Atlanta Medical Treatment Lawyer

Being injured on the job in Georgia can be a difficult and stressful experience. Beyond the immediate pain and disruption to your life, navigating the complexities of the workers’ compensation system to ensure you receive the medical care you need can feel overwhelming.

At Merritt & Merritt Law Firm, we understand the challenges a workplace injury presents to you and your family. We are dedicated to helping injured workers like you collect the compensation they deserve, with a particular focus on ensuring you receive the best possible medical treatment.

We have assisted thousands of Georgia residents in job-related workers’ compensation cases for over 40 years. Our goal is to help you heal quickly and rebuild your life after the misfortune. We are here to inform you of your rights and help you navigate the process of getting the medical care necessary to treat your injuries.Call us today at 404-975-1775 for a free consultation. 

The Importance of Prompt and Proper Medical Care

One of the most critical steps you should take after a workplace accident in Georgia is to seek medical treatment immediately. This is important not only for your health but also for your workers’ compensation claim. Seeking immediate medical care ensures you receive the treatment necessary to address your injuries. It also ensures your injuries are properly documented. Comprehensive medical records can be crucial evidence to show your injuries were work-related when claiming workers’ compensation benefits.

Even if you don’t feel injured immediately after the incident, you should seek medical care regardless. Some injuries may not appear for days or even weeks, and a minor injury can worsen into a severe one. Delaying medical care can make the insurance company much less likely to pay your claim or may lead them to downplay the severity of your injury. By treating promptly, you help your case.

Understanding Your Right to Medical Benefits in Georgia Workers’ Compensation

In Georgia, if you are hurt on the job, you are entitled to medical treatment for your injured body part. This treatment should be paid for by the workers’ compensation insurance company, and you should not have to pay anything out-of-pocket. Medical benefits are one of the key types of compensation available. These benefits typically cover authorized medical treatment related to the work injury, which includes:

• Doctor visits
• Hospital stays and surgery
• Prescriptions
• Physical therapy
• Necessary medical equipment
• Required travel expenses for treatment

Choosing Your Treating Physician

Georgia law includes specific rules about choosing your doctor. Generally, your employer is required to have a posted list of at least six approved physicians or medical care organizations, known as a “Panel of Physicians”. Unless the Board has granted an exception, you must choose a doctor from this posted list for your treatment to be covered.

There are requirements for this panel to be valid:

• It must list at least 6 physicians.
• At least 1 must be an orthopedic specialist.
• No more than 2 industrial clinics should be included.
• There must be at least 1 minority physician.

If your injuries constitute an emergency, you can seek initial medical care from any licensed doctor until the emergency is over. After the emergency, you must return for treatment to a doctor on the posted list. If your employer fails to provide a proper panel that complies with the requirements, or if the panel is not posted, you might be able to choose your own doctor, provided they accept payment under the Georgia fee schedule for workers’ compensation.

You are allowed one change to another doctor on the panel without getting permission if you are not satisfied with the care from your initial doctor. If your initial doctor refers you to a specialist, like an orthopedic specialist, that referral must be honored by the insurance company and does not count as your one-time change. However, even if the panel is invalid, the Board may order a change of physician or treatment upon request from either party.

The Role of the Doctor in Your Claim

In workers’ compensation cases, doctors act as gatekeepers. They are essential to your claim because they determine your work capabilities, what care is needed, and who should provide that care. Choosing the right doctor is imperative. The doctor also assigns a permanent partial disability (PPD) rating once you reach maximum medical improvement (MMI). This rating affects your compensation. Disputes over the doctor assigning the rating or the body part being rated are common.

Independent Medical Examinations (IMEs)

When there is a dispute over the extent, nature, or validity of your injuries, the employer’s insurance company or self-insured employer has the right to request a defense medical exam, also known as an Independent Medical Examination (IME). An IME is performed by a doctor who is not your treating physician. While IMEs are supposed to be neutral and objective evaluations to help resolve disputes, they are less impartial than they appear because the insurance company selects and compensates the doctors performing them. IME doctors often try to find evidence to excuse the insurance company from paying your claim.

The IME doctor’s report can significantly impact your case and is given weight by workers’ compensation judges, who may view it as more impartial than your treating physician’s opinion. This means the insurance company may reduce or reject your claim based on the IME report, even if you believe you are entitled to compensation.

If you have received weekly workers’ compensation income benefits within the past 120 days, you are entitled to one IME of your own choosing, paid for by the insurance carrier, subject to certain cost limitations. This allows you to get a second opinion from a physician of your choice. An experienced Atlanta medical treatment lawyer can assist you in exercising this right and securing an appointment with an appropriate doctor for your own IME.

Before attending an IME, it is advisable to prepare:

• Review your medical records.
• Collect relevant documentation.
• Be prepared for questions.
• Seek legal advice.
• Be honest about your current symptoms but avoid exaggerating or downplaying them.
• Avoid signing documents without reading them.

What Happens If you Don’t Seek Medical Attention Immediately After a Workplace Incident? 

If you sustain a workplace injury in Atlanta and do not seek timely medical treatment, you could face several significant consequences that may jeopardize your well-being and your eligibility for workers’ compensation benefits:

Loss of Workers’ Compensation Benefits

Medical Care Coverage

Workers’ compensation is designed to cover authorized medical bills related to your work injury. If you don’t seek treatment, or if you seek unauthorized treatment, the insurance company may deny coverage, leaving you responsible for all medical expenses.

• Lost Wage Benefits: To receive temporary total disability (TTD) benefits for lost wages, a doctor must certify that your injury prevents you from working for more than seven days. Without medical documentation from an authorized physician, you will not be able to prove your inability to work and therefore won’t receive these benefits.
• Permanent Partial Disability (PPD) Benefits: If your injury results in a lasting impairment, PPD benefits are calculated based on medical evaluations. A lack of medical treatment means no formal evaluation of your impairment, potentially forfeiting these benefits.

Personal Liability for Medical Bills

If your workers’ compensation claim is denied or you fail to follow the proper procedures for authorized medical care, you may become personally responsible for all your medical bills, which can accumulate rapidly.

Difficulty Proving Your Injury

Medical records are crucial evidence in a workers’ compensation claim. Without documented treatment, it becomes much harder to prove that your injury is work-related, the extent of your injury, or that it was caused by the workplace incident. This can lead to your claim being disputed or denied.

Worsening Health and Delayed Recovery

Delaying or foregoing necessary medical treatment can lead to your injury becoming more severe, developing complications, or becoming a chronic condition. This can result in longer recovery times, increased pain, and potentially permanent disability that could have been mitigated with prompt care.

Presumption of Drug/Alcohol Causation

Under Georgia law, if an employee unjustifiably refuses to submit to a drug test following an on-the-job injury, there can be a presumption that the accident and injury were caused by alcohol or drugs. If this presumption is not overcome by other evidence, any claim for workers’ compensation benefits could be denied.

Employer Penalties Not Directly Related to You

While not a direct consequence for the injured worker, it’s worth noting that employers in Georgia can face penalties, including fines and even criminal charges, for failing to have required workers’ compensation insurance or for denying benefits. However, this doesn’t automatically secure benefits for an employee who has not followed the necessary steps for medical treatment.

It is critical to report your injury promptly and seek authorized medical treatment to protect your health and your rights under Georgia’s workers’ compensation system. 

Get Answers! Speak with an Atlanta Medical Treatment Lawyer Today 

Choosing the right legal representation can significantly impact your ability to receive proper medical treatment and benefits. Our experience makes the difference. We have been trusted by families since 1973 to help those injured. Dealing with insurance companies is daunting, and they usually will not treat you fairly unless you have adequate legal representation.

When you hire Merritt & Merritt Law Firm, you get an Atlanta medical treatment lawyer team advocating for you, just as the insurance company and employer have attorneys working for them. We provide free case reviews and consultations. We offer 24/7 service and can visit you at home or in the hospital. Call today for a free consultation at 404-975-1775.