FAQs: Workers’ Comp
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If you are injured or become ill on the job – even if it happens on your first day at work and you are partially at fault for your injury – you should be covered under Georgia’s workers’ compensation laws.To help you understand your rights and some of the legal issues that could be involved in your workers’ compensation case, the Mann Law Firm provides the following “Frequently Asked Questions.” These FAQs are meant to provide general information and not legal advice. At Mann Law Firm, we believe it’s crucial to follow up on what you learn by contacting a lawyer to review the specific facts of your case. An attorney will work hard to protect your rights and guide you through the process of seeking the benefits you are entitled to receive. We are available to take your inquiries. Just call (478) 742-3381 or fill out our online contact form to schedule a free and confidential consultation. We help injured and ill workers throughout Macon and surrounding areas in Middle Georgia.
WHAT ARE WORKERS’ COMPENSATION BENEFITS?
In Georgia, any employer with three or more employees is required to provide workers’ compensation insurance. This insurance provides medical, disability and death benefits to workers (or their families) who suffer work-related injuries or occupational disease. For example, these benefits can pay for all medical expenses you incur because you were hurt on the job. These benefits could pay a portion of your average weekly wage if your injury leaves you unable to work or requires you to work in a lighter-duty, lower-paying job. If your loved one was killed due to a work accident or exposure to a harmful chemical, you could recover benefits, such as for funeral expenses or for a percentage of the income the deceased would have provided. You don’t need to show that your employer was at fault. Instead, you will need to meet all paperwork and procedural requirements and show that the injury, illness or death arose out of and in the course of the employment.
WHAT ARE THE FIRST STEPS I SHOULD TAKE IF I HAVE BEEN HURT ON THE JOB?
The most important step you can take after you are injured in a work accident is to immediately report the injury to your supervisor. You should fill out any forms or other paperwork that your employer provides you. You should also see a physician as soon as possible. As we will explain in more detail below, you will need to select a doctor from the list of physicians provided by your employer’s workers’ compensation insurance company. Next, you should contact an attorney to get help with filing a workers’ comp claim. Although you can represent yourself when seeking benefits, an attorney can use his or her training and experience to make sure you meet all requirements and to help you overcome legal obstacles that may get in your way. For instance, an attorney can help you to gather all documents you will need to prove that your injury was work-related, your average weekly wage and the out-of-pocket medical expenses you have incurred.
IF I’M RESPONSIBLE FOR MY WORK INJURY, CAN I STILL RECOVER BENEFITS?
It depends on what you were doing. If your injury resulted from you doing something wrong because you were in a rush or not paying attention to details, you should be covered under Georgia workers’ compensation law. However, if your injury resulted from you being in a fight, or fooling around, or if you were drunk or on drugs at the time, you would likely be barred from recovering workers’ comp benefits. An attorney can review the facts of your case and help you to determine your eligibility.
CAN I SUE MY EMPLOYER FOR MY INJURIES?
No, you can’t sue your employer. Workers’ compensation benefits are considered your “exclusive remedy” against your employer if you suffer a work-related injury or illness. However, if a third party causes you to suffer harm – for instance, you are hit by a negligent car driver while making a delivery in your work van – then you can file a claim against that party. When you file a workers’ comp claim, you don’t need to prove that anyone was at fault in order to collect benefits. However, when you file a personal injury lawsuit, you do need to establish the other party’s fault. Workers’ compensation claims are limited to covering a portion of your average weekly wages. In a personal injury lawsuit, on the other hand, you could recover all of your lost income as well as other compensation that workers’ comp does not provide, such as pain and suffering and punitive damages.
CAN MY EMPLOYER FORCE ME TO GO TO A DOCTOR THEY CHOOSE INSTEAD OF MY FAMILY DOCTOR?
Yes, your employer can require you to get treatment from a list of physicians that the employer has chosen. Your employer must inform you of this list and post it in a prominent location. This list can consist of a panel of physicians (at least six qualified physicians, including at least one orthopedic surgeon and one minority physician), a conformed panel (at least 10 qualified physicians) or physicians belonging to a workers’ compensation managed care organization (WC/MCO). If you don’t like your first choice, you can select another physician. However, you will need your employer’s permission to make any additional changes. If you don’t go to a physician from among the choices provided by your employer, then your treatment will be considered “unauthorized.” You won’t be reimbursed for your expenses.
WHAT CAN I DO IF I’M UNABLE TO WORK BECAUSE OF MY ON-THE-JOB INJURY?
If you miss more than seven days of work because of a job-related injury or illness, you are eligible to receive “temporary total disability benefits.” These benefits will cover two-thirds of your average weekly wages (or the maximum allowed under the law). You can receive these benefits within 21 days after the date of your injury, and they can last for up to 400 weeks. If, because of your injury, you are only able to return to work at a lighter-duty, lesser-paying job than you had before, you may be eligible for “temporary partial disability benefits.” These benefits would pay two-thirds of the difference between what you earned before and after your injury. They could be paid for up to 350 weeks after the date of injury. If you suffered a permanent disability, then you would be eligible for “permanent partial disability benefits” that would be based on a percentage assigned by an authorized treating physician and calculated according to a formula that takes into account the number of weeks assigned by the Georgia State Board of Workers’ Compensation and your temporary total disability rate.
CAN I RECOVER WORKERS’ COMP BENEFITS IF I RE-INJURED MY BACK AT WORK?
If you had a pre-existing back condition and aggravated it at work, the aggravation would be considered the compensable on-the-job injury – not the pre-existing condition. This means you would be eligible to receive benefits until you returned to your pre-injury condition. Cases involving pre-existing conditions can be hotly contested by both sides. An attorney can stand by your side if your employer argues that your injury condition was not aggravated at work.
WHAT OPTIONS DO I HAVE IF MY EMPLOYER’S WORKERS’ COMPENSATION CARRIER DENIES MY CLAIM?
If you comply with all requirements, and your employer’s workers’ compensation insurance provider denies your benefits claim, you can request a hearing before the State Board of Workers’ Compensation. You will appear before an administrative law judge. You will be able to present evidence and witnesses to support your claim, and you will be able to ask questions of the witnesses that your employer puts on the stand. At the end of the hearing, the judge will make a decision. You can expect that your employer will have an attorney on hand to represent his or her interests in this hearing. You should be represented by a lawyer as well. An attorney’s training and experience can make a major difference in the success of your claim. Keep in mind: If the judge rules against you, you can file an appeal with the Georgia Court of Appeals within 20 days from the date of the judge’s decision.
HOW LONG DO I HAVE TO FILE A WORKERS’ COMP CLAIM?
Generally speaking, you will need to file a workers’ compensation claim in Georgia:
- Within one year from the date of your injury, or
- Within one year from the date of your treatment if you received remedial treatment from your employer for your injury
- Within two years from the date of your last payment of weekly income benefits if you received weekly income benefits resulting from your work injury
- Within one year from the date you became aware of your occupational disease or, in the exercise of reasonable diligence, you should have known of the connection between your disease and your job (but no later than seven years after the date you were exposed to the hazards that caused your disease).
HOW WILL I PAY A LAWYER TO REPRESENT ME IN MY WORK INJURY CASE?
At Mann Law Firm, we represent workers’ compensation clients on a contingency fee basis. In accordance with Georgia law, we won’t charge you any fees unless and until we recover income benefits for you. Our fee will be limited to 25 percent of the income benefits you receive and can’t exceed 400 weeks of benefits.