Most workers’ compensation lawyers will tell you that one of the biggest mistakes an injured worker can make is agreeing to treat at an occupational health clinic. In Georgia, numerous health clinics present themselves as experts or specialists in occupational medicine. Some of these clinics include:
- Concentra (a.k.a. Concentra Medical Center, Concentra Occupational Health,
- and Concentra Urgent Care);
- S. HealthWorks;
- Nova(a.k.a. Nova Medical Center);
- Caduceus (a.k.a. Caduceus Occupational Medicine and Caduceus USA); and
- Occupational HealthworX.
This list is not exhaustive, so you should be wary of any medical group with “occupational medicine” or “occupational health” in its name. On the other hand, not every “urgent care” is an industrial or occupational clinic. For example, most WellStar Urgent Care centers are not occupational clinics, and often are unbiased.
The allegiances and biases of any health group can be hard to determine ahead of time. This article will help you identify the healthcare groups which we counsel our clients to avoid. In our opinion, these “repeat offenders” care primarily about making insurance companies happy, provide sub-standard care, and may seriously damage your workers’ compensation claim.
Why is it a Mistake to Visit an Industrial Health Clinic?
“Occupational health clinics” receive most of their business from big employers and their work comp insurers. For profit, the clinics rely on employers to send patients. To an industrial clinic, the real “client” – and the person paying – is your employer and its insurance company (the “Employer/Insurer”), not the patient. If employers and their insurance companies don’t like the way a particular clinic handles cases, they stop sending patients, and that clinic goes out of business. So, occupational clinics get sent more injured workers if they help the insurance company instead of you.
Obviously, this creates a conflict of interest for these clinics. In theory, their job is to provide care for an injured worker. However, serious care and testing costs their real client – the Employer / Insurer – more money. Likewise, a patient may be badly injured, such that a quick return to work will prevent or slow down their recovery, but taking a patient out of work means that the employer must pay someone else to do that job, and the insurer has to pay the injured worker a weekly wage replacement benefit. The insurance company doesn’t like that, so your occupational clinic doctor may tell you they “aren’t allowed to take you out of work.” That just isn’t true and isn’t the law.
Many occupational clinics have worked with insurance companies to develop “policies” and “treatment protocols” designed to minimize care, testing, and lost time from work. Real-life examples include:
Clinics Often Refuse to Treat the Entire Injury / All Injured Body Parts:
Example: John slipped off scaffolding at work, fell 10 feet, and landed upside down. An ambulance took him to the hospital, where he complained primarily about his arm, which was broken in two places. The truth was, he had injured his head, neck and back, in addition to his arm, but the arm was the most painful and most obvious injury. After leaving the hospital, John was told by his employer that he was required to report the next day to an occupational clinic.
The insurance adjuster then called the clinic and authorized care, but only for the arm. At the clinic, the doctor refused to treat or even discuss John’s other injured body parts. The doctor told John, “that care hasn’t been authorized” and “I’m only allowed to treat your arm.” When John insisted that other body parts were also injured, the clinic doctor stormed out of the room. Worse, the doctor refused to document any of John’s other complaints in his office notes. That way, when a Judge finally read those doctor notes in the future, it looked like John never complained about anything other than his arm. Fortunately, John’s testimony at trial convinced the Judge that he actually reported multiple injuries, both at the hospital and at the clinic. Unfortunately, getting to trial took over a year, during which John was unable to get the care he needed.
Clinics Often Refuse to Put a Patient on “No Work” Status, Even When Badly Injured:
Example: Jane had a slip-and-fall at work, and felt a pop in her back, followed by severe low back pain and tingling down her leg. She was sent by her employer to an industrial clinic which took x-rays and discovered a compression fracture in her lumbar spine. Despite a literally broken spine, she was released to “light duty work” by her doctor, who claimed she could do a seated job, and told her that she could not return to the clinic unless she also returned to work.
Most clinics will not allow a patient to see a real doctor on most visits. Treatment is managed by a physician’s assistant or nurse, and they don’t have authority to get you real care:
Clinics Often Refuse to Order an MRI Unless and Until the Patient Completes Physical Therapy or Some Arbitrary Number of Office Visits:
Example 1: John had a knee injury at work. He could barely walk, so his employer drove him to an industrial clinic. The clinic made him do 12 visits of excruciating physical therapy before allowing him to get a knee MRI, months later. The MRI showed that John had an ACL tear. It turned out, the “physical therapy” had actually made the injury worse.
Example 2: Jill hurt her back at work and was sent to an industrial clinic. Despite having all the symptoms of a severe disc injury, which could potentially paralyze her, the clinic refused to refer her to an orthopaedic specialist or to provide an MRI until she had returned to the clinic 6 times. Months later, Jill was finally able to get her MRI, which showed several disc herniations but, because proper care had been delayed, she now needed surgery.
You may ask yourself, “Isn’t this medical malpractice?” The answer is that every case is different, and if you have been treated this way, you should call our workers’ compensation lawyers about your experience. Depending on what has been done to you, you very well may have a malpractice case. However, it’s very hard in Georgia to file a medical malpractice case, because the laws have been written to protect doctors and the insurance companies that pay them. Typically, only the most egregious behavior, which actually results in catastrophic consequences, results in a lawsuit. Injured workers who get chewed up and spit out by these clinics need to call our workers’ compensation lawyers, because the workers’ compensation claim can be salvaged.
Is that to say that every doctor is like this? Absolutely not. Many doctors have your best interests at heart. Sometimes even the doctors at the occupational clinics want to do the right thing, but have their hands tied by the insurance company and their own management. “Someone in Congress needs to do something about this, now!”
If I Refuse to Go to a Clinic, Do I get to Pick My Own Doctor? Can Workers’ Compensation Lawyers Help Me Find the Right One?
Employers will often tell an injured worker that he or she “must” or “is required to” go to an occupational health clinic after an accident. This is completely against the law, yet it happens frequently.
In fact, employers are sometimes unaware that they are breaking the law, because they are simply telling hurt employers what their insurance company wants them to say, and they don’t know any better. Other employers know they are being dishonest, but they lie to injured workers’ hoping to keep insurance premiums lower. This is more likely to happen if you work in a warehouse, industrial facility, or processing plant.
However, while the employer is not allowed to pick your doctor, they do have some control over the group of doctors you get to choose from.
Every employer in Georgia, with at least 3 employees, is required to post an entire list of doctors in a prominent location in the workplace. The employer is required by law to show you this list, and to educate you about it, following a work accident. (O.C.G.A. 34-9-201). If they do so, then you are not allowed to pick whatever doctor you want. You must pick a doctor from the list, which is called a “panel of physicians.” Once you pick a medical provider from that list, that provider becomes the authorized treating physician (the “ATP”) for your work accident claim. This ATP has supreme power over what care and testing you receive, which is why the insurer wants to trick you into using one of the clinics above. Don’t fall for it.
Here is a panel of physicians from a real case. Notice that the first page is packed with occupational health clinics. However, the Employer / Insurer is required by law to offer other options, so the second page lists some actual specialists.
When in Doubt, Seek Guidance from Morrison & Hughes Workers’ Compensation Lawyers
If you have a tiny accident, with some minimal bumps and bruises, there is no harm in going to an industrial clinic. They will patch you up and send you back to work. However, if you have a serious injury, it is a terrible mistake to use an industrial clinic, for the reasons outlined above.
The best decision you can make, following a serious accident, is to call our workers’ compensation lawyers BEFORE, you pick your doctor. An experienced workers’ comp attorney can tell you which doctors on the list are the fairest, and which are deep in the insurance company’s pocket. In the world of workers’ compensation law, “A good lawyer knows the law, but a great lawyer knows the doctor.”
With offices around Georgia, the Morrison & Hughes Law Firm was founded to fight for the rights of those injured in auto accidents, on the job, and everything between. If you or a loved one have been the victim of a work accident, Don’t go up against the insurance company unarmed, hire “The Big Guns!” Give us a call at (404) 800-5297 or click to schedule a free consultation with one of our skilled workers’ compensation lawyers.