PTP stands for Primary Treating Physician, the main doctor authorized to treat your workers’ compensation injury in Georgia.
Your PTP controls critical aspects of your claim—authorizing treatment, determining when you’ve reached maximum recovery, assigning work restrictions, and providing disability ratings that affect your benefits.
Because the PTP wields so much influence over your case outcome, understanding your rights regarding physician selection and the ability to change doctors is essential for protecting your interests. An Atlanta workers’ compensation lawyer can help you navigate physician selection rules, challenge inadequate treatment, and ensure your PTP provides appropriate care.
How Primary Treating Physicians Are Selected in Georgia
Georgia law requires you to select your PTP from your employer’s posted panel of physicians. Employers must post and maintain a panel listing at least six physicians in different practice groups. This panel should be visible in your workplace, and your employer should provide you with a copy when you report a work injury.
You have the right to choose any physician from the posted panel as your PTP. Your employer cannot direct you to a specific doctor on the panel—the choice is yours among the listed options. However, if your employer doesn’t maintain a proper panel or fails to post it as required, you gain the right to select any physician you want.
Some employers maintain panels consisting entirely of physicians known for minimizing injuries and limiting treatment. These doctors may be competent from a medical standpoint, but they approach workers’ compensation cases conservatively, authorizing minimal treatment and declaring injured workers at maximum medical improvement prematurely.
What About Emergencies?
If you seek treatment from a physician not on the posted panel without authorization, the insurance carrier isn’t required to pay for that care. Emergency treatment is an exception—you can seek emergency care anywhere, and it must be covered.
However, for ongoing treatment, staying within the authorized medical provider network is essential unless you’ve properly exercised your right to change physicians.
For a free legal consultation, call (404) 888-8888
Your Right to Change Your Primary Treating Physician
Georgia law allows you one physician change as a matter of right, meaning you don’t need permission or justification to make your first change. After selecting your initial PTP from the posted panel, if you’re dissatisfied with the care or want a second opinion, you can change to a different physician on the panel. You simply need to notify your employer in writing.
The one-time change rule creates a strategic decision. Should you change physicians early if your initial PTP seems dismissive of your symptoms? Or should you wait to see if treatment improves? Once you use your one allowed change, any subsequent physician change requires either employer agreement or State Board of Workers’ Compensation approval.
After using your one free change, additional physician changes require showing good cause. Good cause might include:
- Your PTP’s retirement or relocation
- A demonstrated need for specialized care that your current physician can’t provide
- Evidence that your PTP isn’t providing adequate treatment.
What Your PTP Controls in Your Workers’ Compensation Claim
Your primary treating physician holds enormous power over your workers’ compensation claim outcome. They determine what treatment you receive, how long you remain off work, what restrictions you’ll have when you return, and ultimately what disability rating you receive for permanent impairment.
If you need surgery, physical therapy, specialist consultations, diagnostic imaging, or medications, your PTP must authorize these treatments for the insurance carrier to cover them.
Work status determinations come from your PTP. They decide when you’re totally disabled and unable to work, when you can return to modified duty with restrictions, and when you’ve recovered sufficiently for full duty. These decisions affect your temporary disability benefits.
Maximum Medical Improvement (MMI)
Maximum medical improvement declarations by your PTP trigger the shift from temporary to permanent benefits. MMI means your condition has stabilized and further significant improvement is unlikely.
Reaching MMI ends temporary disability payments and begins the process of rating permanent impairment. PTPs who declare MMI prematurely, before you’ve received adequate treatment or achieved maximum possible recovery, can permanently shortchange your benefits.
Work Restrictions
Work restrictions assigned by your PTP affect whether you can return to your previous job and what you can earn post-injury. Appropriate restrictions protect you from re-injury and document your reduced earning capacity. Insufficient restrictions may force you back to work before you’re ready or fail to capture limitations that prevent you from performing your previous job duties.
Complete a Free Case Evaluation form now
When to Consult an Attorney About Your PTP
If your PTP refuses to authorize treatment other doctors recommend, declares you at maximum medical improvement when you’re still symptomatic and improving, assigns restrictions insufficient to protect you from re-injury, or provides a disability rating that seems too low given your functional limitations, you need legal advice about your options.
Since founding Bader Law in 2008, Seth Bader has represented over 10,000 injured workers throughout Georgia. His background as a former insurance defense attorney gives him insight into how insurance carriers use panel physicians to minimize claims.
Don’t accept inadequate care or undervalued disability assessments without fighting for the treatment and ratings Georgia law entitles you to receive. Contact us today for a free consultation about your PTP and your workers’ compensation medical treatment concerns.
Call or text (404) 888-8888 or complete a Free Case Evaluation form
