NOTICE TO ALL FULTON COUNTY EMPLOYEES
THE FOLLOWING PROCEDURE MUST BE FOLLOWED FOR ALL ON-THE-JOB INJURIES:
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he following notice is provided to you individually, and also must be posted in a permanent, conspicuous place in each business location. It is the responsibility of each and
all employees to read and adhere to the procedures specified in this notice.
“This business operates under the Georgia Workers’ Compensation Law. WORKER’S MUST REPORT ALL ACCIDENTS IMMEDIATELY TO THE EMPLOYER B
ADVISING THE EMPLOYER PERSONALLY, OR AN AGENT, REPRESENTATIVE, BOSS, SUPERVISOR OR FOREMAN OF THE EMPLOYER. If the worker is
hurt or injured at work, the Employer/insurer shall pay medical and rehabilitation expenses within the limits of the law. In some cases, the employer will also be require
to pay a part of the worker’s lost wages. Work injuries and occupational diseases should be reported in writing whenever possible. The worker may lose the right to
receive compensation if an accident is not reported within 30 days. The employer will also furnish to the employee, upon request, copies of board forms on file with the
employer pertaining to an employee’s claim.”
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I. It is necessary that accident reports be received in the Finance Department within 48 hours of the accident or injury. Failure to meet this deadline may endanger the receipt of Workers’ Compensation
benefits by the
injured person. IT IS THE RESPONSIBILITY OF THE SUPERVISOR TO IMMEDIATELY NOTIFY THE WORKERS’ COMPENSATION DIVISION WHEN AN INJURY OCCURS.
SUPERVISORS
MAY FAX A COPY OF THE OCCUPATIONAL INJURY REPORT TO THE WORKERS’ COMPENSATION DIVISION. THE FAX NUMBER IS 404-730-7596. IF THE INJURY
OCCURS AFTER
HOURS, YOU MAY LEAVE A VOICE MAIL ON ANY OF THE TELEPHONE NUMBERS LISTED AT THE BOTTOM OF THIS NOTICE.
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II. Worker’s will be eligible for claims consideration for treatment rendered by the following facilities ONLY, unless referred by one of these facilities. If an injury occurs after business hours, the employee
can choose to go
to the nearest emergency treating facility; however, you must follow-up the following work day with one of the facilities listed below.
1. THE HAND & UPPER EXTREMITY CENTER OF GEORGIA – 980 Johnson Ferry Road, NE, Suite 1020, Atlanta, GA. Telephone 404-255-0226. (By Appointment Only
2. ORTHO ATLANTA - 1800 Howell Mill Road, Suite 200, Atlanta, GA. Telephone 404-352-1053. (By Appointment Only)
3. GENERAL MEDICAL - Dr. Robin Armenia, Concentra Medical Center, 3580 Atlanta Avenue, Hapeville, GA. Telephone 404-768-3351.
4. GENERAL MEDICAL - Dr. Tracy Naylor, Concentra Medical Center, 688 Spring Street, N.E., Atlanta, GA. Telephone 404- 881-1155.
5.
GENERAL MEDICAL - Dr. Lei Cheng, Concentra Medical Center, 6475 Jimmy Carter Boulevard, Norcross, GA. Telephone 770-242-7744.
6.
GENERAL MEDICAL- Dr. Stephen Dawkins, Caduceus- Midtown, 145 North Avenue, N.E. Atlanta, GA. Telephone 404-607-7677.
7.
EYES - OPHTHALMOLOGIST - Dr. Glen Shear, Clayton Professional Bldg., 33 S.W. Upper Riverdale Road, Suite 114, Riverdale, GA. Telephone 770-991-1624.
8.
EYES - OPHTHALMOLOGIST - Dr. Andrew S. Fineberg, 550 Peachtree Street, Suite 1500, Atlanta, GA. Telephone 404-897-6810.
9.
Any medical doctor treating you at Grady Hospital.
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f you are not satisfied with the treatment that you received from your first choice of doctors on the above panel, you may choose a second doctor on the panel without the approval of the
Workers’ Compensation Division or the Finance Director. However, if you are still dissatisfied and wish to seek treatment from a third choice, you will need approval from the Workers’
Compensations Division.
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mployee’s personal physician DOES NOT qualify as an authorized treating facility. Medical bills from private physicians will not be paid by Workers’ Compensation. Lost time excuses
WILL NOT BE ACCEPTED from private physicians.
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njury Leave may be granted to Fulton County employees only in cases involving catastrophic injuries, i.e., loss of limb, loss of eyesight, burn victims, etc., where the injury arises out of
and in the course of employment as defined by law. (P-1200-5) (Policy and Procedure 340-16)
All
lost time and medical time (MT-lost time due to doctors’ appointments) must be authorized in writing from one of the above nine (9) treating facilities or their referrals.
UNAUTHORIZED LOST TIME will be charged to sick leave, vacation leave or LWOP. UNAUTHORIZED TREATING FACILITY excuses WILL NOT be accepted for lost time or
medical time. Medical Time (MT) is absorbed by department if procedures are followed.
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ach employee must contact his/her immediate supervisor and Workers’ Compensation Division personally, 404- 612-6749 or 404- 612-7686, after each doctor’s visit. Failure to follow
this procedure can result in loss of benefits.
W
hen an employee is released to return to work, whether to limited or regular work, it is the employee’s responsibility to contact his/her supervisor and the Workers’ Compensation
Division immediately. Failure to comply shall result in loss of benefits.
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ailure to report for a scheduled doctor’s appointment shall result in loss of benefits. It is the responsibility of the employee to pay for all charges on a no-show office visit.
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laims consideration will be given for treatment received by an emergency medical facility after hours or in a dire emergency. (If you are treated by an emergency treating facility and NOT
hospitalized, you MUST be seen by one of the above treating facilities the following work day.) DO NOT GO TO EMERGENCY FACILITIES FOR MINOR INJURIES OR
DURING NORMAL WORK DAY. In grave life or death emergency situations, claims consideration will be given for treatment received at the emergency facility nearest to the scene of
the accident or injury.
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ECOND JOBS - If one of our authorized treating facilities has you on a “NO” work or “LIMITED” work status; you shall not work a second job. Failure to comply shall result in
termination of benefits and possible disciplinary action.
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OMPENSATORY TIME - If you are treated by one of our authorized treating facilities prior to or after your work day or on your off day, you are not entitled to compensatory time.
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ulton County Government is self-insured and all bills should be sent to Fulton County Workers’ Compensation Division, 141 Pryor St., Suite 5070A, Atlanta, Georgia Attention: Valarie Howard.
QU
ESTIONS - If you have any questions, please do not hesitate to contact the following: Valarie Howard, Workers’ Comp. Manager 404- 612-6749 (Workers’ Compensation payrolls, lost time,
reimbursements and general information); Lawana Boatwright, Workers’ Comp. Coordinator 404-612-7686 (medical bills, reimbursements and general information); Larry Milner, Safety Coordinator 404-
612-7579 (Investigations, safety hazards and general information); Annette Roberts, Workers’ Comp. Spec. 404-612-0563 (General Information, reimbursements); Darryl Smith, Safety Officer/Investigator
404- 612-6746 (Investigations, safety and general information); Audrey Traylor, Admin. Tech. 404-612-6747 (General Information) or Denise Pinto at 404-612-7663 Manager, Fax Number 404-730-7596;
24 HOUR EMERGENCY NUMBER 404-630-8407.
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have read, had explained to me and understand the “NOTICE TO ALL FULTON COUNTY Employees”. This _________________
Day of _______________________ 20_________.
SIGNATURE: ___________________________________ DEPARTMENT: ____________________________________________ S.S. # __________________________
WITNESS: ______________________________________________
Revised 07/01/19
