at least one orthopedic surgeon and no more than two industrial clinics. Additionally, the panel must include one minority physician, as defined by Georgia law.
Why is the Panel of Physicians Important?
The Panel of Physicians serves several important purposes in Georgia's workers' compensation system:
- Access to Medical Care: The panel ensures that injured workers have access to appropriate medical care for their injuries. Employees can choose from the physicians listed on the panel to receive treatment for their work-related injuries.
- Getting your treatment paid for: If the employer has a valid panel of physicians then you must see one of the doctors on their list in order for your employer to be responsible for teh bill. There are exceptions to this if they do not have a valid panel or there is an emergency.
- Right to Switch Doctors: Employees have the right to change their treating physician once during their workers' compensation claim without needing approval from their employer or insurance company. To do this, they must choose another doctor from the Panel of Physicians. In certain situations, an employee may also request a change of physician outside the panel, but this requires approval from the State Board of Workers' Compensation.
- Doctor choice is important: Don't let the employer tell you which doctor to see. Insist that they show you a panel and let you pick.
Why doctor choice matters
While most medical doctors treat all patients with the same level of care and professionalism, employer's will often try to send you to doctors who care more about their relationship with the insurance company than their own patients. These "company doctors" show up frequently on employer panels. Why do these doctors care so much about insurance companies? This may happen for various reasons:
- Bias and Misconceptions: Unfortunately, some doctors may hold biases or misconceptions about workers' compensation patients, wrongly assuming that these individuals are exaggerating their injuries or seeking unnecessary treatment. This could cause the physician to treat the patient with skepticism, leading to a different level of care than a patient with private health insurance would receive.
- Pressure from Insurance Companies: Workers' compensation insurance companies often have a financial interest in minimizing claim costs. In some cases, they may exert pressure on physicians to limit treatment options, adhere strictly to guidelines, or return the injured worker to work as soon as possible. This pressure can influence the way a doctor treats a workers' comp patient compared to one using their health insurance.
- Fear of Being Taken Off Employer Panels: Some doctors may treat workers' comp patients differently due to concerns about being removed from an employer's Panel of Physicians. If a physician is perceived as being too accommodating to injured workers or ordering excessive treatments, they may worry that the employer or insurance company will replace them on the panel, resulting in a loss of potential patients and income. This concern could lead to more conservative treatment approaches for workers' compensation patients compared to those using health insurance.
- Financial Incentives from Independent Medical Exams: Some doctors who perform Independent Medical Exams (IMEs) for insurance companies receive significant financial compensation for their services as expert witnesses. These doctors often also provide treatment to injured workers through an employers panel of phycians. This financial incentive may lead these physicians to treat workers' comp patients differently, as they may feel inclined to maintain a favorable relationship with the insurance company by minimizing treatment recommendations or downplaying the severity of the patient's injuries.
It is essential for injured workers to be aware of these potential differences in treatment and to choose a physician from the Panel of Physicians who is experienced and dedicated to providing the best possible care for all patients, regardless of their insurance coverage.
Employer's Obligations Regarding the Panel of Physicians
Under Georgia workers' compensation law, employers are required to not only maintain a valid Panel of Physicians but also ensure that their employees are informed about the panel and understand their rights related to choosing a treating physician. The following requirements must be met by employers:
Posting the Panel of Physicians
Employers are obligated to post the Panel of Physicians prominently in the workplace, such as in break rooms or other common areas where employees can easily see and access the information. This ensures that all employees are aware of the panel's existence and can refer to it in the event of a work-related injury.
Explaining the Panel to Employees
Employers have a responsibility to proactively explain the Panel of Physicians to their employees. This includes informing them of their right to choose a doctor from the panel, as well as providing guidance on how to select a physician and initiate the workers' compensation process. Employers should also ensure that their employees understand the potential consequences of not selecting a physician from the panel, such as losing control over their medical treatment and having the insurance company play a more significant role in their care.
Assisting Employees with the Panel
If an employee is injured at work, the employer should promptly show them the Panel of Physicians and assist them in choosing a doctor for their medical treatment. Employers must not attempt to influence the employee's choice of physician or pressure them to select a specific doctor. Instead, they should provide unbiased support and ensure that the employee feels empowered to make the best decision for their individual needs.
In conclusion, employers play a crucial role in facilitating employees' access to medical care through the Panel of Physicians. By posting the panel in the workplace and actively explaining employees' rights and responsibilities, employers can help ensure that injured workers receive the appropriate care and support they need during the workers' compensation process.
How a Biased Doctor Could Unfairly Limit Your Workers' Compensation Benefits
When you're injured at work, it's crucial to receive appropriate medical care from a qualified and unbiased doctor. Unfortunately, a biased physician can significantly impact the outcome of your workers' compensation claim and limit the benefits you receive. The following are ways in which a biased doctor could unfairly limit your workers' compensation benefits:
- Returning to Work Prematurely: A biased doctor may clear you to return to work before you're fully recovered, potentially causing further injury or a prolonged recovery time and reducing wage loss benefits.
- Denying Related Body Parts: Some doctors may claim certain affected body parts are unrelated to the work accident, leading to the denial of necessary medical treatment and limiting the compensation received for injuries.
- Low or No Impairment Rating: A biased physician may provide a low impairment rating or no impairment rating at all, negatively impacting the amount of permanent disability benefits you're entitled to.
- Influenced Referrals: A doctor may allow the insurance company to dictate referral decisions, potentially resulting in suboptimal care as the insurance company prioritizes cost savings over the best interests of the injured worker.
To protect your rights and ensure that you receive the appropriate workers' compensation benefits, it's crucial to select a qualified and unbiased physician from the Panel of Physicians. If you have concerns about the impartiality of your treating doctor or feel your benefits have been unfairly limited, consider consulting with a knowledgeable workers' compensation attorney for guidance and support.
Employees' Right to Choose Any Doctor if There is No Panel or the Panel is Invalid
Under Georgia workers' compensation law, employers are required to have a valid Panel of Physicians in place to ensure that injured employees have access to appropriate medical care. However, there are situations where an employer may not have a panel or the panel is considered invalid. In such cases, employees have the right to choose any doctor they want for their medical treatment.
Invalid Panel of Physicians
A Panel of Physicians may be deemed invalid if it does not meet the necessary legal requirements, such as:
- Having fewer than six physicians listed
- Not including at least one orthopedic surgeon
- Not including at least one minority physician
- Listing more than two industrial clinics
In addition, a panel can also be considered invalid if the employer fails to properly inform the employee of their right to choose a doctor from the panel, or if the employer attempts to influence the employee's choice of physician.
Choosing Any Doctor in the Absence of a Valid Panel
When there is no panel or the panel is invalid, injured employees have the right to choose any doctor they wish to treat their work-related injury. This freedom allows employees to select a physician who best meets their needs, based on factors such as specialty, location, and reputation.
It is essential for employees to be aware of their rights in these situations, as the choice of physician can significantly impact the quality of care they receive and the outcome of their workers' compensation claim. If you are uncertain about the validity of your employer's Panel of Physicians or need assistance in choosing a doctor for your workers' comp claim, consider consulting with a knowledgeable workers' compensation attorney for guidance.