Georgia Workers' Compensation Lawyer Blog

The Georgia Court of Appeals has, fairly recently, decided that injured workers cannot be forced to sign away medical privacy rights--specifically, the right to refuse consent for the opposing attorney to meet alone with the treating doctor and tell him/her God knows what--in order to continue getting workers' compensation disability benefits. A brief summary of the McRae v. Arby's decision can be found here. 

In McRae, the insurer's attorney wanted to speak alone with the injured worker's doctor; the doctor refused the request, so the insurer's attorney tried to compel the injured worker to allow such a meeting. While the trial judge agreed with the insurance company's attorney, the Court of Appeals did not.

Currently, there are discussions regarding how this ruling's reach can be altered or expanded upon via legislation, so there may be additional reach to this ruling in the coming months, as Georgia's state legislature begins its session.  In the meantime, be careful to read any forms given you after your workers' compensation injury from the insurance adjuster.  While a WC-207 release may be required, any additional forms or language requiring agreeing to the scenario explained above is not required. 

Finally, if your medical information and/or health privacy has been violated, you can report and fight such violations by using the steps outlined in this previous blog entry.

Sometimes, for no apparent reason, a workers' compensation insurance company will decide that a referral for surgery or for additional treatment with another doctor, even when the recommendation or referral came from the workers' comp authorized treating physician, is not authorized. Often, we see this when the recommendation is for pain management, psychiatric care, or surgery. Instead of allowing the injured worker to see the expert his workers' comp doctor suggests, the insurance company will want him to go much farther away to a medical provider of its choosing instead.

Under Georgia Workers' Compensation Rule 200(b)(2), there are a few factors a court will consider when deciding whether the insurance company's requested change in doctors is of benefit to the injured worker:

1) proximity of the doctor to the injured worker's home
2) accessibility of the doctor to the worker
3) excessive/redundant performance of medical procedures previously given
4) necessity for specialized care
5) language barriers
6) referral by the authorized treating physician
7) noncompliance of the doctor with board rules
8) who's on the panel of physicians
9) duration of treatment without improvement
10) number of prior treating doctors
11) prior requests for changes in treating doctors
12) if the worker was released to regular duty by the authorized treating doctor
13) if the current doctor has nothing more to offer.

If your "workers' comp doctor" has referred you for treatment with another specialist or at another facility, and the workers' comp adjuster is denying it or has filed a motion through a defense attorney for a change in physicians to keep you from treating with the doctor to whom you were referred, call our Atlanta injury lawyers' office for assistance with filing an objection and/or a hearing request with the State Board of Workers' Compensation so that you can fight for the medical care your doctor wants you to get instead of the medical care your employer's insurance company wants you to get.

When you file a workers' compensation claim in Georgia, you'll need to sign a WC-207 release that allows the workers' compensation employer/insurer to access medical records reasonably related to your injury at work.  Medical records may, of course, be shared between different doctors and specialists.  However, sometimes medical information that is protected is shared with parties that should not get this information, such as companies or organizations where an injured worker is being sent pursuant to a return to light duty under O.C.G.A. 34-9-240. 

If this occurs, here is a link providing the resources you may use to file a complain with the U.S. Department of Health and Human Services for violations of your HIPAA rights.

In short, your complaint must:

1. Be filed in writing, either on paper or electronically, by mail, fax, or e-mail;
2. Name the covered entity involved and describe the acts or omissions you believe violated the requirements of the Privacy or Security Rule; and
3. Be filed within 180 days of when you knew that the act or omission complained of occurred. OCR may extend the 180-day period if you can show "good cause." 
   

For additional information about workers' compensation medical benefits in Georgia, please call our Atlanta law office at 404-354-5432.

The workers' compensation insurer does not have to settle your workers' comp claim in Georgia, but it usually will at some point. Because an accepted workers' comp claim (i.e., one in which you have received disability benefits) means you are owed medical care related to your injury for the rest of your life, absent some subsequent accident or injury, most insurance adjusters want to "close out" their files at some point to avoid a change in condition for the worse popping up years in the future after you've reached maximum medical improvement (MMI).

So, while your claim doesn't have to settle, and you are not owed a settlement, and you can't force a settlement, it's normally in the best interest of all the parties to eventually settle and close an open workers' compensation claim in Georgia.

If your claim has been offered closure and a settlement by the workers' comp adjuster, and you'd like a legal opinion regarding its adequacy, feel free to contact my Atlanta workers' compensation law office:

Moebes Law, LLC
3535 Piedmont Road NE
Building 14, Suite 410
Atlanta, GA 30305
(404)354-5432

If your Georgia workers' compensation claim is compensable, your employer and/or its workers' compensation insurance company will pay for your medical expenses when traveling to authorized medical providers. This can include the following expenses:

• mileage (currently $.40/mile) to and from the doctor's office, physical therapist's office, and pharmacy
• parking at the medical providers' offices
• meal expenses (up to $30/day) when the trip to the doctor takes more than 4 hours 
• lodging and meals when the medical visit is outside your home city.

You have one year to submit your medical expenses related to your treatment; otherwise your right to be reimbursed is waived.  The employer/insurer have 30 days to pay these expenses; otherwise, penalties and interest will accrue.

For additional help with Georgia workers' compensation law, please contact our Atlanta law office:
Moebes Law, LLC
3535 Piedmont Road NE
Building 14, Suite 410
Atlanta, GA  30305
(404)354-5432

If you're currently on workers' compensation benefits and are getting medical care through the workers' comp doctor, please know that the doctor has been chosen by the insurance company with the expectation that you are to be released back to full duty work as quickly as possible for as little cost as possible and with as low a disability rating as possible. The insurance adjuster and workers' compensation doctor are not interested in returning you to your pre-injury abilities and capabilities; they're interested in saving money.

I recently had a client with multiple disc herniations and excruciating pain get released to full duty, heavy labor work with no restrictions or impairment rating (permanent partial disability). This is ridiculous. But, it's not uncommon.  We've worked to get him another doctor who is a patient advocate.

Working with an experienced Georgia workers' compensation attorney will help you learn the reputations of doctors and what your options are regarding medical care and necessary medical procedures that may be denied by the workers' comp insurance company. In short, it pays to have an advocate who's looking out for your interests instead of an insurance company's.

-Moebes Law, LLC
3535 Piedmont Road NE
Building 14, Suite 410
Atlanta, GA  30305
(404)354-5432

If you've been injured on the job in Georgia and need constant care from someone, why not let that person be your spouse? You know you expect him/her to wear that little nurse outfit on Halloween...what about the other 364 days of the year?

While the notion that a spouse can provide attendant care had already been established, it was reaffirmed recently in the Medical Office Management, et al v. Hardee case.  The attendant care needs to be medically necessary to effect a cure, provide relief, or restore the injured worker to suitable employment.  The workers' compensation fee schedule allows payment for such care at $10.01/hour for up to 12 hours/day (hours can be extended at the State Board of Workers' Compensation's discretion). 

Why invite a stranger into your home when you can let the person who already lives there take care of you?  If the workers' compensation adjuster is denying such an arrangement, feel free to contact the Atlanta workers' compensation lawyers at Moebes Law, LLC for guidance.

Several of my clients are nurses, nurse practitioners, or physicians' assistants. They tend injure their backs while lifting patients: disc bulges, disc protrusions, herniated discs, sciatica, etc. Because they have backgrounds in medicine, they often want to have more control and "say" in how their care is delivered.

If your workers' compensation claim is accepted by the insurance company, and you are receiving disability benefits, you do have to attend your medical appointments to avoid a motion to suspend your benefits. However, if your doctor is suggesting you have surgery, and you don't want it, you can certainly get another opinion or opt to wait and instead treat conservatively for longer (using physical therapy, medication, injections, etc.).

Feel free to call my Atlanta law office to speak with a workers' compensation lawyer about your options and recommendations for getting quality medical care while on workers' comp in Georgia.

If you're hurt at work in Georgia, and your employer has a valid panel of physicians, you likely started your medical care with a doctor from that panel. Since these panels are chosen by workers' compensation insurance companies, however, the treating doctors' interests may not align with yours, and you may find that you do not agree with, or even like, your doctor.  Do you have options?

Certainly.  You're allowed a change in physician from the panel of doctors in Georgia.  If you've been on workers' comp disability benefits for several months, you may be able to get an independent medical evaluation (IME) at the workers' comp insurance company's expense.  Or, your Atlanta workers' compensation lawyer may set up and finance an IME for you. 

Whether the workers' compensation insurance company agrees to a change in physicians with you or not, there are options for making a change (your attorney can file a motion if need be).  Certainly, if your doctor is suggesting a treatment you're not comfortable taking, or if your doctor has released you to a job you know you can't perform, please explore some of these options for getting another opinion.  My Atlanta workers' comp lawyers are certainly willing to assist if need be.

Unlike Florida and a few other states, in Georgia, your workers' compensation indemnity benefits will not be cut off when you hit MMI (maximum medical improvement).

Your authorized treating physician (ATP) may issue an impairment rating if you have a percentage of permanent partial disability (called a PPD rating) that will be paid based on the percentage the doctor assigns, the body part(s) affected, and your workers' compensation rate, but your TTD benefits can't be stopped just because you're at MMI.

If your workers' compensation doctor has told you you are at maximum medical improvement, and the workers' comp insurance adjuster has asked you if you're interested in settling your claim, please contact an experienced Atlanta workers' comp attorney to discuss your case's exposure and what to "look for" when settling your claim.

If you are hurt at work in Georgia, workers' compensation will cover medical care related to your injury. Even if you reach maximum medical improvement, continuing therapy, pain management, and other medical care will be provided. Sometimes, an injured worker can have a change in condition for the worse and require additional medical care years after his initial accident at work. While the insurance company may try to argue that an intervening incident caused the change in condition for the worse, medical care should still be provided.

If you hurt yourself at work in the Atlanta area and have had a change in condition for the worse, please call me, the Atlanta workers' compensation attorney. We can examine your medical records and employment records together to see if you are entitled to continuing medical treatment for your injury at work, even if several years have passed.