Georgia Workers' Compensation Frequently Asked Questions
If you suffer a job related injury under Georgia Workers’ Compensation Law, you are entitled to compensation for medical expenses, a portion of your lost wages, and other benefits. A workers' compensation claim is different than a personal injury claim for injuries because you do not have to prove that your employer was at fault. The workers’ compensation system was designed to provide a fast efficient legal remedy for employees that suffer job related injuries and occupational illnesses. The workers’ compensation system can be complicated so it is easy to make a mistake that limits your claim and results in you receiving less than you were entitled to under law. The law firm of Montlick and Associates, Attorneys at Law, has been representing people injured on the job in the greater Atlanta area and throughout the State of Georgia for over 25 years. We get many inquiries from those who suffer a job related injury or occupational illness with basic questions about their rights. We have provided answers to some of the most commonly asked questions below.
What is workers’ compensation?
Workers’ compensation is an insurance system required by state law that provides compensation to employees for work related injuries or occupational illnesses on a no fault basis. While the system does not require that an employer be at fault for an employee's injuries (it pays even if the injuries were your fault), it also shields the employer from liability for personal injury lawsuits resulting from work related injuries.
What compensation is available in workers' compensation cases?
An employee who suffers a work related injury or occupational illness may be entitled to receive compensation for all medical expenses, a portion of your lost wages, compensation for permanent functional impairment of the injured body part, and in some cases vocational rehabilitation. The compensation available in a workers’ compensation case is relatively modest compared to what is typically available in a personal injury lawsuit.
Can I choose to bring a personal injury lawsuit against my employer instead of filing a workers’ compensation claim?
If your employer has 3 employees or more, and is covered under the Workers’ Compensation Act, you may not pursue a personal injury lawsuit against your employer for work related injuries or occupational illnesses. The workers’ compensation system is an “exclusive remedy” for such injuries.
What if other parties besides my employer were responsible for my injuries?
Because the compensation offered by the workers’ compensation system is often relatively modest, it is important to consider third party claims. A third party claim allows an employee to pursue a personal injury lawsuit against other parties that may have contributed to an employee’s injuries. Other parties that contribute to an employee’s injuries may include intentional acts of a coworker, equipment manufacturers or suppliers, sub-contractors, and the like. The most common instance of an injury due to a third party occurs when an employee is operating a vehicle in the scope of employment and is injured due to the negligence of the driver of another vehicle. Under this example, the injured worker can also make a claim against the driver of the other vehicle. Because the workers’ compensation system is an exclusive remedy only with respect to employers, an employee can seek personal injury damages which are typically much greater against third parties.
Who is covered by the workers’ compensation system?
Generally, all employees of employers with at least 3 or more employees are generally covered under workers’ compensation if the employee is injured in the course and scope of employment. This generally means that the employee was on the clock, or performing some act that had benefits to the employer off the clock, such as a business errand, a business social function (like a company picnic), or some other activity that benefits an employer. However, even before an employee arrives at work, or after leaving work, there are instances in which an injury on the premises of the employer shortly before or after work is deemed to be work-related.
Are there exceptions where I may not be covered by workers’ compensation insurance?
If an employee is off the clock, such as on the way home from work, the employee’s injuries would not be covered unless the employee is engaged in some sort of business errand during the commute. Whether an employee is covered during a “lunch break” or when driving home from lunch can be a complex issue- sometimes you are covered and sometimes you are not; an experienced workers’ compensation attorney can help you make this determination. (By way of example only, generally an injury that occurs during a “regularly scheduled” lunch break is outside the scope of employment. However if the lunch break is not regularly scheduled and is in any way contingent on the demands of work, or if the employer restricts the movements of the employee during the lunch break such as requiring the person to be on the premises or to be available to respond to business emergencies, then those restrictions imposed for business reasons for the benefit of the employer are likely to cause the lunch break to be considered in the course and scope of employment). If an employee is injured as the result of being intoxicated or under the influence of drugs on the job, such injuries would also not be compensated by workers’ compensation. Injuries resulting from "horseplay," and fighting may also be excluded.
What if my injuries were a result of my own carelessness?
The workers’ compensation system is a “no fault” insurance program so it does not matter if you are at fault except for very narrow situations like drug and alcohol related accidents. Generally, the fault of the employer or employee is irrelevant in pursuing a workers’ compensation claim.
Do I need to notify my employer if I am injured?
You are required to notify your employer of a work related injury or occupational illness and should do so as soon as possible. With some exceptions, Georgia Law requires you to notify your employer of a work-related injury within 30 days. However, the earlier that you notify the employer, the greater the likelihood your claim will not be questioned, and the sooner you can obtain medical attention.” You should file an accident report. Be aware that a workers’ compensation insurer may wish to take a recorded statement as part of an investigation of your claim. Without realizing it, providing such a statement without the advice of an attorney may cause your claim to be harmed or denied completely. If you are asked for such a statement, we recommend that you arrange for the statement at a later time, and contact an attorney immediately prior to giving the statement. You should contact an experienced workers’ compensation attorney as soon as possible. Other than an accident report, do not sign anything that either the employer or insurance company asks you to sign without seeking legal advice.
My brother in California previously filed a workers’ compensation claim, so can I just do what he did?
Workers' compensation is governed by state law so it differs from state to state. There are many similarities between states, but there are nuances that are unique to Georgia. You should seek the legal advice of a qualified Georgia workers’ compensation attorney who can make sure you receive the compensation you are entitled to under Georgia law. Employees of the federal government are covered under federal law.
How much income replacement will I receive?
Georgia workers’ compensation law requires an employer to pay two-thirds of your average weekly income up to the amount specified by law, which changes from time to time. For example, as of September, 2010 that amount is a maximum of $500 per week for injuries occurring on or after July 1, 2007. Your compensation rate is determined by the law in effect on your date of injury.
Can I be fired for making a workers’ compensation claim?
Georgia law does not prohibit an employee from being terminated for making a worker’s compensation claim. However, you may continue to receive workers’ compensation benefits if this happens. An employer who terminates an employee for filing a workers’ compensation claim may be liable under federal law.
How do I pick a doctor?
Under Georgia workers’ compensation law, the employer is supposed to post a panel of doctors that you may choose from and explain how to seek medical attention from a doctor on the panel after you report your injuries. There are strict rules that govern this notice requirement, and employers frequently fail to meet all the requirements. If the employer does not meet all of the requirements, you may be able to see a doctor of your choosing. You should be very careful about what you say to the doctor as it may be used against you later. If your doctor questions you about your past medical history, it is important to be honest, even if you have had similar injuries in the past. However, it is important to distinguish the severity of your present symptoms compared to any symptoms before your accident at work. It is also important to let the doctor know if the symptoms from the prior injury had resolved prior to the present injury and the length of time that has passed since your symptoms had resolved. The first medical care you are likely to receive in a workers’ compensation claim will likely occur at an industrial medicine type clinic. Be aware that the physicians at these clinics are typically generalists, not specialists. Moreover, since they depend upon employers to provide their clinics with patients, there can be a bias that favors the interests of the employer. If your symptoms do not improve shortly, or if you feel that the physician does not have your interests as a patient at heart, it is important to seek the advice of an attorney to learn your options for changing physicians. The rules concerning physician change are complex and restricted, so an attorney’s advice is essential. Your best option is to contact a qualified Georgia workers’ compensation lawyer before seeing or selecting a doctor.
Do I have to return to work with my employer?
The decision of where to work is totally up to you. However, if a doctor approves you for light duty and such work is offered to you by your employer, your refusal to perform the work may impact your workers’ compensation income replacement benefits. There are very important protections available to you if your physician places you on work limitations. If you are receiving lost wage benefits, your employer must adhere to strict procedures in offering modified work before your wage benefits can be cut off. If your employer is asking you to perform duties that you think you are not capable of doing with your current medical condition, you should contact a workers’ compensation attorney as soon as possible.
What happens if I settle my case for a lump-sum, but then learn I have additional injuries?
Once you settle your case for a lump sum, the case is over. You will likely be responsible for any medical treatment associated with the subsequently discovered injuries. You should always seek legal advice before settling your workers’ compensation claim for a lump sum.
Since workers’ compensation is “no fault,” why do I need an attorney?
The paperwork and procedures associated with workers’ compensation claims can be complex and confusing. It is easy to give conflicting statements or make disclosures that are misconstrued and damage your right to receive the maximum claim. There are a number of situations where workers’ compensation insurance carriers attempt to deny claims: (1) They challenge your claim that your injuries occurred within the course and scope of employment; (2) They claim your injury is not real or is exaggerated; (3) They claim your injury is the result of a pre-existing condition that you lied about; or (4) The employer simply fires you and attempts to ignore your claim. Frequently, even if your claim is accepted, the insurer may deny treatment and procedures recommended by your doctor, or deny that certain medical problems are related to the injury at work. Also the insurer may try to stop your disability benefits even when you consider yourself to be disabled. Additionally, insurance carriers may not pay you all of the money and benefits to which you are entitled. Remember that the insurance adjuster works for the insurance company. The insurance company makes money by paying you as little as possible. Additionally, the insurance companies have lawyers protecting their rights- shouldn't you have someone protecting yours? A qualified Georgia workers’ compensation lawyer will know how to deal with these situations so that you obtain the compensation that you are entitled to under Georgia law.
If I have a pre-existing injury will that prevent me from receiving workers’ compensation benefits?
Generally, a pre-existing injury will not preclude you from receiving benefits if a work related accident made the injury worse or aggravated the injury.
Can an employer have someone spy on me?
Unfortunately, many times workers’ compensation cases are damaged because an employer obtains video or pictures that may be misleading. An employer may put you under surveillance and take pictures or video to suggest that you are not injured or are exaggerating the extent of your injuries. You should be very careful about doing physical work outside that could be caught in a picture and misconstrued. If you have a workers’ compensation case pending, you should always presume you are being watched when you engage in physical activity.
What is an occupational illness?
Worker’s compensation covers claims other than just injuries resulting from accidents. If you have a condition that develops gradually over time, such as, mesothelioma as a result of asbsestos exposure, these claims are also covered.
At Montlick and Associates, Attorneys at Law, our Georgia workers' compensation attorneys know that a job related injury or occupational illness can be stressful and pose enormous financial pressures. We have been representing employees who are injured on the job for over 25 years. We have helped injured wokers throughout all of Georgia including, but not limited to, Albany, Athens, Atlanta, Augusta, Columbus, Macon, Marietta, Rome, Roswell, Savannah, Smyrna, Valdosta, Warner Robins and all smaller and rural towns in the state. Call us today for your free consultation at 1-800-LAW-NEED (1-800-529-6333), or visit us on the web at www.montlick.com. No matter where you are in Georgia, we are just a phone call away, and we will even come to you. Montlick & Associates: Experience that Pays!