April 1, 2020

How to Protect Yourself if Workers Compensation Sends You to an Industrial Clinic Doctor

What should you do if your employer’s posted panel of physicians only includes industrial clinic doctors?

Georgia law gives your employer the right to choose where you get medical care if you are hurt on the job. We may be able to get you to a different doctor down the road but in most cases the first doctor you will see will be one that appears on a “posted panel” of doctors that should be located in a break room or other central location.

Frequently, your employer’s insurance company will give your employer the names of doctors they want for the posted panel. Why? Because insurance companies want you to treat with doctors who are less likely to take you out of work, who will not order expensive tests and who will report their findings directly to a nurse case manager or directly the insurance adjuster.

Just because a physician has an M.D. after his name does not mean that the doctor has your best interests at heart. [Read more…]

Yes, Post Surgical Infections are Covered Under Georgia Workers’ Compensation Law

There is risk to every type of surgery but most of us focus on the possibility that the surgery will not fix the problem it was intended to solve.

  • You underwent a laminectomy at L3/4 but you are still having severe pain radiating into your left hip and weakness in your left leg
  • You underwent a diskectomy and fusion at L5/S1 but the hardware has not remained in place and you can barely walk much less perform any work activity
  • You underwent a carpal tunnel release but your hand is still numb and you cannot rotate your hand at all

Poor results from surgery are always an issue in workers’ compensation because often times the insurance company has delayed approving surgery and permanent nerve damage can occur if a problem is not addressed quickly.

But an equally serious complication from surgery can create even more issues. Sometimes, despite the best efforts by the surgeon and your attempts to keep your wound clean, an infection can develop at the surgical site. [Read more…]

How to Avoid Potential Problems Common to Work Injury Cases Filed by Delivery Drivers

Online shopping is obviously huge business and the growth of e-commerce also means that more people are employed as delivery drivers. Companies like Amex and Walmart operate delivery vans and trucks in every major city in Georgia and delivery companies like UPS, FedEx and DHL operate trucks that service businesses and residences throughout the state.

I have represented and currently represent many delivery drivers who have incurred injuries while making deliveries.

Many of my delivery driver clients have back and knee injuries that arise from lifting and carrying heavy packages, or falling when climbing on or off a truck.

Surprisingly, I have also represented a number of clients who were injured trying to avoid a guard dog or even a family pet who did not appreciate a stranger within their territory.

Avoid Potential Traps

Regardless of how you were hurt, or whether you hurt your neck, back, knees, ankles, hands or feet, you do need to be aware of potential traps when pursuing a claim under the Georgia workers’ compensation law. [Read more…]

What Should You Do if Your Employer Ignores Your Work Injury Claim?

What should you do if your employer takes no action whatsoever after you report a work injury?

Believe it or not, I see this situation frequently.  I get calls every week from injured workers who say “Jodi, I hurt my back at work and I reported the injury to my supervisor but nothing is happening.  Every time I tell my boss that my back is killing me, he says that they are ‘working on’ my claim.  Several weeks have gone by and I don’t know what to do.”

I think that in many ways, being ignored is worse than being denied.  At least you know where you stand if your employer controverts your claim even if your work injury claim is legitimate.

But having your on-the-job injury claim ignored is not acceptable either.  First, you can’t be sure that your employer has reported your claim to the Georgia State Board of Workers’ Compensation.  If your claim is never officially reported (within one year of your injury) you can lose all of your rights.

Second, Georgia law says that you have 30 days to report your work injury claim to your employer.  If they are doing nothing, they may very well claim that you never reported your injury.  This is why I always advise my clients to report their injuries in writing and to ask for a written confirmation of the report. [Read more…]

Why Would the Insurance Company Deny or Delay My Work Injury Medical Treatment?

When you are hurt on the job, Georgia law says that your employer and their insurance company must pay for emergency care.  Further, they must offer you medical treatment with a physician listed on a posted panel of physicians consisting of doctors they have chosen to provide care for work accidents.  However, once you are out of immediate danger, the insurance company has the power to authorize or deny the next step in your care – such as diagnostic testing, surgery or physical therapy.

Frequently I get calls from injured workers who are suffering with severe back pain, shoulder pain or even burns, or folks who can’t walk due to knee injuries, but the posted panel doctor will not order an MRI or CT and ongoing medical treatment just grinds to a halt.  The posted panel doctor may give you pain medications but his main focus seems to be returning you to work as soon as possible, regardless of your medical issues.

Why would the insurance company refuse to authorize (pay for) diagnostic tests like an MRI or CT scan to find out what is really going on? Don’t they know that the longer a back, shoulder, neck or knee injury remains untreated, the harder it will be for you to recover? Or do they just want you to suffer? [Read more…]

Incredible: What Goes on Behind the Scenes of Your Georgia Workers’ Compensation Claim

Why is the Georgia workers compensation system so adversarial? As an injured employee you only have to prove that you were injured on the job – you do not have to prove negligence or any other fault on the part of your employer. Does it make sense that employers and their insurance companies fight so hard to deny claims?

It may not make sense, but employers and their insurance companies do contest claims, even those involving injuries that were witnessed and where all treating doctors diagnose a severe problem.

Some of what I see every day can only be described as incredible:

  • my client was injured and saw no posted panel of physicians in any breakroom or other employee area. Under the law, the employee can choose any doctor and the employer/insurer has to pay. The adjuster refused to authorize a doctor and suddenly a fresh, new posted panel appeared (after the fact)
  • a potential client called to say that she had received no TTD (temporary total disability) checks even though she was out of work and her claim accepted. When I was retained I called the adjuster who emailed me a printout of her screen showing that the TTD checks were sent out by their system, but, of course, never cashed. By the end of that week, the missing funds plus a penalty was fed-exed to my new client
  • I received a call from another potential client who had a serious neck injury. The insurance company would only authorize a hand specialist. After I was retained, we asked the ahnd doctor to authorize a neck specialist, which he did. The adjuster continued to refuse to authorize payment for the neck orthopedist. Only after requesting a hearing and getting a defense attorney to look at the case was the neck specialist approved.

[Read more…]

How to Combat Insurance Company Delay Tactics and Refusal to Authorize Medical Treatment

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?
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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…]