General Workers’ Compensation Questions and Answers
Q. What is Workers’ Compensation in Georgia?
In Georgia. when a worker is injured on the job and the work related injury is covered by law, then Workers’ Compensation State Law provides benefits to the injured worker and his or her family such as: 1.) Medical Treatment; 2.) Rehabilitation; 3.) Income; 4.) Death; and 5.) Other Benefits to the Employee and his or her dependents Due to Injury, Illness and/or Death resulting from a the work related injury that is covered by law.
Q. When am I Covered Under Workers’ Compensation in Georgia?
In Georgia, you are covered under the Workers’ Compensation Law from the first day of your employment. If your Employer has three (3) or more employees, then your Employer is required by law to provide Workers’ Compensation coverage.
Q. What is Considered an On-The-Job Injury, Illness and/or Workers’ Compensation Claim in Georgia?
In Georgia, if you are injured, become ill, or die in the course of your employment then you have a work-related claim that you or your loved ones may be compensated for by law. In order to have a compensable injury, illness or death you must be injured, become ill, or die while doing your assigned job duties during your assigned work hours. If, however, you are doing unassigned duties during unassigned hours such as lunch breaks then you are not covered under Workers’ Compensation. Furthermore, if you incur an injury, illness or death during your commute to and from work, then you are not covered under Workers’ Compensation.
Q. If I am Injured or become Ill on the job, What Should I do First?
If you are injured or become ill on the job, then you should first IMMEDIATELY report your injury or illness to your employer and be as specific as possible when reporting your injury or illness to your employer. If anyone witnessed your accident, then also inform your employer of such a witness or witnesses. In order for your company to begin your Workers’ Compensation benefits in a timely manner, you must notify your employer promptly. Then you should also obtain and fill out the paperwork required by your employer, and this information should be forwarded to the appropriate organization for processing.
Q. What Happens if I am too Badly Injured or for some other reason Cannot make a Report of my Injury?
You will be provided immediate medical assistance if your injury is such that you are unable to make a report, and a report will be made for you. In this case, anyone who reports the injury should be as specific and detailed as possible when making the report, and the report should be given to your employer as soon as possible following the injury.
Q. Are On-the-Job Accidents and/or Injuries Investigated?
Yes, in most cases, On-the-Job Accidents and/or Injuries are investigated by your employer and/or the company who is responsible for handling the Workers’ Compensation Claim in Georgia. These investigations are necessary to make the workplace safer by investigating how and why the injury or accident occurred.
Q. Are Employee Misconduct Claims such as Fighting or a Willful Act for Personal Reasons Resulting from On-The-Job Injuries Covered?
No, if your injury is the result of your own willful misconduct such a fighting, injuries due to alcohol or drug abuse, or other willful misconduct, then Workers’ compensation does not provide benefits for your injury or accident.
Q. Are Injuries Resulting from Haste and Inattentiveness Covered?
Yes, although you may be subjected to company discipline if the company policies are not followed, injuries that result from haste and inattentiveness would be covered under Workers’ Compensation.
Q. What if I am Concerned about my Safety Record?
It is natural to be concerned about your safety record on the job. Regardless, if you fail to report injuries because you are worried about damaging your safety record or a safety program then this could result in undesirable consequences such as having to pay out-of-pocket medical expenses.
Q. Can I Receive from my Employer Money Damages in addition to Workers’ Compensation Benefits if I am Injured on the Job?
No, Workers’ Compensation Benefits are the only, or exclusive, remedy that a worker is entitled to against her or his employer for on-the-job injury damages.
Q. Can I Sue Anyone for a Work-Related Injury?
If your injury is caused by a third party who is not also an employee of your employer, then you may be able to sue that other third party for negligence. If, however, you do sue another party, then your employer is entitled to recover, or be subrogated, for any money award that you receive from suing the third party. Your employer will only be able to recover any monies you have received after you have been compensated in full for your on-the-job injury losses.
Q. How Much Will an Attorney Charge to Handle a Workers’ Compensation Claim?
In order to make sure that you receive the most amount of compensation that you are entitled, it is highly advisable to hire an attorney to represent you in your Workers’ Compensation Claim. Remember, you will be dealing with insurance companies or employers who want to pay you as little as possible for your on-the-job injury. Under Georgia Law, the Workers’ Compensation Statute limits the attorney’s fee to a maximum of 25% of income benefits received, not to exceed 400 weeks of benefits.
Q. How Can I Jeopardize My Benefits?
You can jeopardize your benefits by doing, or failing to do, the following, including, but not limited to:
- Failing to promptly to report your injuries.
- Failing to cooperate with an authorized treating physician regarding your medical evaluations, treatment, rehabilitation services, failing to cooperated with your employer, and failing to cooperate with any claim investigation.
- Refusing to return to suitable employment.
- Working somewhere else while receiving Temporary Total Disability Benefits.
- Submitting fraudulent or untruthful information.
- Refusing to take a drug or alcohol test.
- Refusing to submit to a medical examination by an authorized treating physician when requested at a reasonable time.
Q. Are there Circumstances where I Would Not Receive Workers’ Compensation Benefits as a Result of an On-The-Job Injury?
Yes, as explained herein above, you may not be entitled to receive Worker’s Compensation Benefits if you were engaging in activity such as, but not limited to, willful misconduct, if you were using alcohol or drugs or misusing any controlled substances and were injured on-the-job while engaging in such activities.
Q. Does the State Board of Workers’ Compensation Investigate Fraud?
Yes, fraud is very serious and the State Board of Workers’ Compensation will investigate fraud claim through its Enforcement Division and may impose penalties accordingly for fraud violations.
Q. What if my Claim is Denied by my Employer or the Workers’ Compensation Administrator or the Insurance Company?
If your claim is denied, then you have one (1) year from the date of your injury to file a claim with the State Board of Workers’ Compensation. It is best if you Contact Us (http://www.juliericelaw.com/contact-us.html) for your free legal consultation at this time. If, however, you decide to go it alone, then the procedure for filling a claim is on the form titled “Employer’s First Report of Injury” (WC-1).
Q. What is the Statute of Limitations, or Time Limit, on Filing a Worker’s Compensation Claim?
There are different answers to this questions depending upon the circumstances. For example, after you have reported an injury, then you must file your claim within one (1) year from the date of the injury.
If, however, you did in fact receive remedial treatment from your employer, the you must file a claim within one (1) year after the date of treatment.
You must file a claim within two (2) years from the date of your last payment of weekly income benefits, if you did in fact receive said benefits.
You must file a claim within one (1) year of when you became aware of your disease, or from when you should have reasonably known that your disease was related to your employment, if your case involves an Occupational Disease Claim. However, after seven (7) years from the date of your last exposure to the hazard that was related to your disease, may you filed a claim for an Occupational Disease.
You have one (1) year from the date of your first disablement after a diagnosis to file a claim if the claim is related to asbestosis or mesothelioma in relation to the exposure to asbestos.
Q. May I Receive Additional Treatment for my Injury after I have been Treated, Have Reached the Maximum Level of Improvement, and then Begin Having Problems Again with this Injury?
If your Injury occurred on or before June 30, 2013, then you shall be entitled to lifetime medical benefits. If, however, your accident occurred on or after July 1, 2013, then medical treatment shall be limited to a maximum period of 400 weeks from the accident date.
If, however, your injury is a Catastrophic Injury, you may be entitled to lifetime medical benefits.
Q. When Is My Claim Closed?
Your claim is closed when all the appropriate benefits have been paid, or a settlement agreement, and monetary payment is paid to you or your dependents, is reached by all parties and approved by the State Board of Workers’ Compensation.
It is important to note that not all claims are closed and remain open until the Statute of Limitations has run, or until the worker dies, whichever event shall first occur, and stay open as such given the nature of the injury.