Ensure Payment for Workers’ Compensation Care
Do you provide medical care to individuals involved in workers’ compensation claims? If so, then you are likely aware that workers’ compensation claims may be “controverted” by the employer/insurer if the activity causing the injury was arguably out of scope of the employment or if the inured employee may have been under the influence of drugs or alcohol at the time of injury. A controverted claim affects the injured worker as well as the injured worker’s health care provider—you!
These matters are handled entirely by the Georgia State Board of Workers’ Compensation and the rules and procedures promulgated thereby. If a health care provider does not become a Party at Interest in a particular case, then the case may be adjudicated or otherwise settled without taking the health care provider’s bill into consideration. If this happens, the health care provider may be left to recoup payment directly from the injured employee.
To help avoid this situation, you may petition the Georgia State Board of Workers’ Compensation to become a Party at Interest to a case by filing Form WC-206 and submitting supporting documentation regarding the medical services provided and the amount you are owed (see O.C.G.A. §34-9-206; Board Rule 206).
This action will help support your right to payment, particularly if the case goes before an administrative law judge or if it is settled with an admission of liability by the employer/insurer. Even if the employer/insurer and employee agree to a settlement of no-liability, the settlement must be approved by the Workers’ Compensation Board. Because of this, the employer/insurer and employee should be reluctant to settle a matter that ignores the medical provider’s status as a Party at Interest, and this should allow the medical provider an opportunity to negotiate payment for services as part of a settlement.
Note that becoming a Party at Interest is different from a hospital, nursing home, or physician practices’ lien on a cause of action accruing to an injured person. This type of lien on a cause of action does not apply to “any moneys becoming due” under the Workers’ Compensation rules and regulations (See O.C.G.A. 44-14-474, 44-14-470, and 34-9-11).