Can I Make Workers Compensation Pay for Pain Management?

All too often, serious work injuries result in injured workers suffering some amount of lifelong pain.  I attribute much of this to the problems that Georgia’s workers compensation system continues to have with delay and denial of medical treatment.  When you cannot get the medical treatment you need quickly, you could end up suffering from chronic pain.

When that pain cannot be cured, your treating workers compensation doctor may refer you to a pain management specialist.

Does Georgia’s workers compensation law cover pain management treatment?

Yes, generally it does.  There are some special rules.

First, let’s talk about what pain management is. It’s a medical specialty where doctors provide you treatment that, obviously enough, manages your pain.  This medical treatment usually falls into two categories:

1. Medication management including the prescription of pain medication and other medications to treat your injury
2. Interventional treatment in the form of injections or other medical procedures

When does pain management occur in workers compensation claims?

Pain management specialists might provide you with treatment at a few different times after your injury.  The most common time that pain management treatment occurs is after other treatment options have been tried.  So, an orthopedic surgeon might refer an injured worker to pain management if they had significant pain after surgery.

But, you can also receive treatment from a pain management specialist before that happens.  In a back or neck injury case, pain management doctors often may provide treatment in the form of epidural steroid injections before surgery.

It is important to remember that Georgia’s workers compensation law has special rules regarding medical treatment.  In most situations, you need a referral from your authorized treating physician in order to make the insurance company pay for the medical treatment.  If the doctor who refers you for pain management treatment is not your authorized treating physician, you will likely need to get your authorized treating physician to concur with that referral.

Can the pain management doctor refer me for other medical treatment?

Sometimes, your pain management specailist may refer you to another doctor for specialized medical treatment.  For example, many people in chronic pain get depressed and need a referral to a psychologist or psychiatrist for treatment.

Usually your pain management specialist is not your authorized treating physician. Usually you may have an orthopedic specialist or possibly a primary care doctor serving as your authorized treating physician.

Under Georgia’s law, the workers compensation insurance company is only responsible for paying for medical referrals when they come from your authorized treating physician.   If your pain management doctor refers you to another doctor, you probably need to make sure you have a referral from your authorized treating physician.

Does the workers compensation insurance company have to pay for opiates and other pain medications?

Pain medications have become a concern across the country in recent years.  Some people abuse pain medication.  This abuse can lead to death or addiction.

Opioid medications cause people particular concerns.  The President and political leaders have talked about our country being in an opioid crisis.  These concerns have led to many doctors tightening down on the prescription of pain medications.

Because of these concerns, it is possible that special rules may be passed in the future regarding the prescription of and payment for pain medication in Georgia workers compensation claims.  But, those rules are not yet in effect in 2017.  So, Georgia currently covers the prescription of pain medication in workers compensation cases.