Wednesday, February 23, 2011

What is the "Panel of Physicians?"

The panel of physicians is a list of medical care providers that an employer must maintain for the purpose of giving employees treatment options in the event of a work injury. This list is typically a pink-colored sheet of paper that must be posted in a “prominent place” upon the employer’s premises, such as the breakroom or next to the punch in/out clock. There are three different types of panels which may be utilized by Georgia employers, all of which must meet certain requirements in order to be deemed a “valid” panel. The following is a general outline of the basic differences in the respective panels: 
  1. The “Traditional” Panel – This type of panel must have list of at least six (unless this number is not feasible in a given geographical area) unassociated medical care providers to be valid. If Doctor A and Doctor B both work in the same clinic, they are not “unassociated” for purposes of the Traditional panel. Moreover, the law does not allow for more than two “industrial clinics” to be listed on the panel, and there must be at least one orthopedist listed.
  2. The “Conformed” Panel – This type of panel must have a minimum of ten unassociated medical care providers (the same definition of “unassociated” applies here). Although an employer’s utilization of a Conformed panel initially gave an injured worker different rights than the Traditional panel, the law has changed such that the only practical difference between the two panels is simply the number of care providers listed. Also, this type of panel will state “Conformed” at the top of the document serving as the panel of physicians. Thus, if the panel states that it is “Conformed” at the top of the document, but only lists six physicians, it would be deemed invalid. 
  3. Managed Care Organization (MCO) – An MCO provides a much more expansive network of medical care providers than that of the Traditional and Conformed panels, and there are stricter requirements for the types of physicians that must be listed. This network of physicians is compiled by an organization with whom a self-insured employer or a workers’ compensation insurance carrier enters into a contract. Simply put, the MCO compiles a list of physicians, and then the employer or its insurer enters into a contract with the MCO which allows the employer to send its injured workers to the care providers on the list. Just like the Traditional and Conformed panels, however, the law requires that the MCO procedures be posted in a prominent place on the employer’s premises. 
It should be noted that there are requirements in addition to those mentioned above which must be adhered to by employers with respect to the panel of physicians. If any of the requirements aren’t satisfied, Georgia law states that the injured worker may then commence treatment with the doctor of his or her choosing.

If you have any questions about your workers' comp case or the panel of physicians, please let me know. Even if you're not in the Athens, Georgia area, give us a call and we will gladly help you with your case.

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