Filing a Workers’ Comp Claim
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After getting hurt on the job, you should be entitled to medical coverage and other benefits.You can make a work injury claim when an accident injures you, when you are diagnosed with an occupational disease or when you develop a repetitive stress or overexertion condition from your work. Regardless of the specific nature of your injury, there are certain steps that you must take in order to make a workers’ compensation claim and receive benefits. An experienced workers’ compensation lawyer at the Mann Law Firm can guide you through the process and help you pursue the benefits you need. We serve clients in Macon and surrounding communities in Middle Georgia. Contact us to learn more.
So you will know what to expect throughout the claims process, you can also review the following guide on the steps involved in filing a worker’s compensation claim in Georgia.
1. Notify your employer of the injury immediately.Under Georgia law, you have 30 days from the time of your accident to provide notice to your employer. Although notice can be given orally, in person, within the 30-day period, the best practice is to give the notice in writing (which ensures you have proof that you reported your injury). The notice can be given to your human resources office, immediate supervisor, foreman or other person designated by your employer to receive this notice. The notice must state the time, place, nature and cause of the accident and of the resulting injury you suffered. If you fail to give notice within this time period, you may be barred from obtaining benefits unless you can show a “reasonable excuse” for failing to give notice and prove that your employer suffered no harm, or “prejudice,” due to your failure to give notice.
2. Seek medical help.Your employer must have a posted list of at least six doctors that provide treatment to workers injured on the job. Generally speaking, you have to see a doctor on the list for your treatment to be covered. However, in an emergency situation, you can get temporary medical care from any healthcare provider available. Getting medical help is important to ensure that you can prove that you actually suffered a work-related injury. So, you should not delay getting the treatment you need.
3. Document your time off from work.You need to keep track of any time that miss from work due to your work-related injury. You are entitled to weekly income from workers’ compensation once you have missed at least seven days of work due to your injury. You should get your first check for disability income within 21 days of the first day of work that you missed.
4. Consult with an attorney.You should speak with an attorney about your case without delay. You can learn about your legal rights and options if a dispute or problems arises with your claim. Your attorney can take steps that will protect you if there is an unreasonable delay in receiving your benefits or an unjust denial of your claim.
5. Ensure your employer has filed the required documentation.The Employer’s First Report of Injury or Occupational Disease (WC-1 form) should be filed by your employer with its workers’ compensation insurer or self-insurer office. The insurer then files the form with the State Board of Workers’ Compensation. If you do not receive benefits or if you are unsure whether any action has been taken on your behalf, then you should contact your employer or the insurer (or ask your attorney to make this inquiry).
6. File a WC-14 Notice of Claim form.You may need to complete the WC-14 Notice of Claim form to protect your right to make a claim for work injury benefits. The WC-14 Notice of Claim is available from the Georgia State Board of Workers’ Compensation (SBWC). You can use this form to alert the Board that you have made a workers’ compensation claim and you can use the form to request a hearing if there is a dispute over your eligibility for benefits. Generally speaking, you have one year from the time of the injury (or within one year after you know or should know about your occupational disease) to file your claim. So, do not hesitate to act.
7. Filing Notice of Appeal if your claim is denied by your employer’s insurer.If your employer’s insurer or self-insurer denies your claim for workers’ compensation benefits, you have several levels of appeal that you can go through:
- Hearing before an SBWC Administrative Law Judge
- Appeal to the SBWC’s Appellate Division, or “Full Board”
- Appeal to Superior Court
- Appeal to the Georgia Court of Appeals
- Appeal to the Supreme Court of Georgia.