Many Georgia employees can receive workers’ compensation benefits if they suffer an on-the-job injury or are diagnosed with an occupational illness.
Often shortened to “workers’ comp,” these no-fault benefits can cover your medical costs, offset a portion of your lost income, and provide disability benefits until you return to work.
However, insurance companies deny a significant number of workers’ comp claims every year. An experienced attorney can help remove any obstacles you encounter during the workers’ compensation process.
But how does workers’ comp work in Georgia? Here, the attorneys at Underwood Law LLC, explain the claims process.
Do You Qualify for Workers’ Compensation Benefits?
Who is Covered?
By law, most Georgia employers with three or more full-time, part-time, or seasonal employees must provide workers’ comp benefits to their workers. Coverage typically begins on your first day of work.
Who is Excluded?
There are some exceptions. Georgia workers’ compensation laws do not cover employees who work for U.S. government agencies and most railroads. Farm laborers, independent contractors, and several other occupations are also not covered.
When and How to Report an Injury
If you are a covered employee, you should qualify for workers’ comp benefits if you suffer an injury while performing your duties during regular work hours. You may still qualify even if you were not on the job site at the time of the injury.
The key is whether you were injured while performing duties in the “course and scope” of your employment.
You must report your injury to your employer within 30 days to obtain benefits. You may lose your right to workers’ compensation if you do not. Once you notify your employer, they must inform the State Board of Workers’ Compensation. This step sets the workers’ comp process in motion.
The path to workers’ compensation can be frustrating, involving extensive paperwork, phone calls, documents, and receipts. Hearings or mediations in front of an administrative law judge may be necessary if your employer or its insurer denies your claim.
A workers’ compensation attorney can review your situation and determine whether you are eligible for benefits. Once your attorney determines your eligibility, they can file a Georgia workers’ compensation claim on your behalf.
With a lawyer’s help, you may avoid clerical and administrative problems that often drag out the claims process.
What Does Workers’ Comp Pay in Georgia?
Workers’ compensation benefits provide medical and financial assistance to injured workers until they are well enough to return to the workplace. Benefits can include:
- Weekly payments to offset the loss of your regular paycheck, based on your pre-accident wage and subject to state-set caps
- Payments for authorized medical treatment, prescription drugs, and travel expenses
- Coverage for diagnostic imaging tests, surgery, physical therapy, and more
- Vocational retraining if you cannot return to your old job
Your medical and weekly benefits could last for life if you suffer a catastrophic injury. Otherwise, weekly benefits are capped at 400 weeks.
Weekly benefits begin once you have been unable to work for seven days.
You should receive your first payment within the first 21 days of being unable to work. You can receive a reduced weekly benefit if you can still perform some work but at a lower wage than before the accident.
Your employer likely will not pay workers’ comp benefits directly to you.
Instead, your employer’s insurance company manages the claims process and distributes the benefit payments (unless your employer is self-insured). The insurance company’s job is to help you return to work as quickly as possible while reducing the costs to your employer.
Insurers save money by making low settlement offers or denying claims completely. That’s why you should hire a workers’ comp attorney. A workers’ comp lawyer looks out for your interests.
Steps to File a Georgia Workers’ Comp Claim
Here are the general steps for filing a workers’ compensation claim in Georgia:
Step 1: Report Your Injury
Report your injury to your employer as soon as possible and within 30 days.
Step 2: Get Medical Treatment
Get medical treatment from an approved physician. Your employer can provide a list of approved physicians, or you can search the SBWC physician database.
Step 3: Gather Documents and Submit Forms
Gather documents and receipts related to your injury, medical expenses, employment, and wages/earnings
Fill out and submit Form WC-14 Notice of Claim to the Georgia State Board of Workers’ Compensation, your employer, and your employer’s workers’ compensation insurance carrier.
You are not required to hire an attorney to file for workers’ comp benefits.
However, getting a lawyer involved immediately may help avoid obstacles that could delay your benefits payments. Once the forms are submitted, you will receive a benefits decision from your employer’s insurer.
What to Do After You Receive a Benefits Decision
If your claim is approved, be sure to maintain your eligibility by following your physician’s orders for medical treatments or rehabilitation activities.
You will return to work when your doctor determines you are ready.
Appealing a Denied Claim
If you receive a claim denial or disagree with the amount or extent of benefits you’re scheduled to receive, you can appeal the decision by requesting a hearing. Appealing a workers’ compensation decision is a formal process before an administrative law judge.
You should strongly consider working with an attorney before appealing.
Frequently Asked Questions About Workers’ Comp Process in Georgia
Can I Receive Workers’ Compensation if My Injury Worsens Over Time?
Some pre-existing injuries can be aggravated by performing work-related activities.
In these situations, eligible employees can apply for Georgia workers’ compensation benefits to cover medical treatment, wage loss, and any disability stemming from the condition.
Workers’ compensation doesn’t just apply to injuries from a single event. Many types of job injuries develop over time, such as hearing loss, carpal tunnel syndrome, and repetitive stress injuries affecting the shoulders and back.
The key is providing evidence to your employer and their insurance company that the injury was caused or worsened by performing job duties.
To protect your right to workers’ comp, you must notify your employer within 30 days of becoming aware of the injury. With a gradual injury, determining a precise date can be difficult, so it’s best to report your injury as soon as you begin experiencing symptoms.
What Happens if My Employer Doesn’t Provide a List of Approved Physicians?
Your employer is required to post a panel of approved physicians for medical treatment under Georgia workers’ compensation law.
If your employer does not post a valid panel of doctors or fails to explain how to use it, you are entitled to choose any qualified physician, and your employer is required to cover the cost of your care.
Additionally, you have the right to request one independent medical examination (IME) within 120 days after you begin receiving income benefits for an accepted workers’ compensation claim.
Can I File a Workers’ Comp Claim for an Injury that Happened Offsite but During Work Duties?
Yes. What matters most when applying for workers’ comp is proving that the injury occurred within the course and scope of employment, not your physical location at the time of injury.
For example, delivery drivers spend all day on the road. Any number of workplace accidents could occur during that time, such as a car crash, an overexertion injury, or a slip-and-fall.
If an injury occurs while you were working, it should generally be covered by workers’ comp. However, injuries that happen during a lunch break or while driving home from work typically do not qualify for benefits.
How Do Lawyers Handle Disputes Over Partial Disability or Reduced Benefits in Georgia?
Resolving disputes is a key part of a workers’ compensation lawyer’s job.
When an employer or insurance company challenges the severity of a disability or reduces benefits without a valid reason, an attorney can gather medical records, supporting documentation, and other evidence to justify why you deserve full and fair benefits.
Workers’ comp lawyers can also negotiate directly with insurers, file appeals, represent you at hearings, and take your case to court if necessary.
Is it Possible to Pursue Additional Claims Against a Third Party While Receiving Workers’ Compensation?
Yes, in some cases. Georgia law prevents you from suing your employer for a workplace injury.
However, you can file for workers’ compensation benefits and insurers must send the first check within 21 days of your first missed day of work.
In addition, depending on the circumstances of your case, you may also be able to file a third-party personal injury claim after a workplace accident if someone other than your employer is responsible for your injury.
This could allow you to recover compensation for losses not covered by workers’ comp, such as the full amount of your lost wages and pain and suffering.
How a Workers’ Comp Lawyer Can Help
You don’t have to navigate the Georgia workers’ compensation process alone.
Let the attorneys at Underwood Law LLC file your claim and fight for the benefits you deserve.
With more than a decade of experience successfully obtaining benefits for injured Georgians, our legal team knows the tactics insurers use to deny workers’ comp to deserving claimants and will develop an effective strategy to strengthen your claim.
You can depend on our workers’ compensation lawyers to:
- Explain the benefits you qualify to receive
- Gather evidence to prove your eligibility
- Complete and file all the necessary claim forms on time
- Help you obtain all medical and rehabilitation benefits granted
- Represent you throughout the entire workers’ comp process, including at hearings, mediations, appeals, and trials
Need help with your GA workers’ compensation claim?
Call or contact us today for a free consultation.
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