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Can I Choose My Own Doctor for Treating My Workers’ Compensation Injuries?

Workers are hurt while on the job all too often in Atlanta. Most of the time these worker injuries are attributed to accidents that occur in the workplace. A large piece of equipment might fall on a worker, the worker might suddenly be injured in an explosion or burned, or the worker could slip or fall and injure themselves. Workplace accidents can happen to anyone, even when safety precautions are taken.


Fortunately, most workers in Atlanta can receive workers’ compensation benefits if they are injured on the job. Most Georgia employers are required to get workers’ compensation insurance for their workers, which is effective from the minute the worker starts their job. But like most insurance policies, the workers’ compensation insurer may have restrictions on their policy that injured workers must comply with in order to obtain benefits under the policy. One of the biggest restrictions on workers’ compensation policies is that injured workers are generally required to go to certain doctors for the medical care that they need related to their work-related injuries. These rules and restrictions can be found in the Georgia State Board of Workers’ Compensation Employee Handbook.


Choosing a Doctor for Your Care


In the event that you are injured on the job and need to take advantage of workers’ compensation, you will most likely not be able to go to your normal personal physician for your care, unless – coincidentally – your personal doctor happens to be one of the approved workers’ compensation doctors chosen by your employer, which is an unlikely scenario. Your employer is required to post a list of approved workers’ compensation doctors somewhere that is easily accessible to workers. You must choose one of the doctors from this list to receive your work-related injury treatment from.  The list should be clearly labeled and should give the name, specialty and contact information for the employer-approved workers’ compensation doctors.


Going to a doctor that is not on the employer-approved list is considered unauthorized treatment, and workers’ compensation will not cover any unauthorized treatments received by injured workers from unauthorized doctors. Any treatment sought from an unauthorized doctor must be paid for out of pocket by the injured worker as most health insurance policies do not cover treatment for work-related injuries.


If you select a doctor, and attend an appointment with your chosen employer-approved doctor, but you are dissatisfied with the care you received, you are permitted to choose a different doctor from the employer approved list. You may change doctors one time. If you are still dissatisfied, you must consult with your employer or your employer’s workers’ compensation coordinator or administrator.     


Emergency Situations That Require Immediate Care


Some workplace accidents result in serious or life-threatening injuries that require immediate medical treatment. In truly emergency situations, an injured worker is not required to go to one of the employer-approved doctors. Instead, workers who need emergency medical care are permitted to go to the nearest emergency treatment facility and can still seek workers’ compensation to cover the costs of the emergency care, even though the treating emergency doctor is not an approved doctor. This includes coverage for emergency treatments such as scans, diagnostics and emergency surgery procedures. Once the emergency has passed, and the injured worker has stabilized enough to no longer require the emergency care, the worker is then required to seek medical care from an employer-approved doctor.


When You Need Additional Tests and Procedures


Upon working with an employer-approved workers’ compensation doctor, the doctor may require the injured worker to seek special tests, scans or procedures that the doctor him or herself cannot perform. These tests, scans or procedures must be referred out to another doctor of facility. In such a scenario, your doctor will coordinate with your employer concerning getting you the tests, scans or procedures you need to recover from your work injuries. The arrangements will be made for you, and your employer’s workers’ compensation coordinator or administrator should contact you letting you know when and where your test, scans or procedure will be conducted.  This is true if you need a MRI scan, CT scans, specific surgical procedure, physical therapy, etc.  


What Else Will Workers’ Compensation Cover?


Workers compensation will cover the cost of emergency treatment, treatment from authorized workers’ compensation doctors, authorized scans, tests and medical procedures, physical therapy, prescription medications, and prescribed therapies. Generally speaking, your employer’s workers’ compensation coordinator will be involved in making sure you get the treatment you need and that workers’ compensation takes care of the bills. However, in some situations you may be required to pay up front, and seek reimbursement from your employer’s workers’ compensation program.

Specifically, you may be required to pay for prescriptions and for your mileage, food and lodging costs while receiving care, but these costs can be reimbursed to you through workers’ compensation. Waiting more than a year to seek reimbursement disqualifies your expense from being reimbursed.


Injured workers who would like to be reimbursed for these costs should contact their employer’s workers’ compensation coordinator or administrator and work out how to obtain reimbursements. Reimbursement documents need to be filed within a year of generating the expense. Once you have figured out what your employer’s reimbursement procedure is, you can file for your reimbursement and you should receive reimbursement within 15 days for approved expenses.


Work with an Experienced Workers’ Compensation Attorney


Understanding the rules and restrictions that come with being injured on the job and seeking workers’ compensation benefits can be tricky. You must see an authorized doctor. Workers’ compensation covers all authorized costs associated with you getting the medical treatment you need, and can include emergency care as well, even if the emergency care is not obtained from an authorized doctor. If you are having difficulty getting your employer to pay for medical care you received for your work-related injury under workers’ compensation, you should consult with an experienced Atlanta workers’ compensation attorney. The professionals at Bader Scott Injury Lawyers can assist you with every aspect of your workers’ compensation claim. Contact us today.

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Seth Bader
(678) 562-5595