At Montlick Injury Attorneys, our Workers’ Compensation Attorneys understand the difficulties associated with catastrophic workers’ compensation claims. Our firm has assisted numerous employees who have been severely injured on the job site. We understand the complex laws surrounding catastrophic injury claims and the obstacles you may face. Our firm fights hard on behalf of our injured clients to see that they obtain they compensation you deserve for their considerable injuries.

Defining Catastrophic Workplace Injuries

Catastrophic workplace injuries are defined in the Georgia code in O.C.G.A. 34-9-200.1. A catastrophic injury is considered any of the following:

  • Spinal cord injury involving severe paralysis;
  • Amputation of limb or body part;
  • Severe brain or head injury, involving:
  • Sensory or motor disturbances;
  • Communication disturbances;
  • Complex integrated disturbances in cerebral function;
  • Disturbances of consciousness;
  • Episodic neurological disorders; or
  • Other similarly severe conditions;
  • Extensive second or third degree burns;
  • Total or serious blindness; or
  • Any other injury of a nature and severity so as to prevent the employee from performing his or her work before the accident or any other work available in substantial numbers within the national economy that the employee is qualified.

As you can see, catastrophic work injuries are the most serious injuries. They encompass those injuries that are permanent or long lasting in nature and will prevent the injured employee from resuming the life they led before the accident. Definitions for catastrophic injuries in Georgia are stringent, and it can be difficult to prove you have sustained a catastrophic injury.

Causes of Catastrophic Work Injuries

Catastrophic injuries are not as common as routine workplace injuries. These injuries can occur due to pure accident, carelessness, or neglect. There are many potential causes of catastrophic workplace injuries. They include:

  • Falls—workplace falls occur most often in the construction industry. Construction workers and those in like professions will often find themselves working at extreme heights. Falls from heights can result in paralysis, head injuries, and more.
  • Fires—many workplaces contain combustible materials, such as refineries and construction sites. When a fire breaks out, employees in the vicinity may sustain second or third-degree burns, smoke inhalation injuries, and other fire-related injuries that can be deemed catastrophic.
  • Explosions—related to fires, these accidents can occur in workplaces that contain dangerous chemicals. They can also happen to truck drivers hauling gas and other combustibles. Explosions can inflict second or third-degree burns, blindness, and even death.
  • Automobile accidents—many workers will drive trucks or cars as part of their job. Serious car or truck accidents in a company vehicle can cause an array of catastrophic injuries, including head injuries, paralysis, amputation, and more. In most cases, if a negligent person or company other than your employer is responsible for your accident, you can pursue a personal injury claim against the third party, even while also recovering worker’s compensation benefits.
  • Machine malfunctions—those who work with any machinery could become injured due to machine malfunctions. Malfunctioning machinery can amputate limbs, cause explosions, or crush employees. At times, the machine manufacturer may be responsible for injuries resulting from malfunctions with their product.
  • Electrocutions—electricians and utility workers are exposed to sources of high electricity on a daily basis. Serious electrocutions can cause deafness, head trauma, falls, and more.

Eligibility Requirements for Catastrophic Determinations

To be eligible for catastrophic benefits under Georgia law, you must first prove your injury is catastrophic. If your injury meets one of the specific catastrophic injuries outlined in the code statute above, you may have an easier time meeting the eligibility requirements. If your injury is serious and long term in nature and prevents you from performing a substantial gainful work activity, you could qualify for catastrophic benefits, but you will need to prove your injury meets the definitions set out in Georgia law.

Regardless of your specific injury, you will need to submit considerable medical evidence and vocational evidence to validate your claim. Relevant evidence will include:

  • Emergency room bills and notes
  • Doctor’s bills and notes
  • Records from any specialists
  • Your doctor’s written opinion as to your ability to work and the likely prognosis of your injury
  • Your personal narrative as to how the injury has affected you and your ability to work
  • Records from your time off work
  • Narratives from your friends and relatives as to the impact of the injury
  • A letter from your employer stating that you would be unable to return to your previous position
  • College degrees, your resume, and work experience to establish your qualifications
  • A letter from a job placement agency as to your inability to perform jobs that are currently open
  • Prescription medication records
  • Rehabilitation records
  • Notes from your rehabilitation clinic as to your progress and likely recovery
  • Pictures of your injuries
  • Records of your approval for Social Security Disability benefits

These are just some suggestions that can help to prove your workers’ compensation claim. Our workers’ compensation attorneys guide our clients in gathering necessary evidence and submitting the strongest possible claim in order to maximize the value of their cases under the law. Georgia law requires that the workers’ compensation board will consider whether your doctor has released you to work and whether you have been granted or denied disability benefits. If your doctor has released you to work with restrictions, this creates a rebuttable presumption that the injury is not catastrophic.

Each injury is unique and those injured severely in a workplace accident should consult with a workers’ compensation attorney as soon as possible. The workers’ compensation process can be complex for any claim, but especially so for those with catastrophic injuries who may need to seek large benefits due to the ongoing nature of their injuries. Your attorney will have experience in the realm of catastrophic injuries and can help you to expedite your action.

Losses Associated with Catastrophic Workplace Injuries

While any workplace injury can be painful and potentially debilitating, catastrophic injuries are the most serious and are associated with the greatest losses. If you have sustained a catastrophic injury in a workplace accident, you will likely experience the following economic losses:

  • Lost wages
  • Future lost wages
  • Medical expenses
  • Rehabilitation expenses
  • Lifelong disability expenses
  • Prescription drug costs

Catastrophic injury claims are often denied or minimized because these claims cost them significant sums of money. For this reason, the board or insurer may attempt to deny claims for the following reasons:

  • The injury is not catastrophic—you may be told that your injury does not meet the definition of catastrophic because it is not serious enough or does not prevent you from returning to work.
  • You could work in a different field—if your injury is clearly serious enough to prevent your return to your previous job, your claim could still be denied if the insurer claims you could find work in another field. You will need to combat this with evidence as to your qualifications and your doctor’s beliefs as to your ability to work.
  • You returned to work after the accident—Georgia law states that there will be a rebuttable presumption that your injury is not catastrophic if your doctor releases you to return to work with restrictions within 130 weeks from the date of the injury.
  • You have reached retirement age—once you reach retirement age, Georgia law has a rebuttable presumption that the injury is no longer catastrophic.

If your injury is not deemed catastrophic, your benefit period will be a maximum of 400 weeks. Accordingly, for those with severe and long lasting injuries, it is absolutely critical that your claim is accepted as catastrophic by the workers’ compensation board. Those with catastrophic injuries do not have a maximum time frame in which they can receive benefits; rather, they may receive lifetime benefits.

Frequently Asked Questions About Catastrophic Workplace Injuries

My claim for a catastrophic injury in the workplace was denied. Is there anything else I can do?

Yes. While it can be nerve-wracking to have your claim denied, do not panic because this is not uncommon, and you still may be able to obtain benefits. Consult with one of our workers’ compensation attorneys as soon as possible after your denial so that they can assist you with your appeal, requesting a rehearing, or otherwise proceeding with your claim.

How much will my workers’ compensation benefits be?

This will depend upon your precise damages, but you will likely receive two-thirds of your weekly wage, not to exceed $550 per week. Your medical expenses, prescription drugs, and rehabilitation costs should be covered through your benefits. If your injury qualifies as catastrophic in nature, you may receive lifetime benefits.

I was injured in a car accident while on the job. Am I entitled to any compensation outside of workers’ compensation?

Potentially. If you are injured on the job due to the negligence of a third party, which could be another driver or the manufacturer of a defective product, you may be able to seek compensation for your catastrophic injuries from the third party at-fault for the accident. You could receive greater compensation in this manner, including damages for pain and suffering.

Can I receive Social Security and workers’ compensation benefits at the same time?

Yes, you can receive both, but your Social Security award may be reduced. The workers’ compensation board may consider your award of Social Security benefits in making its assessment as to whether your claim is catastrophic.

How do I file a workers’ compensation claim?

You will first need to report your injury to your supervisor immediately. You will likely need to complete an injury report. You should then consult with a workers’ compensation attorney who can walk you through filing the claim through the appropriate channel.