Does the Workers Compensation Insurance Company Control My Doctor’s Appointments?
When you suffer a serious injury, you need good medical treatment to recover. Because of this, the medical benefits provided under Georgia’s workers’ compensation law are some of the most important benefits in your workers’ compensation case.
Of course, the ability to get the medical treatment you need is almost as important as the right to get treatment. It does not do you any good to have the right to see the doctor if you cannot enforce that right.
Many insurance companies have tried to take control of your workers’ compensation medical treatment. One of the ways that I see this happen is by insurance companies trying to schedule your doctor’s appointments.
Can I schedule my own doctor’s appointments?
Yes. You can schedule your own appointments with your doctor. But, there is a problem that makes this more difficult than it used to be.
You are supposed to be able to go to the doctor that is an authorized physician in your workers’ compensation case to get reasonable and necessary treatment without the insurance company’s approval. But, actually getting that done is getting harder and harder.
Most doctors and other medical providers want to know that they are getting paid by the insurance company in order to treat you. This means that most of them will want to receive authorization from the insurance company for your appointment. Georgia law does not require doctors to get preapproval from insurance companies, but it can be difficult to get a doctor to treat you without that approval.
So, you do have the right to schedule your own doctor’s appointments, but you are probably going to have to make sure the insurance company approves them before the doctor agrees to see you. As long as that approval is given you should be able to get in and see the doctor at your convenience. If the insurance company does not approve the appointment, there are some steps you or a workers’ compensation attorney can take to get the appointment approved.
Can the insurance company schedule a doctor’s appointment for me?
There is not a hard and fast answer to this question. The insurance company does have some ability to schedule certain workers’ compensation doctors appointments, but they do not get to completely direct your treatment.
What does this mean? Many insurance companies will try to schedule all of your medical appointments for you. They may even cancel appointments and reschedule them. The general rule is that you can direct your treatment and that the insurance company cannot force you to go to the doctor on a particular day.
Now, insurance companies do have some rights under Georgia’s workers’ compensation law to schedule medical appointments. The primary way an insurance company can schedule a medical appointment is the ability to force you to return to your authorized treating physician if you have not seen that doctor in a while.
The insurance company’s right to schedule an appointment with your authorized treating physician gives them some power. This power comes from them potentially being able to suspend your weekly workers’ compensation benefits if you fail to attend appointments about which they have timely notified you.
Does the insurance company have any other rights to schedule medical appointments for me?
Yes. The insurance company can also schedule appointments for what are commonly referred to as “independent medical evaluations” or “IMEs”.
When an insurance company schedules an IME, it is not for treatment. Instead, it is the insurance company’s opportunity to have you evaluated by a doctor of their choice.
The workers compensation insurance company gets to schedule your IME appointment. The basic requirement is that the IME be scheduled at a reasonable time and place.
If you are not able to attend the IME appointment at the time that has been scheduled, you should look into getting it rescheduled sooner rather than later. Many doctors who perform IMEs attempt to assess cancellation charges if you do not cancel the appointment with a sufficient amount of notice. These cancellation charges can be significant, and the insurance company may attempt to make you pay them.
There are many specialized rules that apply to IMEs when the insurance company schedules them. If you would like more information about IMEs, this article describes them in more detail.
What if I have other questions about workers compensation?
Georgia’s workers compensation system can be very confusing. You have to worry about getting the treatment you need and paying your bills while also worrying about not missing any deadlines that could cause you to lose your right to receive workers compensation benefits.
If you have questions, I would recommend that you try to get answers. To find out more about how to schedule a time to talk to me about your workers compensation questions, just read this short article.
Jason Perkins is an attorney who specializes in representing injured workers. He regularly publishes videos and write blog articles about Georgia’s workers compensation system and issues that are important to injured workers and their families.
To be notified of Jason’s new workers compensation videos, subscribe to his Georgia Workers Compensation Video Series channel on YouTube by clicking the subscribe button below.
It took me probably too long to finally get a lawyer when my work comp claim started and I had no idea what I should do. I read reviews and upon recommendation of several people started the process of getting a lawyer. I am fortunate and lucky to have come across Perkins Studdard. Jason and his team has taken care of me since the moment I first called them and made sure any and all questions I had were answered as well as working hard to get me my settlement so I can continue receiving treatment. If you're looking for a good law firm to represent you in your worker's compensation case I would highly highly recommend this one.Autumn Fields
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Mr. Perkins and team...Tina* they have all been so awesome. Always available to talk to me with any concerns. Kept me informed on my case all the way. Greatly appreciated!Missy Cherry
Amazing! Jason and his team were very helpful and had the best communication by far. Walked me though every step with great detail and had answers for any question I had. They handled my case better then I could imagine, it was a weird case and they stayed on top of it and kept me updated every step of the way! Highly recommend this Team! Thanks so much to Jason and his Awesome team!
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This law firm is very good at what it does the staff and the lawyer's that were involved with my case all were very perfesional and curious I couldn't ask for a better law firm I want to thank everyone for a great job thanks Les RyanLeslie Ryan
I absolutely love this group of attorneys, when I was at my lowest they did everything they could to help me get justice for my injury. I believe if I were to have never picked my phone up and called the amazing group that helped me I definitely would not have received my idea of rights. If you have an issue and are just not sure please understand that they will help you, stay in contact, answer any question you have, and for sure get you the justice you deserve I thank them from the bottom of my heart and I will definitely refer them to anyone who has been hurt because they most definitely care about their work and clients.China Jones
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If you must get a lawyer involved, you’d do well to work with Jason Perkins and his team at Perkins Studdard Law.
They were thorough in gathering information and in sharing all the steps in the workers comp process specific to my case. Jason and the team were responsive to my bevy of questions and concerns.
I appreciated the informative videos and consultations provided by Jason over video meetings and multiple phone calls.
I hope I’m never injured on the job again. However, if I am and if my employer responds as my previous employer did, I’ll contact Perkins Studdard Law immediately to handle the case.moombi
Everyone at Perkins Studdard was kind and professional. They were always extremely responsive and answered all questions that I had and followed up to make sure I had an understanding of what was going on along with emailing videos to explain every step of my case so I would know what to expect and be prepared. Jason is a very genuine person and I trusted him with my case. He answered so many questions for me even before I retained him as my WC lawyer. I highly recommend him and his associates at Perkins Studdard.Dana Bess
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Navigating Georgia’s workers’ compensation system can be a daunting task, leaving you with numerous questions and uncertainties. If you find yourself in this situation, we strongly encourage you to seek clarification and find the answers you need. Perkins Studdard is here to help you through this process and provide the support you deserve.