Workers Compensation Deadlines for Medical Treatment
Medical treatment is one of the primary benefits workers compensation pays for an injury. But like the benefits, you must contend with deadlines to make sure you receive this benefit.
Georgia’s workers compensation law has a number of different deadlines. You should make sure you know what these deadlines are so they do not affect your claim.
In this article, I focus on the deadlines affecting your rights to medical treatment. I have discussed other workers compensation deadlines in previous articles. To get a general overview of these deadlines, I suggest reading this article about statutes of limitations.
What is the first deadline I need to worry about?
The first deadline to worry about is the deadline for giving notice of your injury. This requirement applies to your injury generally, not just your medical treatment.
The law requires you to give notice of your injury within 30 days. Failure to meet this requirement may mean that you lose your claim. Even though you have 30 days to give notice, it is almost always best to give your notice as soon as possible.
What deadlines specifically apply to medical treatment?
Some deadlines, like notice, apply to your entire claim. But other deadlines apply specifically to medical treatment.
One of the newest deadlines that applies to medical treatment limits how long you can get medical treatment. The Georgia legislature created this deadline in 2013. It only applies to your case if your injury occurred after July 1, 2013.
This deadline only requires the workers compensation insurance company to pay for medical treatment that occurs within 400 weeks of your injury. After 400 weeks, they no longer have to pay unless your case qualifies for a catastrophic designation.
400 weeks seems like a long time. It is for most injuries. However, serious work injuries can cause you to need medical treatment for years or the rest of your life.
What other deadlines apply to medical treatment?
Georgia law has a statute of limitations that specifically applies to medical treatment. This statute requires the medical provider/doctor or you to submit bills for medical treatment to the insurance company within one year. Failing to meet this deadline could mean that the insurance company gets off the hook for that medical bill.
Most of the time, the medical provider submits the bill. Nevertheless, you need to be aware in two primary situations.
- If you pay the bill out of pocket, this deadline affects your ability to get reimbursement
- This deadline also applies to mileage reimbursement so be sure to submit your mileage reimbursement requests within one year
Are there exceptions to these deadlines?
Almost all deadlines have exceptions. The primary exception to the 400 week deadline is a catastrophic designation. The legislature or State Board of Workers’ Compensation may create other exceptions to this deadline in the future.
One possible exception to the one year statute of limitations deadline is when a claim has been controverted or denied. Board Rule 203(b)(1) currently provides one year from the date of a claim is accepted or found compensable to submit medical bills.
But the best thing to do is to avoid having to worry about whether you can meet the exception. You can do this by making sure you meet all the deadlines. Submit your medical bills within a year even if your claim has been denied.
What if I think I failed to meet one of these deadlines?
Talk to a workers compensation attorney as soon as possible. Too many people wait when they fail to meet deadlines because they do not want to hear bad news. Waiting can only make the problem worse.
While you may believe that you missed a deadline, sometimes you have not quite missed the deadline yet. Talking to an attorney will help you figure that out. Also, I have not discussed all the possible deadline exceptions in this article. You may find out you can meet one of the exceptions.
Whether you may have missed a deadline or not, I always recommend that people talk to an attorney if they have a serious work injury. To get treated fairly, you need to understand your rights. That is why I provide free consultations in Georgia workers compensation claims.
Some people have questions about how a free consultation works. This article I wrote explains the process in detail including what you will learn and how long it will take. I hope you find it helpful.
Setting up a free consultation is easy. It only takes a few minutes. Just call our office at (770) 214-8885 or complete and submit our free consultation request form.
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.
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