Independent Medical Examinations in Georgia Workers' Compensation Claims...Understanding Your Rights Under the Act
Often, I am told by my clients that they do not agree with their doctor's opinion regarding their diagnosis and treatment options. I am never surprised to hear this because with workers' compensation, you are usually only allowed to select a physician from a list of 6 doctors the employer and/or insurance company has pre-screened for their practice tendencies and willingness to cooperate with the attorney who represents the interests of the employer or insurer.
In fact, some doctors are reluctant to put injured employees on restrictions or take them out of work because they are afraid of being removed from the insurance company's panel of physicians.
For some doctors, staying on these panels keeps the patients coming in the door and generating cash for their practice. This is notoriously true for occupational medicine clinics. With that said, there are hundreds of good doctors who are on panels that have the courage to stand up for the best interests of their patient - the injured worker - and do what is right.
This issue is important to you because your body and your health are not something that should be taken for granted, especially for unethical reasons. When I find a client's objective medical records are consistent with a serious injury, usually through x-rays, CT scans, or MRI's, and their doctor ignores their subjective complaints of pain, I recommend these clients undergo an independent medical examination or IME. The trick is that O.C.G.A. Sec. 34-9-202 (e) (the applicable law) requires that the case has been accepted as compensable, meaning the employee has received money for their lost time from work, and the injured worker must have received a check within the last 120 days at the time of the appointment. So, if an injured employee's case has not been accepted as compensable, it is often very difficult to arrange for a second opinion; however, other options are available.
At the IME, the physician will perform a thorough physical examination of the injured worker, take a complete medical history of the injury, and review any x-rays, CT scans, or MRI's the worker has had. In many cases, the doctor will take his own x-rays to confirm the diagnosis. After the doctor has had an opportunity to examine the injured worker and review his or her records, the doctor will issue an opinion. The opinion will usually state whether he or she agrees with the patient's former treatment, diagnosis, work restrictions, and permanent partial disability rating, if applicable. Occasionally, the doctor will recommend further treatment and testing and state whether he or she is willing to take over treatment.
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