Who Is the Authorized Treating Physician
On July 27 2023, a decision came out of the Court of Appeals titled City of Atlanta v. Sebastian. This was a workers’ compensation case where there were multiple doctors that treated the injured worker. The primary doctor felt that the injured worker could only do light duty work. The primary doctor referred the injured worker to a number of orthopedic specialists for a different body part examination, all who stated that the worker could return to full duty work.
The City of Atlanta terminated the injured workers’ benefits based upon the full work duty releases. However, none of those doctors were designated as the primary authorized physician.
The Court of Appeals interpreted the authorized treating physician as the primary doctor to manage and oversee the injured worker’s medical care. The court stated that “there is a clear distinction between the primary authorized treating physician and the referred specialist physicians.”
The City of Atlanta argued that as long as any or an authorized treating physician treated and released the injured worker to full duty that was good enough to suspend his benefits. The Court of Appeals stated again: “this position of the City of Atlanta cuts against the statutory scheme’s philosophy of centralized care of one managing physician and it would allow a specialized treating physician of a particular condition, even if the employee has a different condition that might not support the return to full duty work. Such interpretation undermines a humanitarian purpose of the Act.” The Court Cited Generally Were County Bd of Ed, 330 GA. App at 850.
The reason this is such a great case is that too many times the insurance company is quick to suspend my client’s benefits when one doctor treating one body part releases the client to full duty work, yet there are other body parts that need to be treated and that treatment is not completed. The insurance company is quick to suspend my client’s benefits, placing him in a terrible position medically and financially.
This decision will make it much more difficult to suspend benefits on the part of the insurance companies now that this decision has been published. This is the law for the entire State of Georgia. This case represents a small but significant victory for injured workers in Georgia.