Although Georgia's workers' compensation system is supposed to foster an environment where legitimately injured workers can get needed treatment and then return to work, the reality is much different. It has been my experience that workers' compensation practice is just about as adversarial as divorce practice. Often justice and fair play take a back seat to "winning" and efforts by employers insurance companies to avoid paying benefits.
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A front page story in the Sunday, May 24, 2009 edition of the Atlanta Journal-Constitution details the struggle of five catastrophically injured Atlanta police officers to obtain needed medical help from the City of Atlanta's workers' compensation office. Each of these police officers was injured in the line of duty – with injuries ranging from brain damage to paralysis arising from gunshot wounds to the spinal cord.
In our Georgia workers compensation law practice, we regularly see carpal tunnel cases. Carpel tunnel syndrome arises when the muscles in the wrist swell and compress the nerve running down the arm into the hand. When this median nerve gets squeezed, you will experience pain, numbness and tingling in the hands. In severe cases, a patient can suffer permanent nerve damage. Females are more likely than males to develop carpel tunnel syndrome.
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If you are injured on the job and you are a covered worker under the workers' compensation law, your employer is required to provide you with medical care. However, as you may suspect, what you consider as reasonable and necessary care may not be the same thing as what your employer and its insurer want to provide.
More on Medical Treatment in a Workers' Compensation Case – What You Need to Know
One of the issues that I sometimes face arises from my client's initial report of his injury. When you are hurt on the job, you can help your case greatly by thoroughly and accurately reporting your injury.
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I work at a job where I am using a computer keyboard all day long. Over the past few months, my right wrist started to hurt and get numb at times. I reported my injury on November 28, 2006 to the Human Resouces Manager requesting for a keyboard tray from desk.
The HR Manager told me that it was out of his hands and that I should order a tray through my manager for approval. I asked on several occasions for the tray and my injury started to become more aggravated, so I went to his boss asking him about the status of a computer tray. He told me that the tray was too expensive and I now needed a doctors note in order for me to receive a keyboard tray.
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As I was loading a 400lb. piece of freight on an aircraft, my (L) knee twisted. I was sent to a clinic and evaluated that I might need a knee replacement. I have a history of several knee surgeries, my job function is loading and unloading airplanes for 30 years. My question is can I obtain my own Dr. in the state of Ga., under the workmans compensation laws………Thanks
–Andrew
Jodi Ginsberg responds: Andrew, thanks for your interesting question. Here is how I would analyze your situation. First, I would want to know if your potential need for a knee replacement is the result of your most recent injury or is it a combination of this injury and your past injuries/surgeries?
Your employer and its insurer may try to argue that your current problem is the result of past injuries as opposed to this incident, and they may try to deny coverage.
Even if your employer tries to deny coverage based on your old knee problems, your case may be winnable if a treating doctor will go on record that your most recent injury aggrevated your pre-existing condition, and if you did not misrepresent your knee problems at the time you were hired.
If your employer has accepted responsibility for covering your knee problem, then the next step would be to get you to a specialist. Under Georgia's workers' compensation law, an authorized treating doctor can refer you to a specialist and, generally, the insurer would be responsible for paying the specialist to treat you. If your employer has a valid "posted panel of physicians" there may be a specialist there that you could choose.
If the employer is denying coverage, you would need to request a hearing on the issue of whether your injury is compensable.
As you can see, the answer to your question depends on a number of factors. I do not think you can or should assume that your employer or its workers' compensation carrier will act in your best interest.
Feel free to call me at 770-351-0801 if you wish to discuss further.
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