Workers’ Compensation FAQ
Workers’ Compensation generally encompasses injuries and some limited diseases stemming from “on the job” or “work-related” accidents. Georgia’s Workers’ Compensation Act is a no fault system. You do not need to prove fault to obtain benefits. Do not assume that your accident is not compensable. Talk to a lawyer about the facts. You don’t want to find out after it is too late, that you could have filed a claim for an injury which might change your life.
[vc_accordion_tab title=’Which Employers?’]The Georgia Workers’ Compensation Act governs work-related injuries in Georgia. The Act applies to most Employers although there are exceptions. It does not apply to Employers with less than three regular employees. Nor does it apply to Agricultural Employers such as farms and dairies. It also does not apply to railroad workers as they have a separate compensation system available. To make things more confusing, exceptions apply to all of the above categories. Generally, if you work for an employer with three or more employees and you are injured in the course of your employment then you are probably covered. However, a competent attorney needs to hear the specific facts surrounding your employment to determine if you should file for relief under the Georgia Workers’ Compensation Act.[/vc_accordion_tab]
[vc_accordion_tab title=’Medical Benefits’]
So you’re covered. What about medical treatment? You are entitled to prompt medical treatment at the expense of the Employer or its Insurer. This is not an 80/20 plan like your health insurance. Your Employer or its Insurer will be responsible for all accident related and authorized medical treatment in a compensable case together with reimbursement for mileage for medically required travel.
Once treatment goes beyond the Emergency stage, you will need to locate the Employer’s List of Physicians. This is a list which the Act requires an Employer to post in a conspicuous place. You may choose one of the physicians from this list. Hopefully, your Employer will assist you in contacting the adjuster who will authorize the visit with the doctor you have chosen. DO NOT LET THE EMPLOYER SIMPLY TELL YOU THAT YOU HAVE NO CHOICE AND YOU MUST GO TO ONE PARTICULAR DOCTOR! This is a common misconception. You must choose a doctor from the list and you must get authorization for the first visit. If you disregard this and simply go to a doctor of your choice, the Employer and its Insurer may not be later liable to pay for the treatment.
The main exception is if the Employer does not post a List of Physicians. If they do not do so, or if the list does not comply with the Act, then you may go to the Physician of your choice for treatment. Legal advice at this critical stage of the case may save you the expense of paying for medical treatment.[/vc_accordion_tab]
[vc_accordion_tab title=’Wage Benefits’]If an authorized physician states that you are disabled from working or has given you medical restrictions which result in your Employer not being able to accommodate you with a job, the you are probably entitled to Temporary Total Disability Benefits. If you do return to work at a lower pay due to the compensable injury (for example less hours or lower rate of pay at different less strenuous job), you are probably entitled to Temporary Partial Disability Benefits. In Georgia, the maximum rate is 2/3 of your average weekly gross wage up to a certain maximum benefit (at the time of this writing $500.00/week). Don’t get short-changed. There are certain methods defined by the Act to determine the correct Disability pay. Do not simply assume that your Employer’s Insurance Company has the correct information to calculate this rate accurately.[/vc_accordion_tab]
[vc_accordion_tab title=’Permanent Disability ‘]If your injury does not completely heal and leaves you with permanent impairments, your doctor will be asked to assess you and assign the appropriate rating. Once this rating is assigned, your Employer or its Insurer will be asked to make an appropriate payment.[/vc_accordion_tab]
[vc_accordion_tab title=’Time Limitations’]Do Not Delay. There are important deadlines for you pursuant to the Act. You must report the accident and injury and the fact that it occurred at work to your Supervisor or someone above you in the chain-of-command within 30 days of your first knowledge of the accident. If the Employer or its Insurer does not timely accept your claim, you must file the claim with the State Board of Workers’ Compensation within 1 year or forever lose your rights to pursue your claim. If our office accepts your case, we will monitor these deadlines along with other deadlines outlined in the Act.[/vc_accordion_tab]
[vc_accordion_tab title=’Other Issues’]The Workers’ Compensation Act contains many provisions which might drastically affect your case. These can be pitfalls if ignored or crucially important to winning your case. Some of these issues are:
- Determining who are financial dependents in a work-related death claim;
- Whether the injured worker is an Employee or Independent Contractor;
- Whether the inured Employee was intoxicated at the time of the Accident and if such intoxication caused the accident;
- Whether benefits are still available if the Employer fires the Employee;
- If fired, what the Employee needs to do to continue receiving benefits;
- How long do benefits last? Is there an ending date?;
- Whether the accident occurred during lunch break, while traveling, during horseplay;
- What other benefits are available in certain cases, such as retraining, education, etc.;
Do you qualify for handicapped housing or transportation? How do other benefits such as social security or unemployment affect my payments? What is a ‘catastrophic’ injury and what additional benefits does it provide?
Are work-related hernias covered by the Act? The facts of each case are unique. Each Injured Worker is different. Why not talk with us regarding your case?[/vc_accordion_tab]
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Disclaimer for Content
Each state and the federal system has a different set of laws which apply. This discussion is generally applicable to Georgia non-federal injuries. If you are employed by the federal government or were injured in some state other than Georgia, this article may not benefit you. You should seek the advice of competent legal counsel licensed in your state or jurisdiction.