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What Should I Know About Medical Bills Under Georgia Workers’ Compensation?

 

As a workers compensation attorney, I’m here to answer questions about your case or your rights to benefits. When you have been injured on the job, you are entitled to medical benefits, per Georgia workers’ compensation laws.

DoctorYou do not have to foot the bill for any necessary and reasonable medical bills and treatments related to your work injury. In fact, when you see a physician and notify him or her that your injury is work-related, you technically never should receive any medical bills under Georgia workers’ compensation laws. [O.C.G.A. 34-9-205(b)]

Payment of Medical Bills for Work Injuries

The workers’ compensation system was devised as a means to protect workers financially should they ever get hurt on the job. When you sustain a work-related injury or occupational illness, workers’ compensation laws provide that the employer covers medical bills and a certain amount of wage replacement.

ess_grid_0005_hip_injuriesPreviously, there were loopholes in the law regarding medical bill payment. If employees happened to pay for work injuries with their own insurance plans, then the company could get off easily. It might not have to pay the medical bills because they were already satisfied.

In other situations, the State Board would order the employer to reimburse the employee so that the employee could pay back his insurer, but the employee would pocket the money, essentially double-dipping. The Board adjusted the statutes in 1990 to prevent these types of windfalls.

The current rules specify how medical payments should be handled:

  • The employer/insurer has the responsibility to pay the medical bills, not the employee or her regular health insurer; and
  • Compensation for medical bills should be paid directly to health care provider, not to the employee.

Injured workers and health care providers have one year from the date of treatment to submit the charges to the workers’ compensation insurer for reimbursement.

A Few Important Things to Keep in Mind about Your Medical Bills

An experienced workers compensation attorney knows there are a lot of rules and fine print when it comes to workers’ compensation in Georgia. It’s important to have a good handle on the issues so that you don’t inadvertently forego your rights or miss out on benefits to which you’re entitled.

Below are key facts about workers’ compensation cases:

  • If you happen to pay for any expenses related to your work injury out-of-pocket, you are still entitled to direct reimbursement from your employer (their insurer).
  • Your travel expenses for your authorized medical appointments are compensable as well. Keep track of all your mileage.
  • There are time limits on nearly everything in a workers’ compensation claim. You have a limited time to file a claim, appeal a claim, request reimbursement for travel expenses or medical bills, etc. It’s highly recommended that you talk to a workers’ compensation attorney so that you are fully aware of your rights and responsibilities.

Finding a Doctor to Care for Your Injury

Employers are required to follow the laws regarding workers’ compensation injuries. The State of Georgia State Board of Workers’ Compensation oversees workers’ compensation laws, rules, and claims. The law requires companies to post information that identifies the doctor or organization that is to be used for workers’ compensation claims.
They may do this in one of two ways. One option for employers is to post information about a traditional panel of doctors that includes at least six medical professionals. You may choose from any of the doctors included in the list. It is important to note that the list must contain at least one orthopedic doctor and no more than two industrial clinics. You may change doctors at any time without notifying your employer as long as the doctor is one of the listed physicians.
Another option for employers is to provide the name of the Workers’ Compensation Managed Care Organization (WC – MCO). This is the organization that was contracted and certified to provide medical care for work injuries. The employer must provide this information to you along with a phone number that you can call 24/7 to reach the managed care organization. A representative will assist you in locating an eligible physician and with making an appointment.

How Are Medical Bills Paid?

All of the medical bills associated with the injury are paid for by your company’s workers’ compensation insurance provider. In addition to medical treatments such as doctor visits, all other expenses are also paid for by the insurance provider. This includes any prescription medications that you need, doctor and hospital bills, physical therapy sessions and travel expenses to and from doctor and physical therapy appointments. All of the expenses that are due to a work-related injury are to be covered by the insurance provider.
Medical treatment is limited to a maximum of 400 weeks from the date of your injury. However, in cases of catastrophic injuries, you may be entitled to lifetime medical benefits. Different rules may apply to those who were injured before July 1, 2013.

Free Consultation with a Workers’ Compensation Attorney in Atlanta

Have questions about your case or your rights to benefits? The workers’ compensation attorneys at Bader Scott Injury Lawyers in Atlanta can help. Contact us today for a free consultation at 678-562-5595.

Get in touch with us today to get started with your FREE case review. We’re only a call, click, or short drive away.