Although, generally, workers’ compensation is similar across state lines, each state has its own particular laws that govern these claims. An experienced Georgia workers’ compensation attorney can assist in ensuring that a legitimate workers’ compensation claim is approved. It is true that sometimes employers and their workers’ compensation insurance carriers quickly pay out benefits, however, this is the exception to the rule. More often than not, insurers are reluctant to pay out benefits to an injured employee. Some reasons may include concern for paying out fraudulent workers’ compensation claims or simple financial interests. Likewise, an employer may not want to approve a claim out of fear that premiums will increase or in an attempt to cover up the injury and deny the incident ever occurred.
Workers’ Compensation Basics
Georgia law mandates that any company that regularly employs three or more people – including part-time workers – must provide workers’ compensation insurance coverage.
The Georgia Workers’ Compensation Act (GWCA) has all of the required rules and regulations regarding individuals who suffer a workplace-related injury or illness. The GWCA states that anyone who is unable to work due to a workplace accident or injury is entitled to workers’ compensation benefits, which include payment of two-thirds of the victim’s weekly income (not to exceed $550 per week) for up to 400 weeks. In particularly serious cases, when catastrophic injuries are suffered, a claimant may be entitled to receive benefits for life. Moreover, employers are required to pay any and all reasonable medical expenses resulting from the injury or illness for which a claim is made.
Why You Need an Attorney
A Georgia workers’ compensation attorney can increase the chance of a claimant receiving benefits for his or her workplace injury or illness when compared to an individual seeking these benefits on his or her own. A skilled workers’ compensation lawyer can gather medical and non-medical evidence including medical records, safety reports, eyewitness accounts and other information to help bolster a claim. Moreover, should a workers’ compensation claim be denied, the attorney can file an appeal with the Georgia Workers’ Compensation Board and demand these benefits be paid out.
Like other states, Georgia workers’ compensation covers the cost of medical treatment, lost wages, as well as permanent and partial disability benefits. A knowledgeable workers’ compensation attorney can determine whether or not a claimant can seek out additional compensation from a third party, such as an entity other than the employer, if blame can be assigned.
Filing a Workers’ Compensation Claim
Under state law, a Georgia employee who is injured has 30 days to file his or her notice of injury with the employer. It is in an injured or sick worker’s best interest to file this notice right away, or as soon as is practicable. This notice is required before the actual workers’ compensation claim is initiated.
After a notice of injury is filed, a Georgia workers’ compensation attorney can assist with completing and filing a WC-14 form with the Georgia State Board of Workers’ Compensation (GSBWC). Several details that must be addressed to proceed with the claim include: accessing records of the employee’s wages, determining where on the work site the injury or sickness took place, confirming employment status with the employer, proving the injury or sickness was a result of the regular course of employment, and ensuring that the GSBWC has jurisdiction over the matter.
If Your Workers’ Compensation Claim is Denied
There are several tactics an insurance carrier may try to use to undermine someone’s workers’ compensation claim. Some of these include:
- Claiming the injured or sick employee suffered the injury due to his or her own negligence;
- Terminating an injured employee who has received a return to work clearance from an employer-assigned doctor;
- Giving the employee a negative performance review unjustly;
- Alleging the injury or sickness took place outside of the workplace or course of regular employment; and
- Asserting that the employee’s injuries have healed and, therefore, no benefits are payable.
If a workers’ compensation claim is denied, the next step is to appeal this decision. The first step of this process in Georgia is to seek a hearing, which is generally scheduled two to three months after the victim initially filed for workers’ compensation benefits. During this hearing, an Administrative Law Judge (ALJ) will hear the case and either issue an award or confirm the insurance company’s denial of the claim. An injured or sick employee may pursue further appeals, even to the state Supreme Court, if the request is granted.
Independent Contractors and Workers’ Compensation
Typically, independent contractors are not entitled to workers’ compensation. This is not only true in the state of Georgia, but in states across the nation. As a result of this exemption, employers commonly attempt to misclassify workers as independent contractors – especially victims of workplace injuries or illnesses – in an attempt to avoid paying workers’ compensation benefits. Even if an employer were to misclassify an employee, he or she may still be entitled to workers’ compensation benefits if the following are true:
- He or she does not personally control the working conditions;
- A structured work schedule was provided by a third party; and
- The means by which the individual completes his or her job duties is dictated by another person or organization.
Settling a Georgia Workers’ Compensation Claim
Settling a workers’ compensation claim is completely voluntary. In other words neither the victim nor the insurance company is obligated to settle the matter out of court. Work-related injuries or illnesses in Georgia are not compensated as personal injuries and, therefore, there is no element of pain and suffering or loss of consortium in the claim.
There are several factors that go into a workers’ compensation settlement. These include: a permanent impairment rating assigned by an authorized treating physician. This is pursuant to specific guidelines, and is used to calculate with a formula based on the person’s compensation rate; an amount specifically designated for closure of medical care costs; and an evaluation for future income benefits if a doctor has placed the victim on work restrictions that the employer cannot accommodate or if the person is presently off of work.
Workers’ Compensation Help in Georgia
If you or someone you know has been injured or contracted an illness at the workplace, contact the skilled Georgia workers’ compensation lawyers at Bader Scott Injury Lawyers to help determine if you are entitled to benefits. Click here today to schedule your initial case evaluation.