29 May Workers’ Compensation and Initial Authorized Medical Treatment in the Southeast
Aside from emergency medical treatment that may be required for a worker injured on the job, states in the southeast (SC, NC, AL, TN, FL, GA, MS and LA) have different rules regarding the initial authorized medical treatment for injured workers. For employers who operate in multiple states, and for insurance adjusters with claims in multiple states, knowing what to do to authorize this initial medical treatment can be critical to appropriately manage and reduce costs for new claims from the onset
Our review will start with the most employer friendly states and will end with the least employer friendly state in the southeast in terms of initial authorized medical treatment:
In South Carolina, the employer selects the physician. In North Carolina, the employer makes the initial selection of physician, but the employee can choose a physician of his own, but only if the employee obtains the approval of the Industrial Commission by showing good grounds for the change.
In Alabama, the employer makes the initial physician choice. However, if the employee subsequently wishes to have a different physician, they can request that the employer provide a list or panel of four physicians from which the employer may choose a new physician.
In Tennessee, the employee selects the initial physician from a panel of physicians that is provided by the employer no later than five business days of the work injury. However, failure to timely provide a panel of physicians that meets the statutory requirements will result in civil penalties.
In Florida, the employer/carrier has the right to select the initial physician for the injured worker. However, a one time change request is permitted, and the employer/carrier must provide a new physician within a reasonable period of time, i.e. five days. If no physician is provided by the employer, the employee may choose a physician of their choice.
In Georgia, the employee selects the initial physician from a panel maintained by the employer. If the employer fails to provide a valid panel, or if one was not posted at the worksite at the time of injury, the injured worker may select a physician of their choice. The injured worker may make a one time change to another panel provider as well.
In contrast, Louisiana and Mississippi are generally considered to be very employee friendly in comparison to their southeastern neighbors. In Mississippi, the discretion is left to the employee to choose his own physician or to use the employer’s physician. In Louisiana, it’s very simple – the employee gets to choose.
Therefore, wherever possible it is critical to provide timely responses and notices to injured workers regarding their treatment and requests for treatment with physicians, as well as providing and maintaining appropriate panels/lists of physicians where applicable. Failure to do so can often lead to the employee becoming free to treat with a physician of their own choice. Consequently, maintaining control of the initial authorized medical treatment (whenever and wherever possible outside of Louisiana or Mississippi) is the best way to manage a claim from the onset.
Written by: Ashik Jahan, Esq.