What can you do if your treating doctor wants to refer you to a specialist, or tries to order an MRI or CT scan, but the workers’ compensation insurance company refuses to authorize this needed treatment?
Under Georgia workers’ compensation law, if you are receiving care from a “authorized treating physician” and that authorized physician refers you to a specialist, the referred doctor is supposed to be authorized automatically.
Similarly, if an authorized treating physician writes an order for an MRI, CT or other diagnostic test, that test should also be authorized.
What we are finding, however, is that when the referred doctor or the medical testing center calls the insurance company to verify that they will be paid, the insurance adjustor may say “no.” And of course, if a medical provider or testing center does not have a source of payment, they will not provide treatment to you. [Read More…]
When you are hurt on your job, you should not delay seeking medical care.
Your employer and their insurance company will treat your delay in seeking treatment as an “admission” that your injury really is not that severe. They will fight to avoid paying for medical tests and they will oppose your effort to see a specialist. Your settlement will likely be negatively impacted. When an insurance company lawyer deposes one of my clients, one of the first questions asked is “how soon after your injury did you first seek medical care.”
It does not matter if you think that you have a good reason for waiting to see a doctor. Perhaps you believe that ice packs and a little rest will solve the problem, or perhaps you are concerned about reporting a work injury to a cynical or even hostile supervisor. [Read More…]
This is a video from a TV news report in Michigan but the issues raised are the same as what we face here in Georgia. Workers’ compensation insurance companies frequently send claimants to “independent” medical examinations that result in bogus diagnoses and unconscionable claim denials.
I wrote about this issue on this blog back in February – this video clip shows the human tragedy that can occur when a claimant gets railroaded.
A very common tactic used by workers’compensation insurance companies to cut off your benefits involves the use of something called an “independent medical exam” or IME. As you might guess, in my experience these medical evaluations are rarely independent and they often serve no purpose other than medical support for termination of benefits.
Fortunately, most of the State Board judges that consider workers’ comp issues understand how the IME game works, and they look at these results with a very critical eye, but insurance adjusters continue to use this practice as a matter of course.
When I get an IME notice, the first thing I will look for is the name of the examining doctor. There are a number of physicians out there who work extensively for the insurance industry and in almost every file sent to one of these doctors, the resulting report will minimize the extent and nature of the work injury, question the relation of injury to the accident at work , and suggest that a full duty return to work is appropriate.
Because the insurance company has the right to send you out for one of these biased IMEs, you have no choice but to go. I can usually predict what the forthcoming report will say and that the insurance company is planning to try to cut you off, so I gear up to request a hearing challenging the proposed cut off.
The file will end up on the desk of a defense lawyer who I most likely know. He or she and I will talk and acknowledge that the insurance IME was a waste of time and we will either start to discuss settlement, or try to agree on a more unbiased doctor to see you. [Read More…]
Over the years I have written articles and recorded videos about insurance company surveillance. As I explain to all of my work injury clients, the minute you give notice of your on-the-job injury to your employer, there is a good chance that your employer’s insurance company will hire a private investigator to follow you, take photos and videos, or even engage you in conversation at a store or doctor’s office in an effort to undermine your claim.
I tell you this not to make you paranoid but to reveal to you the reality of workers’ compensation practice in Georgia.
As you may know if you have read my biography, back in the 1990’s I worked for a large insurance defense law firm located in midtown Atlanta. The lawyers at this firm were and are zealous advocates for their clients and they are very skilled attorneys. I know from firsthand experience how employers and their insurance companies fight claims.
Your Employer Does Not Believe Your Work Injury Claim is Legitimate
I can also tell you that most of the employer clients and insurance adjusters I spoke to believed sincerely that just about all workers’ compensation claimants exaggerate or completely faked their injuries. Never forget that employers and insurance companies view your on-the-job injury as an expense to be managed and controlled. I believe that this attitude remains the prevailing thought process today. Even if a particular insurance defense attorney personally feels that your injury is legitimate, that attorney is paid to contest your claim, not to debate the merits of your case with an insurance adjuster or company owner. [Read More…]
What does it mean to be deposed in your Georgia workers’ compensation injury claim? Should you be concerned if you have to testify at a deposition?
Under Georgia law, both sides – you, and your employer – are allowed to ask questions to the opposing side. Your lawyer, for example, may depose a witness to your accident, or we may depose your supervisor if there are questions about notice of injury.
Your employer’s lawyer may ask you to sit for a deposition to ask you how you remember your accident, where you were hurt and how your medical treatment is progressing. Your employer’s lawyer may also use a deposition to ask you about your medical history, prior injuries, and your daily activities after your accident.
Depositions take place in your lawyer’s office, so they are less formal than a court hearing. However, your deposition testimony is taken under oath and anything you say can be used later for cross examination purposes. This is why you should always prepare for your deposition by meeting with your lawyer ahead of time so you will know what to expect.
In this short video, I explain more about how workers’ comp. depositions work and what you can expect. Of course, if you would like advice about your case, I would be happy to help – please call me at 770-351-0801 or email me using the form on this page.
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