FREQUENTLY ASKED QUESTIONS AND ANSWERS ABOUT GEORGIA’S WORKERS’ COMPENSATION LAW
WHAT IS WORKERS’ COMPENSATION?
Workers’ compensation is an accident insurance program paid by your employer which may provide you with medical benefits and income benefits if you are injured on the job. It also provides benefits to you if you were dependent upon a Georgia worker who died as a result of a job-related injury.
HOW LONG DO I HAVE TO WORK TO BE COVERED UNDER WORKERS’ COMPENSATION?
You are covered from the first day on your job.
HOW DO I KNOW IF THE COMPANY I WORK FOR IS COVERED BY WORKERS’ COMPENSATION?
The law requires any business with three or more workers, including regular part-time workers, to have workers’ compensation insurance.
WHEN SHOULD I REPORT AN ACCIDENT THAT HAPPENDED ON THE JOB?
You should report any accident occurring on the job to your employer (boss, foreman, or supervisor) immediately. If you wait longer than 30 days, your ability to recover benefits may be impaired.
WHAT DO I DO ABOUT A DOCTOR?
Your employer is required to post information identifying medical care providers. Your employer will usually satisfy this requirement by posting a Traditional Panel of Physicians consisting of a minimum of six doctors. Although your employer will often try to steer you to a specific doctor, you are entitled to choose any one of the six on the panel. The panel must include one orthopedic physician and not more than two industrial clinics. Where possible a minority physician must be included. You may make one change to another doctor on the list without the permission of your employer. The choices on your employer’s panel will often include “company doctors” that will not treat you fairly and your choices from the panel can often have a significant impact on your case.
WHO PAYS FOR THE DOCTOR?
Your company’s workers’ compensation insurance carrier will pay for your authorized medical treatment, if the treatment was for an on-the-job injury. You should not have to use your own health insurance or make any co-pays.
WHAT MEDICAL TREATMENT WILL BE PAID?
All authorized doctor bills, hospital bills, physical therapy, prescriptions, and necessary travel expenses if the injury or illness was caused by an accident on the job. All injuries occurring on or before June 30, 2013 shall be entitled to lifetime medical benefits. If your accident occurred on or after July 1, 2013 medical treatment shall be limited to a maximum period of 400 weeks from the accident date. If your injury is catastrophic in nature you may be entitled to lifetime medical benefits.
WHEN DO I GET MY BENEFITS?
You are entitled to weekly income benefits if you are unable to work for more than 7 days (“waiting period”). Your first check should be mailed to you within 21 days after the first day you missed work. If you miss more than 21 consecutive days, you will then be paid for the first week waiting period.
HOW WILL MY WEEKLY BENEFIT BE CALCULATED?
You will receive two-thirds of your average weekly wage, subject to a weekly maximum. The current (TTD) maximum is $575.00 per week for an accident which occurred on or after July 1, 2016.
WHAT IF I CAN RETURN TO WORK BUT CAN ONLY GET A LOWER PAYING JOB AS A RESULT OF MY INJURY?
You will receive a reduced (TPD) benefit based upon your earnings for a maximum of 350 weeks from the date of injury. This benefit will not exceed $383.00 per week, if your accident occurred on or after July 1, 2016.
HOW LONG WILL I RECEIVE WEEKLY BENEFITS?
If your accident occurred on or after July 1, 1992, you are entitled to (TTD) benefits for a maximum of 400 weeks. If your injury is catastrophic in nature you may be entitled to lifetime benefits. In certain circumstances, your benefits may be reduced after you have been released to return to work with limitations or restrictions, or suspended if you are released to return to work with no limitations or restrictions.
WHAT KIND OF BENEFITS WILL I RECEIVE IF I HAVE A PERMANENT DISABILITY?
You will receive weekly (PPD) benefits based on the type and extent of your permanent disability. The authorized treating physician determines ratings based upon Guides to the Evaluation of Permanent Impairment fifth edition, published by the American Medical Association. You will not be entitled to PPD benefits if you are currently receiving TTD or TPOD benefits.
CAN I BE COMPENSATED FOR LOSS OF SIGHT OR HEARING?
CAN I RECEIVE BENEFITS IF I HAVE LOST THE USE OF A PART OF MY BODY?
Yes. Benefits are based upon the extent of loss of use of a part of your body as determined by the authorized treating physician.
IF A GEORGIA WORKER DIES AS THE RESULT OF AN ON-THE-JOB ACCIDENT, WHAT BENEFITS WILL DEPENDENTS RECEIVE?
Dependents will receive two-thirds of the employee’s average weekly wage or a maximum of $575.00 per week for death on or after July 1, 2016. Dependents include surviving spouse, children or dependent stepchildren. A widowed spouse with no children is limited to a total amount of $230,000.00, unless he or she remarries or cohabitates in a meretricious relationship.
CAN I BE PAID SOCIAL SECURITY AND WORKERS’ COMPENSATION AT THE SAME TIME?
Yes, but social security benefits may be offset or reduced based on the amount of benefit awarded.
WHAT IS THE TIME LIMIT TO FILE A CLAIM FOR WORKERS’ COMPENSATION BENEFITS?
VERY IMPORTANT – A Form WC-14 MUST be filed with the State Board of Workers’ Compensation within one year from the date of your accident. There are some exceptions to this rule but every effort should be made to file a claim within one year from the date of the accident.
WHAT HAPPENS AFTER I FILE A CLAIM?
If you do not receive any benefits, your attorney may request a hearing before the State Board of Workers’ Compensation. A hearing is like a trial in the courts of Georgia. Your claim will be decided by an Administrative Law Judge who listens to both sides of the claim and determines what benefits, if any, you should receive. The judge’s decision will be based on the law and the facts involved.
WHEN WILL THE HEARING TAKE PLACE?
The hearing generally will be scheduled within 60 days from the time the judge receives a Form WC-14 request for hearing.
WHERE WILL THE HEARING TAKE PLACE?
The hearing will generally be held in or near the county where you were injured.
DO I HAVE TO HAVE A LAWYER REPRESENT ME AT THE HEARING?
Everyone has the right to represent him or herself. However, your employer may be represented at the hearing by a lawyer. You may need help from a lawyer in order to present your claim properly.
HOW MUCH WILL MY LAWYER CHARGE ME?
The attorney fee will be based on an agreement between you and your lawyer, subject to the approval of the State Board of Workers’. No fee greater than 25% of the employee’s award of weekly benefits or settlement shall be approved.