Using the WC-PMT(b) When Claimants Skip Medical Appointments

Introduction

Few situations are more frustrating than an injured worker who repeatedly fails to attend scheduled medical appointments while continuing to receive temporary total disability (TTD) benefits. When faced with this scenario, the WC-PMT(b) form—”Petition “for Medical Treatment; Failure to Attend Medical Appointment with an Authorized Treating “Physician”—provides a swift and effective remedy that’s often more appropriate than filing a motion to compel.

WC-PMT(b)

Pursuant to Rule 205(c), employers and insurers are now able to use WC-PMT(b) to petition the Board for a telephone conference with an administrative law judge during which the employee must “show cause” why an order should not be issued directing the employee to attend an appointment with an authorized treating physician. Filing a WC-PMT(b) will trigger the State Board to schedule a telephonic conference with an administrative law judge within a few days of the filing. The claimant and the employer/insurer are required to attend the conference for the claimant to show cause as to why the appointments were missed. This expedited process makes the WC-PMT(b) particularly valuable when TTD benefits are ongoing and time is of the essence. Unlike a motion to compel, which may take weeks to be heard, the WC-PMT(b) ensures immediate attention to the matter, typically resulting in a conference within five business days of filing.

The WC-PMT(b) process includes a built-in efficiency mechanism that can resolve matters without requiring a telephonic conference. The PMT(b) process allows employees and their counsel to submit a response agreeing to attend the at-issue appointment to negate the need for the telephone conference. However, should the employee not attend the appointment after submitting a response agreeing to do so or following the telephonic conference, employers have additional remedies available through the Board. Before filing the WC-PMT(b), adjusters should ensure they have documented evidence of the missed appointments, including appointment letters, confirmation of receipt by the claimant, and any communications regarding the failures to appear. The form itself can be accessed through the Georgia State Board of Workers’ Compensation website at https://sbwc.georgia.gov/publications-and-forms/forms/board-forms.

When preparing for the telephonic conference, adjusters handling the matter without an attorney should be prepared to present clear documentation of the missed appointments, explain any prejudice to the claim’s resolution, and be ready to propose reasonable solutions, such as rescheduling appointments or establishing consequences for future non-compliance. Remember that judges appreciate concise, factual presentations and may ask about efforts made to contact the claimant or accommodate scheduling conflicts. The “show cause” nature of the proceeding places the burden on the claimant to justify their non-attendance, which can be particularly effective when dealing with pattern violations or when no legitimate excuse exists for the missed appointments.

Conclusion

While the WC-PMT(b) process can be handled without legal representation, having experienced workers’ compensation defense attorneys manage these proceedings can significantly improve outcomes and ensure all procedural requirements are met. Our team of Georgia workers’ compensation defense attorneys are experienced with this process and happy to help. Feel free to contact us today to discuss how we can assist with your non-compliant claimant situations and help keep your claims moving toward resolution.

Disclaimer

This material is provided for informational purposes only. It is not intended to constitute legal advice nor does it create a client-lawyer relationship between Hall Booth Smith, P.C. and any recipient. Recipients should consult with counsel before taking any actions based on the information contained within this material. This material may be considered attorney advertising in some jurisdictions. Prior results do not guarantee a similar outcome.