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A PRACTICAL RESEARCH QUESTION
Move from a legal question to a focused result set.
RESEARCH QUESTION
When may an employee obtain medical treatment outside the employer’s
posted panel because of employer noncompliance?
SBWC Decisions
Keywords
posted panel noncompliance
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RELATIVE TEXT-MATCH SCORE
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The relevance percentage compares the frequency of the supplied terms
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Quoted phrase: 5 points per occurrence
INDIVIDUAL TERM COUNTS
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occurrences found in the decision.
posted 7
panel 50
noncompliance 1
HIGHLIGHTED ORDER REVIEW
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term highlighted throughout the document.
The employer failed to maintain a properly
posted panel
of physicians, permitting the employee to obtain treatment outside
the panel.
Search Results (12)
New Search
Keywords: posted panel noncompliance
VIEW HITS:
posted 7
panel 50
noncompliance 1
Select a term to review its highlighted occurrences in the order.
Primary Issues:
Temporary Total Disability; Temporary Partial Disability;
Medical Treatment / Authorization; Assessed Attorney Fees
Summary:
The ALJ awarded the Employee TPD benefits from December 28, 2022, through February 26, 2023, and ongoing TTD benefits starting February 27, 2023, following a motor vehicle accident on December 27, 2022, which aggravated pre-existing conditions in the lower back, neck, and right shoulder. The Employee’s request for Dr. Daftari as ATP and reimbursement for out-of-pocket medical expenses was granted, while the request for assessed attorney’s fees was denied. The Employer/Insurer appealed the decision, leading to a review by the Appellate Division, which affirmed the ALJ’s findings regarding the compensable aggravation injury but reversed the reimbursement for chiropractic expenses due to inconsistencies in the medical records. The Employee’s cross-appeal for attorney’s fees was also denied.
Case No. 2023-006649 | ALJ: Meg Hartin (Atlanta): 2024-02-23 |
Appeal: Frank R. McKay; Concurring: Benjamin J. Vinson, Neera Bahl: 2024-07-30
VIEW HITS:
posted 3
panel 46
noncompliance 1
Primary Issues:
Change in Condition; Authorized Treating Physician;
Surgery / Invasive Treatment
Summary:
The ALJ denied the Employer/Insurer’s request to suspend the Employee’s benefits based on a claimed change in condition for the better, affirming that the Employee’s compensable injuries had not resolved and that he could not return to work without restrictions. The ALJ also ruled that Dr. Shevin Pollydore remained the authorized treating physician despite the Employer/Insurer’s contention that he lost this status upon leaving Peachtree Orthopedic Clinic. The Employer/Insurer’s appeal to the Appellate Division resulted in a partial reversal, where the Appellate Division appointed Dr. Douglas Pahl as the new authorized treating physician, citing concerns over the proximity of Dr. Pollydore’s practice to the Employee’s residence and the need for further evaluation and treatment. The Appellate Division denied the request for assessed attorney’s fees, finding the Employer/Insurer’s defense was not unreasonable given the conflicting medical evidence.
Case No. 2017-030484 | ALJ: Johnny Mason (Atlanta): 2023-04-10 |
Appeal: Neera Bahl; Concurring: Benjamin J. Vinson, Frank R. McKay: 2023-10-17
FROM RESULT TO SOURCE
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Highlighted Term: panel
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Actual Size
2023006649TrialAppeal
STATE BOARD SEAL
STATE BOARD OF WORKERS’ COMPENSATION
270 Peachtree Street, NW
Atlanta, GA 30303
A hearing was held on January 12, 2024, to determine the Employee’s
entitlement to workers’ compensation benefits. The Employee contends
that he suffered an on-the-job injury to his lower back, neck and right
shoulder while working for the Employer.
STATEMENT OF THE CASE
The Employee seeks an award of temporary partial disability benefits
and temporary total disability benefits. He also requested penalties
for the alleged late payment of benefits.
The Employee contends that there was no explanation of the
panel
and no valid posted
panel
of physicians, which the Employer/Insurer disputes. He asks for the
designation of an authorized treating physician and payment of
previously incurred medical expenses.
There is also a request for an award of assessed attorney’s fees
and expenses.
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2. VIEW HITS
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3. REVIEW
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4. VERIFY
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