Georgia Worker's Compensation - Help For Injured Georgia Workers

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  1. #1
    anonymous Guest

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    Can you sue your employer or their W/C insurance for not providing you with a panel list of doctors after you were injured on the job, but instead force you to see a specific specialist? This doctor, by the way, performed an unnecessary surgery on my husband's arm, because later it turned out that his pain and other problems in the arm as well as shoulder & neck area were due to a displaced disc as could be easily seen on the MRI ordered by another doctor, whom he was finally allowed to see after his arm was messed up (he will have permanent damage to the arm resulting from the surgery). The quarrel with the W/C insurance is still ongoing and currently, although in pain and the other arm now affected by the injury as well, the insurance requires him to wait until his next appointment with the doctor, who discovered the neck injury (over 6 weeks from now, the earliest possible date), before they let him make an appointment at Emory for further diagnostics and treatment. Is there anything we can do about this gambling for time and get him the immediate medical care he needs right now?

  2. #2
    anonymous Guest

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    You can obtain medical care on your own and request reimbursement.
    You can complain to a supervisor at the insurance company if you believe your claim hasn't been handled properly or contact the Georgia Work comp board: Toll Free Number 800-533-0682.
    You can always sue about something i.e. medical malpractice or Insurance company delays, employer mishandling etc; the problem is finding an attorney who'll take your case. Contact your state bar for a list of lawyers who specialize in the types of suits you want start.

  3. #3
    tina Guest

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    It really depends on what state you are in. Some must have the panel doctors posted at the workplace and there are very specific guidelines as to what doctors must be on that list. If that list of doctors is not posted in the workplace, comp is in big trouble right off the bat. In GA you are allowed one "free" change of physician, and comp has to provide it and I think its still from that list of panel doctors. In our case they did not. They denied everything.

    If your case is controverted by comp and they lose control of the medical, then yes, you can seek any physician and comp will be forced to pay. But its complicated and you really need professional help. If you miss a step in the process you could blow it. We have not had a problem finding an attorney, but it took two trys to find a good one. I am happy to share that with you
    http://www.ok-law.org/workcomp.htm
    just click on the link to view the web site. There also is alot of straight information about comp and some other related issues.

    When we complained to a comp supervisor about the adjuster it only made things worse. The only improvement in the case that we've seen is when we hired the attorney. And he's a very good one.

  4. #4
    jonathan Guest

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    Here's my take on your question - from a lawyer's perspective...
    1. you cannot sue your employer for failing to post a panel. Workers comp in Georgia is a "no fault" system, meaning that fault is not an issue, nor is pain and suffering. By statute you give up your right to sue in exchange for the alleged ease and speed of a comp claim.
    2. As someone else noted above, if the employer does not have a panel posted, they may have waived the right to control your medical treatment. Control of the medical tx is huge because getting stuck with a bad company doctor can hurt a case.
    3. You are allowed one free switch from one panel doctor to another (with some strings attached). You can also request an IME. Other than that, you have to file for a hearing to request a change in treating physician - for some cause.
    4. Don't assume that there is no panel. I have seen panels suddenly appear - in fact, I sometimes send a private investigator into the break areas to take pictures, then call him to testify that there was no panel or it was blank (a blank panel or an improperly completed panel is the same as no panel). The law also says that the employer is supposed to instruct workers about how to use the panel.
    5. The big picture here is that you want to get the employer/insurer to pick up the claim and you want control of the medical. That puts you in the strongest negotiating position.
    Good luck.
    Jonathan
    http://www.georgia-workers-compensation.com

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