You’ve been hurt on the job. Your primary concern is your health and you know that you need medical treatment. However, getting medical treatment for a work-related injury or illness is different than getting medical treatment for other types of injuries or illnesses.
After a Work Injury Your Employer Has a Responsibility to Provide You with Reasonable Medical Treatment
If you qualify for workers’ compensation, your employer has a duty to provide you with reasonable medical treatment and medications. However, there are special rules you must follow if you need medical treatment because of something that happened at work. If you fail to follow these rules, you may be solely responsible for all of your medical costs. If you do follow the rules, however, you may not need to pay for your medical treatment at all. Below is an overview of the workers’ compensation medical treatment rules that may apply if you’ve been hurt on the job in South Carolina or Georgia.
The Medical Care You Should Receive
Georgia workers’ compensation will cover your medical treatment for your job-related injury. This should include:
- Authorized doctors’ bills
- Hospital bills
- Physical therapy bills
- Prescription medications
- Necessary travel expenses for medical care
In some cases it may also include medical and vocational rehabilitation.
In South Carolina, you are entitled to all medical treatment that is “likely to lessen your disability.” This includes surgeries, hospitalizations, authorized doctors’ bills, prescription medications, medical supplies, and prosthetics. Travel expenses may also be included if you have to travel more than ten miles from your home for care.
Only Certain Healthcare Professionals Can Provide Medical Care
In an emergency, you may get medical care from the nearest medical facility such as a hospital emergency room or urgent care clinic. Once you are stable and the emergency is over, you need to get medical care from an authorized provider.
In Georgia, medical care must be provided by an authorized physician. Your employer must tell you about the authorized doctors in one of two ways. First, your employer may have a list, or panel, of authorized physicians that is posted in a prominent spot in your workplace. This panel of physicians must:
- Include at least six doctors
- Have no more than two industrial clinics
- Have at least one orthopedist
- Include a minority doctor, if possible
You Have the Right to Choose Which Doctor on the List You Want to Use for Your Medical Care
Alternatively, your employer may post the name of the Workers’ Compensation Managed Care Organization (WC/MCO) certified by the Georgia State Board of Workers’ Compensation which your employer has contracted with to provide medical services. This posting must include a 24-hour toll free number for a managed care representative who can help you make an appointment with the doctor of your choice.
In South Carolina, medical treatment must also be provided by an authorized healthcare provider. You must see the doctor authorized by your employer’s insurer; however, if you have an issue with the care that you are receiving, you may be able to see another doctor in some situations.
You May Have the Right to Get a Second Opinion
Second opinions can be an important part of your medical treatment. If you have questions about your diagnosis or your care, you may want another qualified medical professional to examine you and determine if the diagnosis and treatment plan are correct.
Workers’ compensation laws in both South Carolina and Georgia allow you to get a second opinion if you follow the rules set out by workers’ compensation law. In Georgia, you can change doctors once without prior approval by the Board or your employer. Any change after that may need to be authorized by the Board. In South Carolina, you may request a second opinion by asking the insurance company. Additionally, you can request a second opinion by requesting a hearing with the South Carolina Workers’ Compensation Commission on Form 50 and having a commissioner decide whether or not you should get a second medical opinion.
You May Need an Independent Medical Evaluation
In Georgia, you may have to submit to an independent medical evaluation if your employer requests it. If you are required to get an independent medical evaluation, your workers’ compensation benefits may be stopped until you attend the appointment. Additionally, you may be able to request one independent medical evaluation by a doctor of your choice. While this doctor won’t become your regular doctor, the doctor who performs the independent medical evaluation may provide you with important information.
In South Carolina, you may also be able to obtain an independent medical evaluation if you have questions about or if you disagree with the diagnosis or treatment plan from your physician.
When Should Medical Care End?
Medical care should continue until you are cured or you can return to suitable employment. It is a decision that should be made with your treating physician.
However, Georgia law does provide a maximum of 400 weeks of workers’ compensation medical benefits if you were hurt on or after July 1, 2013, and your injury was not catastrophic. If you were hurt on or before June 30, 2013, or if you were hurt later and your injury was catastrophic, you may be able to receive medical benefits for the rest of your life.
In South Carolina, you can generally receive medical care: (1) until you reach maximum medical improvement; or (2) until such care would no longer shorten your period of disability. However, in cases of severe disabilities you may be able to receive lifetime medical benefits.
How a Lawyer Can Help You Get the Medical Care You Need
In a perfect world, the workers’ compensation doctors you see would have only your maximum medical improvement in mind during treatment. Unfortunately, these healthcare providers know that your employer and your employer’s insurance company want you to go back to work as soon as possible and some healthcare providers may be motivated to send you back to work too soon.
A workers’ compensation lawyer can make sure that you were given a valid choice of physicians who are not sending workers back to work too early. If you were not given access to a qualified physician who could properly treat you, you may be able to pick a different doctor. An attorney can work to protect your right to get the medical care you deserve.
Don’t choose between substandard medical care and high medical bills. Instead, get the medical care you deserve and have workers’ compensation insurance pay for it. If you need help, please don’t hesitate to contact an experienced South Carolina and Georgia workers’ compensation lawyer today at 888-795-6261.