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Does the Panel of Physicians Affect the Type of Medical Treatment I Will Receive?

Employers who are subject to the Georgia Workers’ Compensation Act are required to post a panel of physicians.  The employer’s panel of physicians consists of medical facilities or individual physicians who are authorized to render treatment to employees injured on the job.  There are three types of panels employers may elect to post:

  1. a Traditional Panel of Physicians;
  2. a Conformed Panel of Physicians; or
  3. a Workers’ Compensation Managed Care Organization (WC/MCO).

The requirements regarding what types of medical professionals are listed, how many medical professionals or medical facilities are listed differ for each type of panel.

Although the Georgia Workers’ Compensation Act has different requirements for each type of panel of physicians, the care provided to the injured worker receives remains consistent.

Quite frequently, employers utilize either a Traditional Panel of Physicians or a Conformed Panel of Physicians.  Since the WC/MCO is less frequently used by employers, very few individuals understand a WC/MCO Panel.  If an employer elects to contract with a WC/MCO to provide treatment for its injured employees, the employer must make sure the WC/MCO is certified by the State Board of Workers’ Compensation pursuant to O.C.G.A. § 34-9-208 and the corresponding Board Rule.  The application process for certification of a WC/MCO is outlined in O.C.G.A. § 34-9-208.

The State Board of Workers’ Compensation has mandatory requirements for a WC/MCO Panel.  For example, a WC/MCO Panel must have minority providers and must have the following providers listed in their Panel:

  1. internists,
  2. family practice,
  3. orthopedic surgeons,
  4. neurologists,
  5. general surgeons,
  6. chiropractors,
  7. physical and occupational therapists,
  8. psychologists or psychiatrists,
  9. diagnostic pathology or laboratory services,
  10. radiology services and hospital,
  11. outpatient surgery, and
  12. emergency care services.

Please see Board Rule 208(a)(1)(e).

The State Board also requires certified WC/MCOs annually report an updated list of providers in their network, any sanctions taken against the WC/MCO or providers in its network, reported complaints and summary of dispute resolution proceedings.  A WC/MCO’s reporting requirements provide employers and its employees with information about the providers who are providing treatment, which ensures employees receive quality treatment.

No matter which panel is chosen, O.C.G.A. § 201 requires employers post the panel in a location that is visible to all employees.  If using a WC/MCO, employers must educate employees on how to seek medical treatment when injured on-the-job.

Although the WC/MCO is quite different from the Traditional or Conformed Panel of Physicians, the State Board of Workers’ Compensation requires that WC/MCOs are certified and monitors these panels in order to ensure medical treatment rendered to injured workers remains consistent.  If you have additional questions regarding WC/MCO panels, please contact the attorneys at the Ramos Law Firm.

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