Atlanta Pre-Existing Conditions Lawyer

When you’ve been injured on the job in Atlanta, navigating the complexities of the Georgia workers’ compensation system can be challenging, especially while you are trying to focus on your recovery. Obtaining proper medical care is not only crucial for your physical health, but it also plays a vital role in your workers’ compensation claim.

At Merritt & Merritt Law Firm, we understand the challenges injured workers face and are dedicated to helping you get the medical treatment and benefits you deserve. With over 40 years of experience, our team has assisted thousands of Georgia residents with their job-related workers’ compensation cases. Call our Atlanta pre-existing conditions lawyer team today at 404-975-1775 for a free consultation today.

The Importance of Immediate Medical Attention

Your health should be your first priority after any workplace accident. Seeking immediate medical attention is critically important, even if your injuries seem minor at first. Some injuries may not be apparent right away and could worsen over time. Prompt medical care is essential not only for your well-being but also to ensure your injuries are properly documented, which is necessary for claiming workers’ comp benefits. Medical records serve as evidence of your injury and its severity. A delay in seeking medical care could negatively impact your health and your personal injury case.

In emergency situations where your injuries are very serious, you can seek initial treatment from any licensed doctor, and the bill should still be covered by workers’ compensation. After the emergency is over, you must then get treatment from a doctor on the list provided by your employer.

Reporting Your Injury

In addition to seeking immediate medical care, you must also report your injury to your employer as soon as possible. According to Georgia law, you must report any accident immediately, but not later than 30 days after the accident, to your employer or their representative. Failure to do so may result in the loss of your workers’ compensation benefits. Never hesitate to report an injury just because you don’t think it’s serious; even minor issues can become major health problems later, resulting in lasting injuries that could have been prevented.

Choosing Your Doctor in Georgia Workers’ Compensation

Under Georgia workers’ compensation laws, your employer is required to post a list of at least six approved physicians or medical care organizations, known as a “Panel of Physicians”. Generally, you must choose a doctor from this list for your treatment to be covered by the insurance company. The law specifies certain requirements for this panel:

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

If your employer fails to post a panel, or if the posted panel does not meet these legal requirements, you may be able to choose your own doctor who accepts payment under the Georgia workers’ compensation fee schedule.

The doctor you choose from the panel then becomes your authorized treating physician. This physician acts as the gatekeeper for almost everything in your workers’ compensation case as they are the ones to determine your work capabilities, necessary care, and who should provide that care. This is why choosing the right doctor is imperative to your workers’ compensation case.

Even if you choose a doctor from the panel, you are generally allowed a one-time switch to another doctor on the list without needing your employer’s permission. If your initial doctor refers you to a specialist, such as an orthopedic specialist, that referral should be honored by the insurance company and does not typically count as your one-time change.

Independent Medical Examinations (IMEs)

In the Georgia workers’ compensation system, an Independent Medical Examination (IME) is an evaluation performed by a doctor who is not your treating physician. The employer’s insurance company or self-insured employer has the right to request a defense medical exam (IME) if there is a dispute about the extent or nature of your injuries or the validity of your claim. While IMEs are intended to be “neutral” and “objective” evaluations to help resolve medical disputes, sources note that insurance companies can easily find doctors who may support their position. The purpose from the insurance company’s perspective is often to verify if previous injuries contributed, confirm the necessity of treatments, and determine when you can return to work. They may try to uncover evidence that excuses the insurance company from paying the claim.

During an IME, the doctor will examine you, review your medical records, and potentially order additional tests. The doctor will then provide a written report determining your entitlement to workers’ compensation benefits. Despite the potential for bias, IME doctors’ opinions carry weight with workers’ compensation judges, who may view them as more impartial than the treating physician. If the IME report finds your injuries are not work-related, your claim may be denied or reduced.

However, if you have been receiving workers’ compensation income benefits within the last 120 days, you are entitled to one IME of your own, chosen by you (or your attorney), with certain cost limitations. The employer or insurer must cover the cost, subject to pre-payment limits and restrictions on diagnostic procedures already performed. An attorney can assist you in exercising this right and finding a reputable doctor to provide a non-biased opinion and potentially a more sympathetic permanent partial disability (PPD) rating.

Your Responsibilities Regarding Medical Care

To protect your workers’ compensation claim, you have certain responsibilities related to your medical care. These include cooperating with medical providers, accepting reasonable medical treatment and rehabilitation services, and attempting a job approved by the authorized treating physician, even if it’s lower paying.

It is also crucial to follow all recommended treatment plans. Attend all medical appointments and physical therapy sessions, even if you don’t feel they are helping. Missing appointments or failing to follow treatment can be used by the employer or insurer as evidence that you are not truly injured.

When seeking medical treatment, always specify that your injury was work-related and occurred on the job, and ask to have this reflected in your medical records. Keep private notes on everything that happened and important things that were said, but only share these notes with your Atlanta pre-existing conditions lawyer.

How a Workers’ Compensation Attorney Can Help with Medical Care

A workers’ compensation attorney can provide invaluable assistance in navigating the medical aspects of your claim. At Merritt & Merritt Law Firm, we can help ensure you receive the best possible treatment by assisting you in choosing a doctor who will listen to your complaints and provide appropriate care.

Specifically, an Atlanta pre-existing conditions lawyer at our firm can help with:

• Understanding your rights regarding the Panel of Physicians and your ability to change doctors.
• Helping you avoid industrial clinics that may not be equipped for serious injuries.
• Ensuring that authorized medical bills and necessary travel expenses are paid by the insurance company, preventing out-of-pocket costs and protecting your claim’s statute of limitations.
• Assisting you in exercising your right to an independent medical examination (IME) with a doctor of your choosing, particularly if you’ve received wage loss benefits within the last 120 days.
• Preparing you for an IME and helping you understand what to avoid during the examination to protect your claim.
• Contesting inconsistent or inaccurate IME reports.
• If your claim is denied, helping you understand your medical treatment options and potentially requiring the insurance carrier to pay for past treatment if your case is deemed compensable at a hearing.
• Helping you obtain proper documentation of your injuries and medical needs to support your claim for benefits.
• Working with healthcare providers to potentially defer payment until your case is settled.

The doctor in your workers’ compensation case controls your work status, making them essential to your claim. An Atlanta pre-existing conditions lawyer at our firm can help you choose a doctor who is going to actually listen to your complaints of pain and provide appropriate treatment. We have solid relationships with doctors and other medical professionals who can provide the care you need.

What to Avoid When Dealing with Medical Providers and Insurers Alone

Navigating a workers’ compensation claim without legal representation can be frustrating and overwhelming, especially when dealing with medical care issues. Insurance companies are for-profit businesses whose financial objectives may not align with your best interests. They have legal teams and protocols designed to handle claims efficiently and cost-effectively, which may be disadvantageous to you.

When dealing with insurers or medical providers on your own, be cautious and avoid certain pitfalls:

• Do not exaggerate or downplay your symptoms or the circumstances of the accident.
• Do not discuss unnecessary details about your claim or frustrations with your employer with medical staff or adjusters.
• Do not give recorded statements to the insurance company before consulting an attorney, as adjusters are trained to ask questions that could damage your case.
• Do not sign documents without reading and understanding them first.
• Be aware that insurance companies may try to steer you towards industrial clinics that may not be best suited for serious injuries.
• Remember that an insurer may pay for medical treatment while denying indemnity benefits.
• Do not rely on your employer or the insurance company to fully inform you of all your rights and entitlements.

Hiring a lawyer ensures you have a legal representative advocating for your best interests and helping you navigate these complexities. We can help you protect your rights, ensure you meet all necessary requirements, and explore avenues within the system to receive proper treatments and maximum benefits.

Focus on Your Recovery, We’ll Handle the Rest–Speak with an Atlanta Pre-Existing Conditions Lawyer Today

Being injured on the job is difficult enough without the added stress of navigating the workers’ compensation system and ensuring you receive proper medical care. Merritt & Merritt Law Firm is dedicated to helping injured workers like you. We understand the challenges you face and are here to provide the legal guidance and support you need.

If you’ve been injured on the job in Atlanta and have questions about your medical care or workers’ compensation claim, don’t hesitate to contact us. Our Atlanta pre-existing conditions lawyer team offers free consultation to discuss your case and explain how we can help protect your rights and fight for the benefits you deserve. Let us handle the legal complexities so you can focus on getting back on your feet and recovering fully.

Call Merritt & Merritt Law Firm today for your free consultation at 404-975-1775. We can come to you at your home, office, or hospital.