Under Georgia law, medical providers are not required to have insurance approval before rendering treatment to workers’ compensation claimants. However, many physicians will not provide such treatment until they have written confirmation that the insurer is going to pay for their medical services. This situation resulted in long delays for claimants in receiving the medical treatment they needed. Without timely answers from their insurance companies, men and women were without means to obtain necessary care, which often had the effect of worsening their conditions.
Starting in July 2017, the State Board of Workers’ Compensation enacted a new procedure to address this issue. Under the new system, workers’ compensation claimants can petition the Board for a conference with an administrative law judge, during which their insurers/employers will have to show cause as to why treatment by authorized providers has not been approved. Insurers/employers can attend the hearing telephonically, or they can approve the treatment in lieu of the hearing. If the hearing proceeds, the judge can issue an order authorizing the recommended treatment within 10 to 15 days and directing the insurer to approve such treatment.
The new process allows medical providers the assurances they need and that are customary to their practices, as well as facilitates the timely medical care claimants need. The whole system benefits from these expedited processes. For more information, visit the Georgia Bar website or go to the newsletter linked above.
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If you have been injured in any type of work accident caused by someone else’s negligence, call Montlick & Associates, Attorneys at Law for your free consultation today.
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