Workers’ compensation is a form of accident insurance required by employers for businesses with three or more employees. It protects employees should they get injured or ill because of their employment.
Examples can include slipping and falling in a restaurant kitchen, getting cut using machinery in a factory, falling off a ladder on a construction job, chemical poisoning, or asbestos poisoning.
If you were injured in an accident at work that required medical attention and/or at least 7 days off work, you are likely entitled to workers’ compensation in the form of medical or weekly wage benefits.
Wage Benefits
A person is eligible for weekly income benefits if they are unable to work for at least 7 days. If they are unable to work for 21 days, then they will receive benefits for the first 7 days of missed work.
In the state of Georgia, the maximum amount of time an employee may receive weekly wage benefits is 400 weeks, unless the injury is catastrophic in nature.
Work-related injuries are categorized by extent and duration, and they outline the wage benefits an employee is entitled to depending on their injury.
- A person may receive weekly wage benefits equal to ⅔ of their wage, not to exceed $800 a week and no less than $50.
- If a person makes less than $50 weekly, they will receive their full wage.
- A person may receive ⅔ of the difference of their pre-injury wage and their wage post-injury, not to exceed $533 per week for 350 weeks.
- A person may receive weekly benefits of ⅔ of their weekly wage for a duration predetermined by the injury.
An employee may not combine one category of benefits with another. For example, if you are receiving benefits for a permanent partial disability, you cannot also collect temporary partial disability benefits. If your condition changes, your benefits may as well.
The first wage benefit payment is due to the injured worker within 21 days of the employer being notified of the incident. If they fail to pay on time, there will be an unpaid interest fee paid to the injured worker.
Permanent Partial Disability
The state of Georgia defines permanent partial disability (PPD) as a “disability partial in character but permanent in quality resulting from loss or loss of use of body members or from the partial loss of use of the employee’s body.”
Employees experiencing PPD as a result of a work accident are entitled to benefits regardless of economic loss. The employee will be compensated ⅔ of their weekly wage for a number of weeks determined by the injury. The default schedule is as follows:
Bodily loss/Maximum weeks
Arm: 225
Leg: 225
Hand: 160
Foot: 135
Thumb: 60
Index finger: 40
Middle finger: 35
Ring finger: 30
Little finger: 25
Great toe: 30
Any toe other than the great toe: 20
Loss of hearing (one ear): 75
Loss of hearing (both ears): 150
Loss of vision in one eye: 150
Disability to the body as a whole: 300
If an employee has a preexisting condition that was worsened by an accident or injury at work, they may still receive benefits under the limitation of loss or loss of use as increased by an accident.
Medical Treatment
According to Georgia Code 34-9-200, employers or their insurer must provide compensation for medical, surgical, and/or hospital care to their injured employee when prescribed by their physician and the State Board of Workers’ Compensation believes will provide a cure or relief for the injury, or it may restore them for employment.
For catastrophic injuries, you may receive medical treatment for life. For most injuries, you may receive treatment for up to 400 weeks.
In the event of a catastrophic injury, the employer is required to refer the employee to a rehabilitation supplier within 20 days of being notified of the injury and its severity.
Catastrophic injuries include but are not limited to:
- Spinal cord injuries resulting in paralysis of an arm, leg, or the chest
- Amputation of an arm, a hand, foot, or leg
- Brain injury characterized by severe:
- sensory or motor disturbances;
- communication impairment;
- complex integrated disturbances of cerebral function;
- disturbances of consciousness; or
- episodic neurological disorders
- Second or third-degree burns on 25% of the body, or first-degree burns on 5% of the body
- Blindness
Medical expenses are required by law to be paid by the employer or their insurer within 30 days of receiving the bill. If the employer fails to pay any bills or reimbursement fees on time, they are subject to interest and penalties. For example, if the employer pays the bill more than 30 days after it was due, they will be charged an additional 10%.
Panel of Physicians
Georgia Code 34-9-201 requires employers to post a list of at least 6 licensed physicians reasonably accessible to employees. The employee must select a physician from the provided panel. The physician will diagnose and treat the employee at the expense of the employer or insurer.
The employee must be available and consent to examinations by the physician. If the employee refuses to do so at any time, compensation will cease until they complete the examinations deemed necessary by the physician. The employee may switch their physician for a different physician on the panel one time without approval from the employer.
Instead of posting a panel, an employer may post information for a Workers’ Compensation Managed Care Organization. The employee may use the contact information provided by their employer, and the organization will connect them with an appropriate provider. The employee may switch to a different eligible physician one time without approval from the employer.
The employee must choose a physician on the panel or from the MCO to receive treatment from, except for emergency care.
If the employer fails to post a list of physicians, or a Managed Care Organization, the employee is free to choose their physician at their employer’s expense.
Reimbursement
The employee may also be entitled to reimbursement for transportation costs to and from medical appointments and prescription pickups (i.e., gas mileage and parking fees with receipts). These must be paid by the employer or the insurer within 15 days. If they fail to do so, they will be subject to interest fees.
Reporting an Injury
Georgia Code 34-9-80 requires any injured employee to notify their employer of any accident or injury on the job immediately. If the employee fails to do so in 30 days, they may lose benefits. The employee is not entitled to medical benefits before notice, written or oral, is given to the employer. It is best to provide the employer with written notice so there is a record.
Legal claims must be filed by the injured employee within one year of the injury, unless the employer had been providing benefits or remedial treatment. Then, the claim may be filed one year from the last treatment date or two years from the last payment.
If an employee is under 18 years of age, a legal guardian may file a claim on their behalf.
How Do You File a Claim?
You may file a claim by visiting the State Board of Workers’ Compensation website, or calling their phone number. The board will provide the WC-14 form that is required to file a claim.
Your employer may also provide this when you give them notice of the accident. This form can be confusing, so it is best to seek legal advice to maximize your benefits.
Georgia is a no-fault state, meaning that if you are injured in an accident at work, it does not matter if the accident was your fault. You are still entitled to workers’ compensation benefits.
If you were injured at work, it is important to seek medical attention promptly (from the employer’s panel, if provided). This will provide a medical record of your injuries.
Notify your employer of the incident, ideally in writing, as soon as possible. You will then fill out the paperwork required to file a claim, including details about the injury. Your employer will notify their insurance company and the workers’ compensation board to review your claim and evaluate the benefits you are entitled to.
Your claim may be rejected or the insurance company may try to settle for less than is owed. You may have the opportunity to appeal and request a hearing.
Filing a workers’ compensation claim is complex and overwhelming. Many employees seek the help of a lawyer to navigate the process. An attorney can give you legal advice from the beginning and ensure you receive the weekly or lifelong compensation you deserve.
Contact Gary Martin Hays and Associates for a free consultation with an experienced workers’ compensation attorney today.
If you suffered an injury due to a car accident, work accident, or other incident caused by someone else’s negligence, contact our Georgia personal injury law firm today at (770) 934-8000. Consultations are free and confidential.
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