What Can I Do If the Insurance Company is Not Authorizing Medical Treatment?
The Georgia State Board of Workers' Compensation updated Board Rule 205 to provide a mechanism for injured workers to seek authorization of treatment recommended by the authorized treating physician. The new rule allows an injured worker to file a Petition to Show Cause when an insurance company fails to authorize treatment if more than five days have passed since the treatment was recommended by the authorized treating physician. Within five business days of filing the Petition to Show Cause, the State Board will schedule a conference call for the parties with an Administrative Law Judge so that the Employer/Insurer can “show cause” as to why the recommended treatment has not been authorized.
The insurance company can either authorize or deny the medical treatment after it receives the Petition to Show Cause. If the insurance company does not respond to the Petition to Show Cause, the parties must participate in the conference call with the Administrative Law Judge. After the conference call, the Administrative Law Judge will issue an order. If either party disagrees with the Administrative Law Judge's Order, they may file a WC-14/Request for Hearing with the State Board.
If you have questions regarding the new Board Rule 205, please contact Andrew M. O'Connell of the O'Connell Law Firm, LLC.