The Panel of Physicians is an important list of medical providers for the treatment of employees injured on the job. It is a way employers and insurance carriers use to control medical costs and claims. Most carriers rely on the insured to fill out the panel or they may direct you to a website for assistance.
WARNING FLAG: The Panel form is often overlooked, not filled out correctly, not followed up for accuracy, or worse... never taken out of the envelope it came in with your policy. If you try to get your panel in order at the onset of an accident you have already set in motion a challenging claim process. You do not want to spend time trying to find a physician who accepts a work comp patient when you have an injured worker waiting for medical care. Lack of planning also leads to a risk that the physician does not return your employee to work. Improper protocols can increase the cost of a claim by tens of thousands of dollars, it affects your modification, and the future insurance renewals negatively.
EXAMPLE: Each state has its own set of guidelines. We will take the Tennessee/Georgia/Alabama Tri-State area as an example.
TENNESSEE - Requires a panel given to the employee after an accident occurs. A minimum of three physicians must be on the panel.
GEORGIA - Requires a panel to be posted prior to an injury. If the panel is not posted prior to an injury, or the physicians listed do not have the correct address, nor treat work comp patients, then your panel is invalid! A Georgia panel must have a minimum of six (6) physicians with at least one minority physician listed. The panel must also have at least two orthopedics listed.
ALABAMA - The employer selects and directs medical care. If the injured employee does not like the treating physician, the employee can request a new physician. The employer then presents a panel to the employee to select from; however, once the employee makes the new selection, that will be their treating physician without any more changes in the selection process. A minimum of three (3) physicians must be on the panel. (The only other time that an employee can choose a panel is when surgery is recommended by the Authorized Treating Physician that was selected by the employer or employee.)
REAL-WORLD EXAMPLE: A Georgia Panel of Physicians had an incorrect suite number listed on the panel. Unbeknown to the employer, the physician's address and phone number was the same but the suite number had changed from Suite A to Suite B. In court, this one error on the panel resulted in the company's panel as being invalid.
In court, if the employer had not defended this attempt to invalidate the panel, the claimant would have prevailed and could go to any doctor to take the claimant off work. This error cost the insured around $5,000 to defend. However, the alternative could have cost much more as well as losing control of the claim. All from the one minor change in the provider's address. Even though the Georgia State Board of Workers' Compensation has been a little more forgiving, you still have the costs of defending.
FAQ:
Q. What types of physicians should I use?
A. General practitioners, orthopedics, hand specialist, plastic surgeon, ophthalmologist or optometrist, etc.
Q. Can I use telemedicine on the panel?
A. Yes, and it is a good choice to add. In Tennessee, it can be added as a main provider only if they have a brick & mortar office. If they do not, then you would add them as an additional (4th) physician. In Georgia and Alabama, you will add them as an additional physician and not a main provider. Telemedicine allows a quick evaluation by a physician that also handles part of the work comp paperwork process. It allows your employee to be seen without leaving the workplace. If increased medical care is needed, the telemedicine physician will initiate the process.
Q. Can I put a massage therapist as one of my requirements?
A. No. A massage therapist can be recommended by a treating physician from the panel but not listed as a paneled physician.
Q. Can I use a chiropractor as one of my requirements?
A. It is not recommended. You can add a chiropractor as an additional physician but not as a main provider.
Q. Can we list a nurse practitioner on the panel?
A. No. It must be a physician. The employee can be seen by the nurse practitioner but a licensed physician must be at the facility and also sign off on all the paperwork. The physician's information (not the NP) must be listed on the panel.
Q. What if our company is headquartered in Tennessee but has a satellite office in Alabama, which panel rules do we follow?
A. This is considered "Election of Remedies" and allows the injured employee to select which rules to follow and then abides by that state's rules for the duration of the treatment. If the employee elects Alabama, then the employer tells them where to go. If the employee elects Tennessee, then the employer provides them with a panel.
Q. If the employee does not like the doctor, can they switch?
A. Yes, but from the panel. The injured employee cannot see their own physician or a "random" physician that is not on the list.
Q. Do panels have an expiration?
A. No, but they should be updated every six months. Call each physician on your panel. Make sure they are still in practice, still seeing work comp patients, verify the address you have listed with them. Update your panel accordingly.
Q. How many physicians can you put on a panel?
A. You must have the number of requirements for your state, then you can add as many as you want as additional physicians. There is no maximum... only minimum requirements. Remember, they MUST take work comp patients.
WHEN TO CALL YOUR INSURANCE AGENT
You do not have a panel. Contact Immediately!
You're not sure if a physician should or should not be on the panel.
You have multiple office locations in various states. In this situation, you need to verify with your agent that you are insured in each state. Very Important!
You need guidance and have additional questions.
Making sure your panel is filled out correctly AND posted correctly is a VERY, VERY, VERY IMPORTANT first step in a work comp injury process.
Written by: Chris Cain
Chris Cain is the podcast host of Work Comp Chaos and is Vice President of The Southern Agency Insurance & Bonds, serving over 40 states and parts of Canada. If you would like a quote on your business or personal lines of insurance, feel free to contact us.
Chris's cell phone: 423-309-2564
Email: Ccain@TheSouthernAgency.com
The Southern Agency Headquarters: 423-763-1111
For comments, questions, and topic recommendations regarding this blog/podcast, email Lauren at: WorkCompChaos@gmail.com
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