Showing posts with label Panel of Physicians. Show all posts
Showing posts with label Panel of Physicians. Show all posts

Thursday, September 29, 2011

Quick Definitions: Panel of Physicians

The Panel of Physicians is a list of doctors and care providers which must be maintained and posted by the Employer in the event that a worker gets injured on the job. After an injury, a worker must treat with one of the physicians on the panel. In Georgia, there are three kinds of panels that may be utilized by an Employer: Traditional, Conformed, or MCO. 

For more information on the Panel of Physicians, please look here

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.

Tuesday, February 22, 2011

I was hurt at work. Can I treat with any doctor I want?

Not exactly. An injured worker must choose from one of the physicians listed on the employer’s panel of physicians (there are three kinds of panels of physicians: traditional, conformed, and MCO). Although Georgia law states that it is the injured worker’s right to choose which physician he or she would like to have designated as the authorized treating physician (ATP), this usually doesn’t happen. From my experience, it is usually the employer who chooses and sends the injured worker to one of the physicians on the panel once the injury is reported.

It’s also important to point out that if a worker is injured at a time when it is not possible to go to a panel physician (such as late at night when the clinic is closed), and the injury is serious enough to warrant immediate care, the employer will be responsible for expenses incurred as a result of the emergency care. For example, if you are injured late at night and have to go to the nearest emergency room, the employer will be responsible for the ER bill. However, this doesn’t mean that the ER physician is your ATP. At some point in the subsequent days, you will be given the option to choose a panel physician as your ATP.

Tip:  Don’t let the employer force you to treat with a doctor you don’t want to go see. It is your right to choose which physician you would like to have designated as the ATP. Having said that, if you have no preference and don’t know anything about any of the doctors, it would only serve to complicate things if you object to the physician recommended by the employer for no other reason than to assert your right to choose. In other words, don’t argue for the sake of arguing, as this could create a hostile situation between you and your employer and make your time out of work even more inconvenient than it already is. If you are dissatisfied with the care provided by your first ATP, you have the right to make a one-time change of physicians to a different doctor—but this new doctor must also be listed on the panel (unless the panel is invalid, in which case you can choose any doctor at all). You only get one chance to make a change, however, so this choice should be made very, very carefully.

Thursday, February 17, 2011

Did you know? (Panel of Physicians Edition)

Did you know that if the "Panel of Physicians" maintained by the Employer is not valid (for example, if it does not contain up-to-date information or if it does not comply with the requirements of the Georgia statute), then an injured worker "may select any physician to render service at the expense of the employer"? (O.C.G.A. ' 34-9-201).

Tip:  If you've been injured at work, always ask to have a copy of the Panel of Physicians that was posted on the date of your accident--it may come in handy if you're not satisfied with the treatment provided by the physician chosen by the Employer.