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Do Not Let A Simple Change In Name Invalidate Your Panel
Tina M. Trunzo Lute
Attorney, Workers' Compensation
As all of you are aware, the importance of Employers in the state of Georgia having a properly posted panel of physicians cannot be understated. Employers must provide certain benefits to its injured workers, including the payment of related medical treatment. Since Employers, and/or their Insurers, will pay 100% of medical costs for an injured worker, Employers have the opportunity to “control” the medical treatment by ensuring that its injured workers seek treatment only with doctors listed on the posted panel of physicians. This means you want to make sure you have trustworthy doctors on the panel who understand workers’ compensation and who understand the importance of returning injured workers back to work without unnecessary and prolonged disability.
Board Rule 201 explains the requirement necessary for a posted panel to be valid. To have a valid panel of physicians, it must contain six physicians who are reasonably accessible to the employee. The panel must include an orthopedic physician and there cannot be more than two industrial clinics. There should also be at least one minority physician listed on the panel. This is the bare minimum required to have a valid panel. Employers often find themselves in trouble when only six physicians are listed on their panel, then one retires, moves practices, or decides to no longer accept workers’ compensation, possibly invalidating the panel. If it is found that the panel was not valid on the date of accident, the injured worker is then free to choose his or her own doctor or, most likely, the doctor his or her attorney wants to dictate medical treatment. It is best practice to name more than six providers on the panel, in case one retires, moves, stops accepting workers’ compensation, etc. Further, it is most beneficial to avoid naming entire practices generally, such as “Peachtree Orthopedics” or “The Hughston Clinic,” and instead list a few trusted doctors from the practice of your choice.
Duty to Maintain a Valid Panel
After an Employer posts a valid panel, Georgia law places a burden on the Employer to make sure the panel is always valid. An Employer should regularly check the panel and confirm that all of the physicians listed are still in practice, have correct contact information, and still accept workers’ compensation. For those Insurers who provide panels to their insureds, it is best to send revised panels when changes are made, at least yearly. It is crucial to note that even if an Insurer provides courtesy panels to its insureds, it is ultimately the Employer who is responsible for making sure the panel remains valid and that it is always posted properly. Employers who believe their panel may be invalid should contact their insurance agent or attorney promptly.
An Upcoming Change by Carrollton Orthopaedic Clinic Could Impact Panels
Medical providers routinely change names, locations, and what insurance they accept, which is why regular maintenance of your panel is imperative. Recently, Carrollton Orthopaedic Clinic, who has several locations in Northwest Georgia, announced that beginning April 1, 2023, they will be changing their name to Orthowest. All locations will remain open and no contact information will change.
It is debatable whether an improper practice name on a panel will invalidate a panel, especially when the address and phone number remain correct. However, whether a panel is invalid is a question for the judge, and certain judges are more likely than others to invalidate a panel on this basis. It is best practice for Employers to update their panels immediately upon learning of a change in information made by a doctor on its panel.
Employers or Insurers who use Carrollton Orthopaedic Clinic on their panels should update those panels on April 1, 2023 and change the name to Orthowest. A quick change on April 1, 2023 could avoid litigation in the future over the validity of the panel.
Conclusion
While you are checking your panels to see if they contain Carrollton Orthopaedic Clinic, it is a perfect time to make sure your panels have the following:
- At least 6 doctors;
- At least one orthopedist;
- No more than two industrial clinics; and
- At least one minority physician.
Take a few moments to call each facility and make sure the address and phone number are correct, make sure the name of the practice is correct, and confirm they still accept workers’ compensation. Please feel free to use our included checklist when checking the validity of the panels you manage, or send a copy of the checklist to the department in your business that is responsible for maintaining the panel. As a courtesy to our clients, our firm is always happy to review panels and discuss panel issues. Levy, Sibley, Foreman & Speir has attorneys throughout the state of Georgia and have relationships with many doctors. We routinely work with our clients to create strong panels with reputable doctors. Spending the time now to craft and post a valid panel will undoubtedly save time, money, and frustration in the event an employee is injured on-the-job.
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