It is important to seek medical attention immediately after a workplace accident for your own wellbeing. With only a few exceptions, you are eligible to recover financial benefits for the money you or your health insurance company spends in medical care related to an occupational injury or illness.
Medical care is a key part of any workers’ compensation case in Georgia. It is important to understand what types of medical treatments are covered by Georgia’s workers’ compensation system and which aren’t.
Medical Treatments That Are Available With Workers’ Comp in Georgia
The monetary benefits available with a workers’ compensation claim in Georgia include 100 percent reimbursement for your medical bills, as well as your lost wages, disability costs and death benefits (if applicable). Medical workers’ comp benefits can cover all necessary past, current and future medical expenses you incurred during your treatment and recovery. As long as the treatment was medically necessary, you can list it as part of your workers’ compensation claim to recoup the costs.
The Georgia workers’ compensation system covers most types of medical care connected to an occupational injury or illness, including:
- Emergency medical care
- Ambulance fees
- Time spent in the ICU
- Tests and x-rays
- Primary care
- Chiropractic care
- Physical therapy
- Industrial medicine
Workers’ compensation typically does not, however, cover nontraditional forms of medicine, including most homeopathic and holistic options. An insurance company in Georgia will generally deny workers’ comp coverage for alternative medicines, such as massage or acupuncture, with only a few exceptions for treatments that have medical data supporting their effectiveness. If you want your medical treatment to be paid for, therefore, you are safest using scientifically proven medicines.
Your Employer Must Have a Panel of Physicians
After a work-related injury, report to your employer right away. Explain what happened and describe your injuries. Then, ask to see your employer’s panel of physicians. In Georgia, every employer with three or more employees must carry workers’ compensation insurance and must create a panel of medical practitioners for injured workers to visit. This panel must include:
- At least six physicians.
- At least one orthopedic specialist.
- No more than two industrial clinics.
- At least one minority physician.
Your employer’s panel of physicians should be posted someplace conspicuous at your job site, in a public space. If your employer does not have a panel, you can choose your own doctor instead. In this scenario, you can pick any physician or medical provider you want, as long as the facility accepts payment through the workers’ compensation system. You can also switch to your own doctor if you are not satisfied with the one you initially chose from the panel.
What to Do If Your Workers’ Compensation Claim Is Denied
Unfortunately, workers’ compensation claim denials are common in Atlanta, Georgia. Workers’ compensation insurance providers prioritize their profits, not injured workers. This can make it difficult to obtain fair and full financial compensation for the full extent of your injuries and losses during a workers’ comp claim, even if you received covered medical care.
If your employer’s insurance company or the State Board of Workers’ Compensation rejects your claim, don’t panic. This is common and does not necessarily mean you are not eligible for a monetary recovery. Contact a workers’ compensation lawyer in Atlanta for a free consultation. A lawyer can review the facts of your case and let you know if he or she believes you are the victim of a wrongful claim denial.
If the insurance company denied coverage for medical treatments that it should have paid for, your lawyer can help you request an internal review or file an appeal. If your case goes to a hearing, your lawyer can represent your rights and best interests before a judge. Your lawyer can help you prove the validity of your claim with medical records and testimony from a qualified physician. The right attorney can take many steps to make an insurance carrier pay for your medical care.