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Tillman & Associates, Attorneys at Law

Georgia woman denied medical benefits for using own doctor

Most Atlanta, Georgia workers may understand that state laws require employers to provide workers' compensation benefits to cover work-related injuries. Injuries may occur in a wide variety of ways, ranging from a workplace accident to a repetitive use issue such as carpal tunnel syndrome. Occupational illnesses caused by exposure to toxins or bad air may also qualify under workers' compensation laws in Georgia.

The idea is that when a worker suffers an injury on the job workers' are intended to be a streamlined way for a worker to get medical care. However, employers and insurance companies may wish to use the law in an effort to deny paying benefits. Workers need to know that issues can arise in a workers' compensation claim.

A recent appellate court decision in Georgia highlights one issue where an employer did not want to continue to pay workers' comp benefits to an injured worker based upon her decision to change doctors. Employers must have a panel of doctors to handle workers' compensation treatments. A Georgia woman who was injured on the job sought treatment from three of the doctors who were listed on the company's panel.

One of the treating physicians from the panel of approved doctors issued a regular-duty release to allow the woman to return to work. However, the release was dependent upon the outcome of tests that had not been conducted. The woman apparently chose to see her own doctor for treatment-a doctor who was not on the list of approved physicians. She also apparently did not ask her employer if she could change doctors.

The company cut off the woman's workers' compensation benefits based upon the regular-duty release provided by the panel physician. The woman sought reinstatement of benefits in court, challenging the validity of the panel of physicians offered by the company. Ultimately, the courts ruled that the panel was valid.

The woman was not allowed workers' comp benefits to cover medical treatments supplied by her own doctor. However, the court ruled that the woman is entitled to income benefits. The court said that the company failed to prove that the woman's condition improved. The regular-duty release was dependent upon future medical tests that were never performed.

Workers' compensation issues can be complex. An injured worker who is struggling with how the law is applied, or a worker who is hitting roadblocks in obtaining workers' compensation benefits, may wish to speak with legal counsel to learn what options are available.

Source: The Telegraph, "Employer's Corner: Don't get caught without a valid panel of physicians," Jason Logan, April 2, 2013

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