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.

Employer may maintain a traditional panel of physicians that shall consist of at least six (6) non-associated physicians. Employers are allowed to have more than six physicians on this panel as well. The minimum panel shall include an orthopedic physician, and no more than two physicians shall be from industrial clinics. This panel shall include a minority physician, where feasible.

Employers may maintain a list of physicians that shall be known as the conformed panel of physicians, which shall include a minimum of 10 physicians or professional associations. The physicians and groups listed on the panel shall be counted as a separate choice from the others listed only if they are not associated with other physicians or groups on the panel. This panel includes the same physicians required in the traditional panel, plus a chiropractor and a general surgeon.

Finally, Employers may contract with a Workers’ Compensation Managed Care Organization (WCMCO) certified by the Board. A “WCMCO” provides for the delivery and management of treatment to injured employees with a complex network of physicians. The WCMCO sets its own rules and regulations for treating the Employees.

As a matter of course, Employers must post the panel in prominent places around the work area or in the case of a WCMCO, provide a toll-free number to every Employee where she can facilitate treatment. Moreover, Employers must fully explain the purpose of the panel to all Employees and must assist Employees in obtaining medical care when an injury occurs.

An Employee may select any physician on the panel and may make one change to another physician on the panel without approval of the Employer. Further changes require approval of the Board or by agreement of the parties.