Frequently Asked Questions about Georgia Workers’ Compensation
If you’ve been injured on the job, you have the right to benefits under Georgia’s workers’ compensation system. Here are the basics.
What is workers’ compensation?
Under Georgia law, employers are required to carry workers’ compensation insurance so that, in the event of a workplace injury, workers can be compensated for medical treatment, rehabilitation, income benefits, and permanent disability. Workers’ compensation may also provide benefits to dependents of work-related death victims.
How do I know if the company I work for is covered by workers’ compensation?
Georgia law requires any business with three or more workers, including regular part-time workers, to have workers’ compensation insurance. You can verify your employer’s coverage at www.sbwc.georgia.gov.
What should I do if I’m injured at work?
You should report any work-related accident immediately to your employer – whether that be your boss, foreman, or supervisor. Under Georgia law, if you wait longer than 30 days to report an accident on the job, you may lose your benefits.
We also recommend that you report your accident in writing to further prove you gave notice to your boss. This can even be in the form of a text message to your supervisor.
At the same time you report your accident to your employer, you should always request medical attention – even if you think the injury is minor. We have had many cases where the injured worker thought their injury was minor at first, only to later find out that their accident caused serious health complications. For example, we have had diabetic clients stub their toe and, not giving it too much thought, didn’t see a doctor. Later, the injury caused an infection that resulted in amputations.
Lastly, and this is where many people mess up, always tell your boss that your need for medical treatment is due to the work accident. Never assume your boss will make the connection between an accident at work and your request to see a doctor, especially if you report it several days or weeks later.
Do I get to choose my own doctor?
It depends. If your employer has a valid, posted panel (list) of physicians, then you must choose from that list.
However, do NOT let your boss choose your doctor for you, even if they have a valid list. You have the right to choose from your employer’s list. If you let your boss pick your doctor, you will receive inadequate medical care from the most employer-friendly doctor on their list. For example, missing an arm? Full duty. Unconscious on arrival? No treatment required. Don’t let this happen to you. Choosing the right doctor is the second most important decision you will make on your claim.
The most important decision you will make is choosing the right experienced workers’ compensation lawyer to protect your rights. Your boss may pressure you from the very beginning and may insist that you see a specific doctor. You need someone in your corner to put a stop to the employer’s pressure tactics. You have rights, and we know how to use them.
Here’s a little secret that insurance companies don’t want you to know: If your employer did not have a valid, posted panel of physicians in place on the date of your accident, then, yes, you and your lawyer get to pick ANY doctor you want to be your authorized treating physician ‒ and the insurance company has to pay for it.
Do I need an attorney to get workers’ compensation benefits?
No, assuming insurance companies always do the right thing. In your experience, do insurance companies always do the right thing? Of course not.
Insurance companies are in business to make profits and their shareholders rich in the process – at your expense. Profits over people like you.
Hiring an experienced workers’ compensation attorney not only makes the claim process easier, but it also ensures you get the best treatment possible, with the maximum benefits and the maximum settlement at the end of your claim. Why do you think insurance companies love it when people don’t hire lawyers? You guessed it Less money for you, and more money for their shareholders.
Not all workers’ comp cases are cut and dry. Some employers may contest the claim that the accident occured at work, or there may be an issue surrounding pre-existing conditions. Insurance companies put profits over people and will do what they can to prevent paying benefits.
It’s important to find an attorney with specific expertise in workers’ comp because of the complexity of this area of law.
Call DeMedeiros Injury Law at (678) 996-5050 or contact us online for a free consultation today.
What can a workers’ compensation lawyer do for me?
It is a proven fact that injured workers represented by experienced workers’ compensation lawyers get significantly more benefits, significantly better benefits, and significantly higher settlements than people who don’t have someone in their corner taking the fight to the insurance company.
Also, while a workers’ compensation claim can be incredibly stressful, you will have less stress in your life by letting a workers’ compensation lawyer handle all communications with the insurance company. Have you ever had a conversation with an insurance adjuster? If so, would you describe it as a positive, helpful experience? Of course not. Let us take care of everything. That’s why we’re here.
Contact us today for a free, no-strings-attached legal consultation.
How do I find the right attorney for my workers’ compensation claim?
A general lawyer who dabbles in workers’ compensation is not advisable due to the complexity of workers’ comp law. If you see that a lawyer’s website lists a hundred different practice areas, then that just means they’re an expert in none of them. Also, will you actually get to speak to your lawyer on a consistent basis, or will you only get to talk to an assistant? With us? Yes, you will speak with your lawyer on a consistent basis. If you ask for a call back from your lawyer, will your lawyer return your call by the end of the day? With us? Absolutely, the lawyer will return your call by the end of the day. We even text with our clients after business hours, if needed.
Do your research. Look for an attorney with favorable online reviews that demonstrate clear client communication, understanding of the law, and a passion for helping people.
Most workers’ compensation attorneys offer a no-strings-attached, free initial consultation. Don’t be afraid to speak with multiple attorneys and treat this consult like a lawyer interview. Ask just as many questions as they do. Does the lawyer take their time with you, or do you feel rushed? Evaluate the attorney’s professionalism and if they address your concerns and listen to you.
In addition, take note of your interaction with office staff and paralegals – if you hire that attorney, chances are you will be interacting with the staff frequently as well.
What benefits am I entitled to if I’m injured at work?
Georgia workers’ compensation law has rigid guidelines to determine how much you are entitled to as a result of a workplace injury or work-related death.
Temporary Total Disability (TTD): This type of compensation occurs when an authorized treating physician says you can’t work at all. Or, when your authorized treating physician says you can perform light-duty work, but your employer has none to offer you.
After a week of not working (the waiting period), you will be entitled to weekly checks that equal two-thirds of your average weekly wage for lost income until you are cleared by the physician to return to full-duty work or until your employer has suitable light-duty work for you.
Temporary Partial Disability (TPD): TPD compensation occurs when your authorized treating physician clears you to go back to work, but only in a light-duty capacity. As a result, you are earning less money due to reduced work hours or because you are making less per hour due to a demotion.
Should you qualify, weekly TPD checks equal two-thirds of the difference in pay between what you were making pre-injury and what you are making now.
Permanent Partial Disability (PPD): This type of compensation typically occurs at the end of a claim when your authorized treating physician says you’ve reached maximum medical improvement (MMI) – which is just a fancy way of saying, “You’re as good as you’re gonna get.”
Each body part has been given a value by the Georgia legislature in terms of the number of weeks of benefits. For instance, an arm is worth 225 weeks of income benefits.
Once you’ve been determined to be “as good as you’re gonna get,” the authorized treating physician assigns a percentage of disability (impairment rating) for that body part. For example, your authorized treating physician may assign you a 12% rating to your arm, which, again, is worth a maximum of 225 weeks of benefits. This will result in the insurance company owing you 27 weeks of income benefits. (12% of 225 weeks = 27 weeks.)
The final calculation is straightforward, but you will need an experienced workers’ compensation lawyer to aggressively advocate for the highest possible impairment rating to be assigned to you. If the PPD rating is low, you need an experienced workers’ compensation lawyer to get you a second opinion. Weekly benefits for PPD equal two-thirds of the average weekly wage, but can only be paid when you are not receiving TTD or TPD benefits. Georgia law does not allow you to get both TTD/TPD and PPD benefits at the same time.
When do I get my workers’ comp benefits?
You are entitled to weekly income benefits if you are unable to work for more than 7 days (the waiting period). You can then recoup that first week later on – 21 days after the first day you missed work. Workers’ compensation checks are mailed weekly. Unfortunately, most insurance companies do not yet offer direct deposit.
Are any benefits available to me while I’m waiting for my claim to open?
You are entitled to immediate medical treatment after your accident. In fact, if you have a serious accident and need to go to the emergency room, you can do that. You do not have to wait to speak to your boss for emergency treatment.
How much is my case worth?
It’s important to understand that workers’ compensation is not a lawsuit. Workers’ compensation ensures employees can secure benefits as a result of workplace injuries and pays benefits according to Georgia workers’ compensation law.
Any lawyer who tries to entice you to sign up with them by promising you a certain settlement number is unethical and is lying to you. Unfortunately, there are those lawyers out there who try to steal clients from other lawyers by making guarantees or promises they can’t keep. Lawyers who badmouth other lawyers and who will promise you the sun and the moon just to get you to hire them are the ones who give good lawyers a bad reputation.
I will, at all times, be 100% honest and transparent with you and will fight the insurance company for every dime. Think of it like squeezing an orange – I want to squeeze every last drop of juice. I will never recommend any settlement that is not in your best interest.
To that end, it is virtually impossible to tell you with accuracy how much your case is worth at the beginning of the claim. Why? Well, we won’t yet know who your doctor is going to be. We won’t yet know what your MRI will show. We won’t yet know whether your injuries will require surgery. We won’t yet know what your PPD rating will be. We won’t yet know what your work status will be.
If you are given light-duty restrictions by your authorized treating physician, we won’t yet know whether your employer will have a suitable job to offer you. We won’t yet know how your body will respond to your treatment plan. We won’t yet know whether there will be complications. You get the point.
As much as we would love to give you an exact number, there are just too many unknown factors at the beginning of a claim to be able to give you a number for your case value.
As the case moves along and as those questions get answered, I will then be able to give you a more accurate idea of how much your case is worth. I would be doing you a disservice as my client if I just guess and give you a random number at the beginning of your case. I’m here to provide you with expertise and informed answers – not guesses.
Run from any lawyer (or doctor for that matter) who makes you any sorts of guarantees, especially at the beginning of a claim.
Do I have to pay for medical treatment if I’m injured at work?
No. If you were injured on the job, your company’s workers’ compensation insurance carrier will pay for your authorized medical treatment.
I was injured months ago. Can I still file a claim?
Under Georgia law, if you wait longer than 30 days to report an accident on the job, you can jeopardize your claim.
However, failure to provide notice within 30 days alone does not necessarily mean your case is lost. Experienced workers’ compensation lawyers know that this defense, by itself, is pretty weak and that it can be overcome. Nevertheless, accidents should always be reported immediately.
In terms of filing your claim, you have one year from your date of accident. Filing your claim requires a special form to be filed with the State Board of Workers’ Compensation.
This area of the law is very form-based, and it is easy for someone who is not experienced to get the forms, their significance, and any filing deadlines confused. An experienced workers’ compensation lawyer will know which forms to file, how to appropriately complete them, and when to file them.
Can I be fired for making a workers’ comp claim?
Yes, it is possible. Georgia is an “at-will” employment state. This means you can be fired at any time for any reason, except for being a member of a class protected from employment discrimination.
That said, being fired for filing a workers’ compensation claim is considered retaliation and is therefore illegal. It may be difficult to prove retaliation, unless your employer specifically states the motivation behind the firing. Should your employer fire you after you file a claim, it’s imperative you hire an experienced attorney to help you through the process.
Call DeMedeiros Injury Law at (678) 996-5050 or contact us online for a free consultation today.
What if I have a pre-existing condition and I re-injure that body part?
If you aggravate an existing condition at work or re-injure it in a work-related accident, you are eligible to receive workers’ compensation benefits under Georgia law.
However, insurance companies will do what they can to keep the claim value as low as possible or dispute the claim altogether.
Pre-existing cases can be medically and legally complex, and it’s advisable to hire an experienced workers’ comp lawyer to help you navigate the process and help you receive the benefits you deserve by law.
Contact us today for a free, no-strings-attached legal consultation.
What happens if my workers’ compensation claim is denied?
If your workers’ compensation claim is denied, it does not mean that you are not entitled to Georgia workers’ comp benefits under the law. You have a right to seek a clear reason for the denial and to request a hearing in front of an administrative law judge with the State Board of Workers’ Compensation.
While filing for a hearing is not the same as a traditional lawsuit, it does involve litigation, and the lawyer for the insurance company will get a chance to depose you and to ask background questions along with questions about your accident, injuries, and limitations.
While it’s not necessarily a requirement to have an experienced workers’ compensation lawyer represent you at the hearing, it is always a good idea because a lawyer will protect your rights, will make the process smoother and less stressful, and will help you win your case. You should never go to court without a lawyer to represent you!
If your claim has been denied, contact us today for a no-cost legal consultation.
How long does it take to resolve a workers’ compensation claim?
There’s not really a definite answer to how long it can take to resolve a workers’ compensation claim. Every case is different. Some cases can be resolved and settled in a few months, some can take years, and a few never settle at all. On average, though, a typical workers’ compensation claim can take about six months to settle, but, again, every case is different.
What happens if my employer won’t file a workers’ compensation claim?
There are a few reasons an employer might refuse to file a workers’ comp claim with their insurance company, such as your injury did not require medical attention, you were not actually injured on the job, you filed a false claim, or you failed to report the accident within the required time frame.
While these may be legitimate reasons for refusing to file, employers do not have the right to not report an accident. If your employer has an issue with your claim, they have the right to contest it – only after the report is made.
Some employers might offer to pay for medical treatment out of pocket, might tell you to use short- or long-term disability, or ask you to use your private health insurance to avoid filing a claim. Do not take the offer. If your condition gets worse or persists, you may miss the workers’ compensation filing deadline and miss out on benefits to which you’re entitled.
Can I get paid for pain and suffering?
No. This is perhaps the biggest misconception people have about work injuries.
Workers’ compensation is not a personal injury claim, and, therefore, you are not paid for pain and suffering. A personal injury (negligence) claim is based on a completely different set of laws that do allow monetary recovery for pain and suffering in those cases. A work injury claim against your employer is not a personal injury claim, and, therefore, the law does not allow for any monetary compensation for pain and suffering. Workers’ compensation ensures employees can secure benefits as a result of workplace injuries and pays benefits according to Georgia workers’ compensation law.
That being said, if your work injury was caused by another person or business not related to your employer (a third party), then you actually have two claims: a workers’ compensation claim against the employer (no pain and suffering) AND a personal injury claim (pain and suffering) against that third party who caused your injuries.
I am undocumented. Can I still obtain workers’ compensation benefits?
Yes, absolutely. Many businesses and industries in Georgia reap the benefits of using undocumented workers because the labor is cheaper.
It was determined a long time ago that, if an undocumented person is hired, then they should have the same protections as documented workers. There are a few instances where there could be a difference in entitlement to benefits, so please contact us for more details if this situation applies to you. However, don’t let your employer threaten or intimidate you into remaining quiet. You have rights under the law. Hire us, and we will put a stop to that intimidation immediately.
I keep getting calls from a nurse case manager. Who is this?
A nurse case manager (NCM) is a licensed professional hired by the insurance company to save them money on your claim. Plain and simple.
They are paid by the insurance companies to interfere with your medical treatment and to convince the authorized treating physician to limit your medical care and release you back to full-duty work as soon as possible. Your NCM may seem nice and may pretend to be your advocate, but don’t be fooled. They are there solely to advocate for the insurance company and against you.
Do NOT speak to a nurse case manager and do NOT allow a nurse case manager to enter into the examination room with you at your doctor appointments.
Unless your claim has been deemed catastrophic, you can opt not to have any communication or dealings with the NCM and can request that the NCM be excluded from the examination room.
As part of our services to our clients, we handle communications with nurse case managers and always instruct them that they are forbidden from communicating with our clients and are also forbidden from entering into the examination room with our clients.
Should I provide a recorded statement to the insurance adjuster?
No. If you are injured on the job, an adjuster with the insurance company will contact you and ask you to provide personal information and give a recorded statement detailing the accident. However, your recorded statement (no matter how truthful) plays a key role in denying claims, and it typically depends on the insurance adjuster handling your case.
You can and should decline the recorded statement, and then contact an experienced workers’ compensation lawyer who can provide counsel, advice, and guidance through the process and help you get the benefits you deserve by law.
Contact DeMedeiros Injury Law or call (678) 996-5050 for a free consultation.