Georgia Workers’ Compensation Adjusters should be aware of a Rule change and a new form, which will require a quick decision to either controvert or authorize medical treatment/tests prescribed by an authorized treating physician. Effective 7/1/2017, the WC Board amended Rule 205 to add subsection (c) authorizing use of the new form WC-PMT, which is attached.
This new WC-PMT (Petition for Medical Treatment) does not require submission of the form by the healthcare provider, as is done with a Form WC-205. Instead, new Board Rule 205(c) allows the claimants and the claimants’ attorney to complete a Petition for Medical Treatment (WC-PMT) when:
1) ATP has recommended medical treatment/testing;
2) Employer/Insurer have been provided medical documentation confirming recommended medical treatment/testing for at least five (5) business days; and
3) Employer/Insurer has failed to authorize the treatment/testing recommended by ATP.
When the foregoing three steps have been met, the employee or their attorney may file the WC-PMT, which will result in the issuance of a notice requiring the Employer/Insurer to participate in a telephonic conference before an ALJ so the Employer/Insurer has an opportunity to explain why the requested medical treatment/testing has not been authorized. The telephonic conference will occur within 5 days from the date the petition is filed.
Employer/Insurer may authorize treatment/testing by completing WC-PMT Section C. or controvert treatment/testing by completing WC-PMT Section D. Be sure to timely respond to WC-PMTs going forward.
Feel free to contact us with any questions. If you need assistance in handling the conference calls, or in the alternative, would like our firm to handle the conference call for you, just give us a call.