The ATP is your primary doctor.  He is the medical gatekeeper of your case.  He has total and exclusive control of your medical care.  He is allowed to provide all medical treatment necessary to bring about a cure or relief from your medical problems.  He also has the exclusive power to refer you to any other doctor for additional treatment.

If the ATP believes you would benefit from specialized care – for example, from an orthopaedic surgeon or psychologist – he has the absolute power to not only refer you for that care, but the ATP also has the ability to even name the particular doctor whom he wants you to see.  Once that happens, the insurance company is required by law to comply.

Some unscrupulous insurance adjusters try to convince the doctor that he must get everything pre-approved by the insurance company, and that’s simply not true.   Once the ATP makes the referral, it’s a done deal.

Some doctors will tell the injured worker that they would like for the worker to receive a particular kind of medical care or treatment, but they don’t want to prescribe it because there’s no point - the insurance company won’t approve it anyway.  That is not relevant.  They have to approve it, although they may not want to do so.  I may have to file for a hearing and let the adjuster explain to the judge why they choose not to follow Georgia law, but in the end, 99% of the time what the ATP wants, the ATP will get.

The ATP is like a bicycle wheel with spokes and a hub.  The hub is in the middle and the spokes radiate out to the wheel.  The hub is the ATP, and the spokes represent the referrals he can make for you to see other doctors.  Once the ATP has made a referral to one or more doctors, those new doctors cannot then turn around and refer you to yet another doctor, but instead must go back to the hub, the ATP, for another referral.  The ATP is the absolute and ultimate gatekeeper of the medical aspect of your case.

Most of the time, the first doctor you see will be deemed to be your ATP.  That’s why it is important to always get a copy of your employer’s panel of physicians before you start receiving medical care.   Some employers or insurance companies don’t follow the law and just tell the injured worker where to go.  That’s not how it works.  The posted panel of physicians must be given to the worker to choose from.  That way you can review the list and pick out a doctor who is fair – one who will have your interests at heart and not the interests of the insurance company.

Many times the employer has an invalid panel of doctors.  For example, a valid panel must contain an orthopedist, can only have so many “industrial clinics,” and the doctors on the panel must still be practicing medicine.  Many times the employer either does not have a panel, or it is invalid.  When that happens, the injured worker is allowed to choose any medical doctor they want to be their ATP.

You are allowed a one-time change of ATPs on the panel.   Because it can only happen once, it has to be used judiciously.

If you have been injured on the job, make sure you choose your ATP wisely.  If you need help choosing a doctor, or if you want to see whether the panel is a valid panel of doctors, call a qualified Georgia workers’ compensation lawyer to review the panel for you.

Workers’ compensation laws are state laws.  They are not federal laws.  While all workers’ compensation laws are similar, there are differences between the state laws.  Some states have laws that are more favorable for the employee; some states have laws more favorable for the employers.

Sometimes the injured worker has a choice of which state law to apply.  You may be eligible to file a workers’ compensation case in several states.  You cannot collect duplicate benefits from multiple states.  There are offset provisions preventing that from happening.

Where a Georgia worker working for a Georgia employer is injured in Georgia, Georgia is the exclusive state in which it is proper to file the workers’ compensation claim.  However, where a Georgia worker is injured outside of the state of Georgia, or when a worker from outside the state of Georgia is injured in Georgia, things become a little more complicated.

There are several legal theories that allow jurisdiction in Georgia.

If the contract of employment was in Georgia, Georgia has jurisdiction.  If the accident occurred in Georgia (even to an out of state employee working for an out of state employer), Georgia jurisdiction applies.

If a Georgia employee or a Georgia company hires someone to work exclusively outside of Georgia, Georgia jurisdiction does not apply.

It is possible in Georgia to prosecute a workers’ compensation claim in another state and later pursue a workers’ compensation claim in Georgia.

If you were either injured in Georgia, worked for a Georgia employer, or entered into an employment contract while residing in Georgia, contact a qualified Georgia workers’ compensation lawyer to see whether you have a Georgia workers’ compensation claim.

Your obligation is to provide notice to the employer, not the state board of workers’ compensation.  You need to inform your supervisor immediately of a job injury.  Be aware that you as the employee bear the burden of proving that you provided timely notice.  It has been held that even if your supervisor witnesses you falling, that is not enough.  You must inform your supervisor that you were injured from the fall.

An employee or his representative must give the employer (supervisor, foreman, HR department, etc.) notice of the injury immediately upon injury or as soon as practical thereafter, but it must always be done within 30 days of the date of the injury, or 30 days of death.  Notice can be oral, but to be safe, a registered or certified letter is always better.

There are a few exceptions.  For example, if the employee is physically or mentally incapacitated, that is a valid reason for not providing timely notice.  Also, the Court of Appeals ruled that a truck driver who felt a burning sensation in his back after stepping off his truck at work one day provided timely notice after going to the doctor (more than 30 days later) and finding out that he had a pinched nerve from the incident.  The Court determined that the 30 day period did not begin to run until the worker first had reason to realize that he had received a job injury.  Also, when an injury happens over time, the Court has ruled that the 30 days began to run when the injury becomes extensive enough to either prevent the employee from working or to constitute a “disability.”

For notice to be considered valid, it does not have to be given with a view towards filing a worker’s compensation claim.  You only have to provide notice of an injury sufficient to allow the employer to conduct an investigation.  At the very least, the employee must notify the employer that he was injured.

Failure to give timely notice will forever bar you from receiving workers’ compensation benefits.  If you or a loved one has been injured on the job, notify your employer of the injury immediately.

Your future medical requirements are also a substantial financial risk to the insurance company that the insurance company will seek to reduce or eliminate.  If you require home modifications, that represents another financial risk to the insurance company.  If you require rehabilitation, that represents yet another financial risk to the insurance company.

The more financial risk to the insurance company has, the more they will pay to settle your case. The objective of the insurance company is always two fold.  Number one is to do whatever it takes to completely eliminate their financial risk associated with your case.  If that doesn’t work, number two is to do whatever it takes to reduce their financial risk associated with your case.

After the insurance company calculates their risk, they will make a business decision.  Is it cheaper (in their mind) for them to continue paying you the worker’s compensation benefits, or is it cheaper for them to pay you a lump sum to eliminate their risk?  The insurance company will never make any decisions based on what is best for you.  Their primary concern will always be what is best for them.

A lot of the risk of your case will arise from what your doctor says about your future work restrictions and medical requirements.  It is important that you have a doctor overseeing your case who has your best medical interests at heart.  It is important that what is primary to your doctor is your medical needs, not the insurance company’s desire to eliminate its risk.

The insurance company is not your friend, and the insurance company adjuster is not a good-will ambassador.  The insurance companies are in business to make money, and they do so by collecting premiums and paying out as little as possible.

If the insurance company realizes that they will pay out a lot of money on your case in the future, they will put a high value on your case.  If the insurance company believes they will pay out a small amount of money in the future, they will assign your case a low value.

The insurance company will always make a decision based on what s best for them.  That includes valuing your case for settlement.

When an insurance company values your case, they will not base that value on what may or might happen to you in the future.  They don’t make that decision based on the fact that you lost your house, car or even your marriage.  They don’t have to.  No jury will ever hear that testimony and place a value on your case.

When the injured worker and the insurance company agree on a dollar amount, the case settles.  Our job is to ensure you receive medical treatment from doctors who are looking after your best interests.  Our job is to help you get all the medical care you deserve.  Our job is to help you get the full value for your case.

Workers’ compensation laws are designed to protect injured workers.  It is a “no liability statute,” which means you don’t have to prove it was someone else’s fault that you were injured.  It doesn’t even matter if you were injured through your own negligence.  Liability, or fault, is simply not an issue.

In order to qualify for worker’s compensation in Georgia you need only show two things. First, that you were hurt, and second, that the injury happened on the job.  Now there are a few exceptions, like if you were drunk, on drugs, or “horse-playing” at the time you were injured.  But, basically, if you are hurt on the job, you qualify for workers’ compensation benefits.

What are those benefits?  Workers’ compensation pays for all of your related medical bills without copay or deductible and you get a weekly check.

Your medical care starts with what is known as a posted panel of physicians.  That is a list of eight medical providers chosen by the employer.  This list is presented to you when you are injured.  From the list, you choose a doctor to start your medical care.  You are entitled to medical care for LIFE for problems you suffer for your on-the-job injury.

Your weekly check is based on your last thirteen weeks of employment.  In order to calculate your weekly check, you average your gross wages for the thirteen weeks prior to your date of injury.  Now, that is subject to certain minimums and maximums set by the Georgia legislature.

After you have finished your medical care, you may not be physically 100% of where you were before you were injured.  If you are not, your doctor will assign you a disability (or impairment) rating called a permanent partial disability rating (or PPD rating for short).  This rating has a dollar value which is paid to you.

That is a basic overview of the Georgia workers’ compensation system.  There are plenty of issues that can and usually will be raised between the start and finish of your case.