Reminder: Correctly Post and Present Those Lists of Approved Treating Physicians

The Rock Law Firm

Last year the Georgia Supreme Court dismissed an appeal regarding an injured worker who had unilaterally changed her authorized treating physician without giving notice to her employer (See: Zheng v. New Grand Buffet Inc.). Ms. Zheng was injured on March 27, 2010 and began to receive medical care and income benefits. First, Zheng saw a non-panel physician for treatment on August 3, 2010, while simultaneously seeing an approved doctor until August 24, 2010. She continued to see the non-panel physician even as of her hearing on March 30, 2011. On October 1, 2010 her employer suspended benefits, which later an Administrative Law Judge (ALJ) held to have been proper. But then several days later Zheng’s benefits were reinstated because the employer did not establish that Zheng had undergone a change in condition for the better that allowed her to return to work without restrictions.

At the hearing before the ALJ, Ms. Zheng stated that she had neither been presented with an approved panel of physicians nor seen one posted. This was in direct contrast with the employer (of course) who said that they had both presented the panel, and had also posted it. The ALJ determined that it had been presented correctly. This was of huge factual significance for the case at hand, but it also serves to underscore the importance of following proper procedure when it comes to posting panels.

The Court of Appeals in this case noted that, “‘if the employer fails to provide any of the procedures for selection of physicians as set forth in subsection (c) [of OCGA § 34-9-201], an employee may select any physician to render service at the expense of the employer.’ OCGA § 34-9-201 (f). Further, if an employer terminates the employee’s medical benefits, the employee is entitled to see any doctor she chooses and make the employer pay for it if she can prove she was still injured at that time as a result of the accident. Boaz v. K-Mart Corp., 254 Ga. 707, 710 (1) (334 SE2d 167) (1985).”

So again, make sure you have your posted panel placed correctly in your place of business. The Court of Appeals found that because Ms. Zheng had visited her approved treating physician two times after meeting with her non-panel physician, she should have sought Board approval prior to making her unilateral change to a non-panel listed physician. Had the ALJ found that the panel had not been properly posted, this case would likely have not gone forward and thus the employer would have lost control of the medical treatment, thereby increasing their exposure significantly. Finally, Georgia Supreme Court ultimately dismissed this case due to a lack of jurisdiction, and as such this determination now stands.