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…]

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 my Employer Deny my Legitimate Injury Claim?

I have written a lot on this blog about how strategies you and your lawyer can use to fight insurance company delays, refusal to authorize needed medical treatment and refusal to start weekly wage benefits.

You may be wondering why your employer – and by extension, their insurance company would fight you on a work injury claim that was witnessed and where even the posted panel doctor agrees that your injury arose from your job?

Isn’t there some sort of “good faith” requirement that insurance companies need to meet? And beyond that, what benefit accrues to the insurance company if their delays result in more needed medical treatment and more off-work status for you? [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…]

Delays in Medical Treatment: Bad for Your Work Injury Case

 

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…]

Injured Workers Suffers Due to Insurance Company Tactics

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.

Delay in Treatment of Your Back Pain May be Hazardous to Your Health

low back painIn my Georgia workers’ compensation law practice I interact with dozens of insurance companies each week and I frequently find that claims adjusters take a very short sighted approach towards medical treatment for back injuries.

At least half of the clients I represent are suffering from some form of back injury. Low back pain (often disc herniations at L5/S1) is the most common problem I see but I also represent clients with damage to the spine at all regions: cervical, lumbar, sacral and thoracic.

Regardless of where the injury is localized, a common argument I have with insurance adjusters has to do with the need for fast treatment.

Despite dozens of research studies which show that fast diagnosis and treatment of any type of back injury results in faster and more complete recovery, I almost always find that insurance companies work to limit access to care and slow down the course of treatment.

Even in cases where an MRI shows a herniated disc that will require surgery, I inevitably find myself fighting to get the insurance company to agree to a surgeon, authorize surgery, approve post-surgical physical therapy or agree to pay for even short term prescriptions for beds, home modifications or even medications. [Read more…]