Nearly all workers in the United States are protected under some form of workers’ compensation insurance, although each state has the autonomy to form its own workers’ compensation laws. Despite the fact that the regulations and rules for workers’ compensation may vary on a state-by-state basis, the premise of workers’ compensation insurance is the same nationwide: to provide injured workers’ with medical benefits and lost wages when a workplace accident results in an injury. If you have been injured while on the job in Atlanta, you probably have a workers’ compensation claim.
Workers’ Compensation and Fault
One of the central points of workers’ compensation insurance is that it is no-fault based; workers have the right to seek damages for their injuries regardless of whether or not they contributed to them. In exchange for no-fault benefits, the worker forfeits their rights to sue their employer. This means that even if you did something to contribute to the occurrence of your injury, you can still file a claim for workers’ compensation insurance; your employer cannot bar you from recovering benefits because you were (partially) to blame. It also means that your employer is shielded from tort liability, so even if your employer was to blame for the injury, you cannot sue them.
The only time that a worker may not qualify for benefits is in the event that their willful misconduct was the cause of the injury (i.e. fighting with another employee or being intoxicated while on the job).
What Type of Injury Qualifies for Workers’ Compensation Insurance?
Workers in the state of Georgia are not only eligible for benefits when they sustain an acute injury; acquired injuries and illnesses also qualify a worker for benefits. Assuming that the injury, illness, or death arose out of and in the court of employment, the worker suffering from the injury, illness, or death is eligible for workers’ compensation insurance.
Who Qualifies for Workers’ Compensation in Georgia?
According to the Georgia State Board of Workers’ Compensation, all of those employers with three or more regular employees/workers are required to carry workers’ compensation insurance. Employees can be part-time, full-time, minors, or any other person who is working under contract of hire, written or implied. This means that even if you are a part-time employee, are not yet a legal adult, or are working without proper authorization, you have the right to workers’ compensation insurance when you are injured on the job.
Benefits Available Under Workers’ Compensation
An Employee Handbook provided by the Georgia State Board of Workers’ Compensation provides a detailed explanation of the benefits that a worker injured in the state of Georgia is entitled to receive. These benefits include:
- Medical benefits. A worker who is injured on the job is entitled to all necessary and reasonable medical benefits, including doctors’ visits, hospital visits, surgeries, rehabilitation, medications, and more. You do not have the right to visit your own physician, but instead must select from a list of physicians provided by the workers’ compensation insurance provider.
- Income benefits. In the event that your injury forces you to miss work, you may be eligible to recover income benefits. Income benefits are available to those workers who miss seven or more days of work due to a workplace accident. In the event that your time missed from work extends to more than 21 days, then you will also receive pay for the first seven days of missed work. If your injury is catastrophic, you are eligible to receive benefits for the entirely of the time that you are unable to return to work; if your injury is non-catastrophic, wage benefits are paid up to 400 weeks.
- Death benefits. In some cases, a workplace injury can result in death. If this is the case, your dependents are eligible to receive death benefits, including benefits for burial and funeral expenses and lost wages.
As a note, workers who are eligible to receive income benefits will do so at a rate that is equal to ⅔ of their average weekly wage, up to the maximum allowable amount.
How to File a Claim for Workers’ Compensation Insurance in Atlanta
In order to ensure that your right to benefits is protected, it is important that you take action quickly from the moment that your workplace accident occurs. If you delay, you may forfeit your right to compensation.
As an injured employee, you have the responsibility to report the accident to your employer immediately. In fact, you must report the injury within 30 days’ time after the injury occurs.
After you have reported the injury to your employer, your employer is required under law to file a First Report of Injury or Occupational Disease form. If your employer does not report your injury, they may face civil penalties. If your employer refuses to report your injury, it is important that you seek legal counsel as soon as possible – otherwise, time may run out. You may file a claim with the State Board of Workers’ Compensation on your own; the time limit for doing so is one year from the date of your workplace accident.
Appealing a Denied Claim
If your employer or the insurance carrier responsible for providing you with workers’ compensation denies your claim, you have the right to take legal action. It is within your best interest to secure the counsel of an experienced Atlanta workers’ compensation attorney to help you appeal a denied claim.
If your claim is denied, the State Board of Workers’ Compensation will send you a notice explaining the denial. At this point, you have a right to request a hearing before the State Board of Workers’ Compensation.
During a hearing, you will have the opportunity to present evidence that supports why you deserve workers’ compensation benefits. Evidence that you are allowed to present includes your own testimony, expert testimony (from medical experts), testimony from any other relevant witnesses, and any other evidence that may be essential to your case. A hearing takes place before judge, who will issue their decision about your claim.
Even if the judge who presides over your hearing issues a decision that is not in your favor, your claim is not necessarily over. In fact, you have the right to file an appeal with the Appellate Division of the State Board of Workers’ Compensation insurance. You must file this appeal within 20 days’ time of receiving notice that your workers’ compensation claim has been denied.
Filing a Workers’ Compensation Claim and a Third Party Liability Claim
You are barred from filing a civil action against your employer after being injured on the job (unless your employer willfully or wantonly caused your injuries). However, you may file a civil action against a negligent third party who caused or contributed to your injury. This might include the manufacturer of a defective product, the owner of a dangerous property, the driver of a vehicle that hit you, or anyone else whose negligence directly caused/contributed to your harm. In some cases, you may be able to file both a third party liability claim and workers’ compensation claim for benefits. A third party liability claim allows you to recover noneconomic benefits, like compensation for pain and suffering.
Why You Need a Workers’ Compensation Attorney
Some workers’ compensation claims are straightforward. Consider the following: a worker falls on the job and suffers a cut, for which they seek stitches. They take the rest of the day off, as well as the following day, but return to work the third day. They immediately notify their employer of the injury and medical treatment received, who then files a First Report of Injury. The workers’ compensation insurance carrier quickly reimburses the employee for the money they spent on stitches. The claim is settled.
But other workers’ compensation claims are just the opposite. An employer may deny an employee coverage, an employer may be released back to work before they are ready, or there may be a dispute over whether or not an employee caused their injuries due to reckless or wanton conduct. When this is this case, and a workers’ compensation claim is more complex, it is within an employee’s best interests to hire a workers’ compensation attorney.
A workers’ compensation attorney will ensure that all paperwork and necessary forms are filed within a timely manner. They will also help you to gather evidence, appeal a denied decision, and recover your full benefit amount. The best part about having a workers’ compensation attorney is that you have someone who will advocate for you and who doesn’t charge a fortune; Georgia law limits the amount of money a workers’ compensation attorney can receive to 25 percent of the worker’s income benefits.
Atlanta Workers’ Compensation Attorneys Serving You
At the Bader Law Firm, LLC, our experienced Atlanta workers’ compensation attorneys are just a phone call away. If you are looking for an advocate who will get to work on your case immediately, who will put your needs first, and who will not give up until your case is settled, contact our law firm as soon as possible. You can reach us by phone or by using our online contact form.