On-Site Meetings with Medical Provider

  • If we plan to meet privately on site with an authorized treating physician, do we advise injured worker/attorney of our planned meeting?

    Yes, 10 days advance notice is required to injured worker, attorney & provider as defined in Rule 200.1(II)(D).

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  • Is consent required?

    No.

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  • If no attorney, do we advise the injured worker directly?

    Yes

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  • Can an injured worker/attorney be excluded from this meeting?

    No.

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  • Are there circumstances in which advance notice of a private meeting with an authorized treating physician is NOT required?

    Exceptions to notice requirement may be made in cases of medical necessity or with the consent of the injured worker or attorney per Rule 200.1(II)(D)(4).All other reporting requirements remain in effect.

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  • There are some requests for medical case managers to work under Board Rule 200.2 with no intent to contact the injured worker or the treating physician. Is that okay?

    •Yes, in a consultative role to the claims professional.
    •If strictly consulting, the medical case manager is not required to advise the injured worker/attorney or provide documentation BUT must not have any contact with the injured worker or physicians, or will no longer be operating in a consultant role.

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  • Are we allowed under Board Rule 200.2 to present job descriptions/job analyses to the treating physician?

    Yes. If the presentation to the treating physician is in writing, be sure to simultaneously provide copies to all parties and their representatives in compliance with Board Rule 240.If the presentation will be in person, 10 days advance notice of such meeting with a copy of the job description/job analysis to all parties is required.

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  • Board Rule 200.2 states specifically that we can meet with treating physician. Is this the only medical provider we can contact or with whom we can meet?

    The case manager may contact or meet with any authorized treating physician providing care for the compensable conditions in the workers’ compensation claim. Written consent is required to attend the medical appointment with the injured worker. Advance notice is required for a private medical conference.This rule should not be read to permit meeting with a physician who has not provided care for the injured worker for the compensable injury.

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  • Are we permitted to speak with other specialists: occupational therapists (OT); physical therapists (PT); imaging; durable medical equipment; prosthetists; hospitals; etc. in order to provide medical management and appropriate treatment and care?

    Yes the case manager is tasked with assessing, planning, implementing and evaluating options and services required to effect a cure or provide relief. Consent is required to attend any appointment with the injured worker. Advance notice is required for a private conference with such a specialist.

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  • Can the injured worker/attorney use Rule 200.1(II)(D) to prevent a case manager fromcontacting/meeting the treating physician?

    No.

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  • Is advance notice of the intent to meet with a doctor, but not attend a medical appointment, required to the injured worker/attorney?

    •Yes, 10 days notice is required for such a private medical meeting to include the day, time and location.

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  • If the doctor schedules the private meeting to take place following the employee's scheduled appointment and the appointment is for some reason rescheduled, does the previous notice from the case manager apply to the rescheduled date?

    Yes, if the case manager provides notice which would incorporate the rescheduling. For example: A private meeting is scheduled with Dr X to follow the employee's next appointment on date. You are also advised, if the appointment is rescheduled, the private meeting will likewise be rescheduled. The case manager shall advise the parties of the rescheduled date/time/location as soon as possible.

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  • What is a “private medical meeting?”

    Any meeting with a treating provider at which the injured worker is not planned to be in attendance.

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  • Are case managers permitted to participate in any part of the Independent Medical Evaluations?

    Rule 200.2 does not specifically address the selection, scheduling or conduct of Independent Medical evaluations as defined by O.C.G.A. § 34-9-202.

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