Georgia Workers’ Comp Dos and Don’ts
If you’ve suffered a workplace injury, you’re entitled to receive workers’ compensation benefits.
The problem is that there are several workers’ comp dos and don’ts that can impact your chances of receiving the benefits you deserve.
The first thing to understand is that you are not the only person who finds all the workers’ comp dos and don’ts confusing.
According to the Bureau of Labor Statistics (BLS), “Over 78,000 nonfatal workplace injuries and illnesses were reported among Georgia’s private industry employers in 2019, resulting in an incidence rate of 2.5 cases per 100 full-time equivalent workers.”
Even though 78,000 were nonfatal, “41,600 were of a more severe nature, involving days away from work, job transfer, or restriction—commonly referred to as DART cases.”
With such a high number of workplace injuries, there are entire sets of legislation and state departments devoted to it (the State Board of Workers’ Compensation).
Given that there are so many rules and laws governing workers’ compensation benefits, it’s important you understand workers’ comp dos and don’ts so you know you’re being treated fairly by your employer and the worker’s comp insurance company.
Do Report Your Injury Immediately
If you are injured at work, you must report your injury immediately. Do not delay.
Let’s say you were injured at work on Friday, but you wait to tell your boss until the following Monday.
Your boss may question why you waited and falsely believe you actually were injured over the weekend outside of work.
Time is of the essence when it comes to workers’ comp claims. Under Georgia law, if you wait longer than 30 days to report an accident on the job, you can jeopardize your claim.
In addition, when you report your injury to your boss, you need to be very clear.
Spell it out. Don’t assume that if you say, “I need to go to the doctor” that your boss will understand that you were hurt at work.
Your boss may think you just aren’t feeling well or that your reason for going to the doctor doesn’t involve a workplace injury.
Instead, say something like, “I hurt my back lifting some boxes in the warehouse at work this afternoon and need to go see a doctor right now.”
It’s also recommended to put it in writing. This can be something as simple as a text message to your boss.
[Related Read: The Magic Words to Use When Reporting a Work Injury]
Don’t Lie about Your Injury or Medical History
A common workers’ comp mistake is failing to be honest.
We get it. It’s tempting to downplay your injury. For many of us, it’s almost natural to say something like, “Oh don’t worry about me. It’s not that bad” – even if the injury is bad.
Saying something like this when you report your injury can come back to bite you. Your boss may argue that you shouldn’t receive workers’ compensation because you said your injury “wasn’t that bad.”
If you are hurt, tell the truth!
Similarly, it is tempting to hide certain pre-existing conditions out of fear of the insurance company.
This is a mistake.
If you worsen an existing condition at work or re-injure it in a work-related accident, you are still eligible to receive workers’ compensation benefits under Georgia law.
However, insurance companies will try to use pre-existing conditions against you, but it is still better to be upfront about pre-existing conditions than for insurance companies to find it out on their own.
Do Seek Medical Attention Immediately
After reporting your injury to your supervisor, it is critical to seek medical care.
Even if your injury seems minor at the time, it may be much worse over time (such as a disk herniation or concussion).
For instance, I had a client who stubbed his toe and didn’t think too much about it at the time. Unfortunately, he was diabetic, and the stubbed toe injury caused an infection which resulted in amputation.
Moreover, seeking medical attention can add to the documentation paper trail when seeking workers’ compensation benefits.
Don’t Let Your Boss Choose Your Doctor
Don’t make the mistake of simply going to the doctor your boss suggests.
While your employer is supposed to have a list of valid physicians posted in the workplace, you still get to choose the doctor you want to see from that list.
The problem with going with your boss’s recommendation is not receiving the quality of care or treatment you deserve.
For instance, your boss may not want to lose a worker, so he may recommend a doctor with a reputation for being employer-friendly. This kind of doctor helps out the employer, not the employee.
If you go to an employer-friendly doctor, they may say you are ready for full-time work well before that is actually true.
Tip: If your employer does not post a list of physicians, you get to pick ANY doctor you want to be your authorized treating physician, and the insurance company has to pay for it.
Do Comply with Doctor’s Orders
If your doctor puts you on bed rest, stay in bed.
If your doctor restricts you from heavy lifting, don’t do any heavy lifting.
Failing to comply with doctor’s orders gives the insurance company cause to deny your workers’ compensation claim.
Don’t Speak with a Nurse Manager or Insurance Adjuster
If you have a workers’ comp claim, don’t speak to a nurse manager or an insurance adjuster.
It is especially important to watch your words.
These people will seem as if they are talking to you out of genuine concern. And they are – genuine concern for the insurance company, that is.
Insurance companies pay nurse managers to save them money on your claim.
They advocate for the insurance company by fighting for you to get back to work sooner or receive less medical care.
Not only should you avoid speaking to a nurse case manager, but you should also not allow a nurse case manager to be present during your examinations.
Also avoid giving an insurance adjuster a statement.
Sadly, even if you are truthful, insurance companies will often use your innocent remarks as a reason to deny your claims (such as the “it’s not too bad” statements).
Do Stay Aware of Surveillance
In addition to watching your words, you also need to watch what you do and say in public and online.
This is because insurance companies are notorious for hiring private investigators to spy on people who have filed workers’ compensation claims.
If they can catch someone not complying with doctor’s orders, they have reason to deny a claim.
If they find out someone is behaving as if they aren’t injured, they can fight the claim.
Even when it is completely innocent, such as lifting a large empty box, the insurance company can and will use surveillance photos and videos to make you out to be a liar.
[Related Read: Is My Workers’ Comp Insurance Company Spying on Me?]
Don’t Try to Handle It on Your Own
Don’t make the mistake of thinking you can handle your workers’ compensation claim on your own.
It’s not a matter of being smart or capable enough. It’s a matter of insurance companies.
Insurance companies put profits over people. They are out to save money – not give it away.
Therefore, they will do everything in their power to make it difficult for you to get the benefits you deserve.
You are far more likely to get more benefits or a better settlement if you allow a licensed attorney to deal with the insurance company headaches.
Do Hire a Workers’ Comp Attorney
At this point, let’s assume you know you need an attorney. However, you shouldn’t just hire any old attorney.
An experienced workers’ comp lawyer in Georgia understands the legalities specific in the state of Georgia (such as filing deadlines), as well as how to deal with insurance companies effectively.
[Related Read: 12 Questions to Ask a Workers’ Comp Attorney Before You Hire One]
Don’t Accept a Denied Claim
Unfortunately, workers’ compensation denials are common. But you can and should appeal the insurance company’s decision!
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.
Since a hearing requires litigation, it is important to have an experienced workers’ comp attorney represent you.
If you’ve been injured on the job, contact us today for a free, no-strings-attached consultation.