Atlanta Workers’ Compensation FAQs

When you’re injured on the job, getting the compensation you deserve is very important. It’s helpful to know the basics of how workers’ compensation operates.

Your case may have unique issues that aren’t covered here, and we always recommend that you work with our experienced attorneys who specialize in this area. However, here are answers to some of the most asked questions about workers’ compensation in Atlanta.

Basic Information About Workers’ Compensation

What is workers’ compensation?

Workers’ compensation is a state law that creates a benefit system for workers hurt on the job. Injured workers may receive no-cost medical care, replacement income, and other benefits. Employers must have insurance to cover their obligations.

Does Atlanta have workers’ compensation laws?

Yes. Georgia workers’ compensation laws apply in Atlanta and throughout the state.

Are Atlanta employers required to have workers’ compensation insurance?

Atlanta employers must have workers’ compensation insurance if they have three or more employees. Part-time employees count.

Use this search feature to see if a Georgia employer has workers’ compensation insurance.

How can I tell if my boss has Georgia workers’ compensation insurance?

The State Board of Workers’ Compensation in Atlanta has a website that will assist you in looking up your employer to see if the company carries a Georgia workers’ compensation insurance policy, as it is likely required by law to do, assuming there are three or more employees.  Use this resource to see who the workers’ compensation insurer is for your date of injury.

Some employers are exempt from having to carry workers’ compensation insurance in Georgia, even if they have three or more workers.  For questions about whether workers’ comp is needed for your Georgia workplace, feel free to contact the workers’ compensation lawyers in Atlanta at Moebes Law.

How do you get workers’ compensation in Atlanta?

To get workers’ compensation in Atlanta, you must be injured in the course of your employment. You must report the injury to your employer, seek medical care, and file a claim for benefits.

Is a workers’ compensation claim the same as a personal injury claim?

There are a few major differences between workers’ compensation and personal injury claims. While both cover your accident-related medical expenses and lost wages, workers’ compensation benefits do not cover intangible losses such as pain and suffering and loss of life enjoyment.

During a personal injury claim, proving liability on the part of the defendant is very important. However, with a workers’ compensation claim, this is not necessary.

Is it possible to have a workers’ comp claim and a personal injury claim from one accident in Georgia?

Several of the cases my workers’ compensation law office in Atlanta is handling involve clients who have had injuries at work caused by another party’s negligence. Thus, they have a workers’ compensation claim and a personal injury lawsuit stemming from the same injury or injuries.

Injuries stemming from trucking or other motor vehicle accidents often present these issues if the victim drives a truck for a living or is traveling for their employment.  “Slip and fall” accidents can also lend themselves to negligence lawsuits on top of a workers’ comp claim, assuming the injured party fell while working.

If you’ve had a workplace injury in metro Atlanta and think there could be a personal injury lawsuit and a workers’ comp claim, please contact my office.

Is proving your employer is at fault required to get workers’ compensation?

No. Georgia’s workers’ compensation system is no-fault. Proving negligence or other legal fault of the employer is not required.

Can I sue my employer for my injuries?

You cannot sue your employer if you file a claim for workers’ compensation. Because workers’ compensation is a no-fault system, your employer’s role in workplace accidents and injuries will not be considered. By claiming workers’ compensation benefits, you waive your right to sue your employer for your losses.

Only if you were injured due to your employer’s malicious actions may you pursue additional damages by filing a personal injury claim. You will need strong evidence that your employer intended to injure you.

Workers’ Compensation Rights and Benefits

What benefits can I get from workers’ compensation if I’m injured on the job in Atlanta?

Benefits that may be available to you from workers’ compensation for an on-the-job injury in Atlanta are:

• Medical treatment – Reasonable and necessary care
• Physical therapy
• Mileage reimbursement for travel to medical care
• Temporary total disability benefits – if you cannot work at all after the injury
• Temporary partial disability benefits – if you can work in a reduced capacity
• Permanent disability – compensation for permanent injuries that remain after treatment
• Death benefits
• Funeral expenses – up to a maximum amount

How much will I be awarded in damages in a Georgia workers’ comp claim?

This will depend on the specifics of your claim. The benefits that you receive will depend on factors such as your medical expenses, the extent of your injuries, your earning history, your lost income, and your future earning capacity.

Your workers’ compensation lawyer will be able to estimate the potential value of your recovery by assessing these factors above. Severe injuries may cost more to treat and may have more detrimental, long-lasting effects. Your compensation is then likely to be more. If you cannot return to work due to permanent disabilities, you may be able to include the loss of future earning potential as part of your claim.

If I’m attacked at work, can I get workers’ compensation in Georgia?

Sadly, acts of violence in the workplace are not uncommon, and depending on the circumstances surrounding the attack, injuries sustained because of a coworker’s or customer’s violence can be covered under the Georgia Workers’ Compensation Act.

If you’ve been injured at work because of a coworker’s or customer’s act of violence, please contact our office for questions about compensability and your rights under the law.  Variables such as who the aggressor is, where the attack took place, and whether the attacker and victim had a relationship outside of the work environment can all affect whether the injury arose out of, and in the course of, employment.

Are pain and suffering awarded in Atlanta workers’ compensation claims?

No. Pain and suffering are not awarded in Atlanta workers’ compensation claims.

What medical care is paid for in workers’ compensation?

An injured worker in Atlanta may receive paid medical care for all treatment authorized by the treating physician as reasonable and necessary. Care may include doctor visits, physical therapy, prescription medication, and mileage reimbursement for travel to medical appointments.

Can I get my medical mileage paid while on workers’ compensation in Georgia?

If your Georgia workers’ compensation claim is compensable, your employer and/or its workers’ compensation insurance company will pay for your medical expenses when traveling to authorized medical providers. This can include the following expenses:

• mileage (currently $.40/mile) to and from the doctor’s office, physical therapist’s office, and pharmacy
• parking at the medical providers’ offices
• meal expenses (up to $30/day) when the trip to the doctor takes more than 4 hours
• lodging and meals when the medical visit is outside your home city.

You have one year to submit your medical expenses related to your treatment; otherwise, your right to be reimbursed is waived.  The employer/insurer has 30 days to pay these expenses; otherwise, penalties and interest will accrue.

How long can I receive medical care in the Georgia workers’ compensation system?

Generally, there is a 400-week limit to medical care in Georgia workers’ compensation cases unless the injury is catastrophic or the person receives prosthetic devices or durable medical equipment.

How long do you have to be off work to get workers’ compensation?

If you miss seven or more days of work, you receive weekly income benefits. If you miss 21 or more consecutive days, you also get paid for the first seven days.

What is temporary disability in a Georgia workers’ compensation claim?

Temporary disability is compensation if you are unable to work following an on-the-job injury. The payments make up for the income that the injured person cannot earn because of their injuries. Temporary disability may be total or partial, depending on whether the person can work in a limited capacity.

How much can I get in replacement income with workers’ compensation?

Replacement income in Atlanta workers’ compensation is two-thirds of the person’s average weekly wage before the injury. There is a weekly maximum and minimum amount. If the person can work for reduced wages, they receive two-thirds of the difference in pay up to a maximum amount.

What death benefits are available for workers’ compensation in Atlanta?

Dependents of the deceased worker may receive compensation equal to temporary total disability benefits. Payments continue for as long as the recipient is dependent. For a spouse, if there are no other dependents, benefits are capped at $270,000.

Can you lose Atlanta workers’ compensation benefits for failing to attend a medical appointment?

Yes. Always be sure to attend your medical appointments and follow any restrictions put in place by your care providers.

Can you get fired for getting workers’ compensation?

Your employer cannot fire you because you file a workers’ compensation claim. They cannot lawfully retaliate against you for requesting the benefits you deserve. However, your employer may terminate you for a lawful reason.

I just got a letter saying my workers’ compensation benefits will be cut off. Now what?

Don’t panic just yet. In the past few weeks, I’ve seen several WC-2 filings indicating a client’s workers’ compensation disability benefits were about to be suspended, but the insurance adjuster did something incorrectly, meaning benefits were immediately recommenced (along with some penalties and fees).

For example, if the adjuster filed a WC-240 commanding you to return to light-duty work in Florida (and you live in Atlanta), that’s not a reasonable offer, and the insurance company cannot cut off your benefits.

What if your doctor opined that you might be able to do regular duty in 2-3 months, and 2-3 months have passed, but you haven’t seen your doctor in 60 days? They can’t cut off your benefits.

What if you get a WC-2 indicating your benefits were cut off yesterday (meaning you did not get 10 days’ notice)? They can’t cut off your benefits.

All 3 of these examples I’ve seen this month. Unfortunately, many workers’ compensation adjusters handle hundreds of files in several different states, and they don’t always comply correctly with the Georgia Workers’ Compensation Act. Mistakes are made. That’s why you need an experienced Atlanta workers’ compensation attorney to be your advocate and guide you through your workers’ comp claim as you recover from your injuries.

Will my Georgia workers’ compensation settlement stipulation be approved by the State Board of Workers’ Compensation?

Almost every time we submit settlement paperwork to the Georgia State Board of Workers’ Compensation, the stipulation is approved. Settlement paperwork is normally generated by the workers’ compensation defense attorney and is then sent to our office for signatures. Once we review the forms and make any necessary changes, we submit the papers back to the employer/insurer’s lawyers’ office, and it’s submitted to the State Board for approval.

The only time I’ve seen a client’s stipulation paperwork fail to get Board approval was when a client was not forthcoming about child support liens he had in another state. So, always be honest about any child support liens that are outstanding when you settle your workers’ compensation claim in Georgia, even if they are from other states.

How much tax do I owe on my workers’ compensation settlement in Georgia?

Unless your workers’ compensation payment reduces your Social Security benefits, the amount paid pursuant to a settlement or other judicial award is NOT taxable income, per IRS Publication 525. If your Social Security benefits have been reduced because of your workers’ compensation benefits, only that portion of your workers’ comp benefits is taxable.

In addition to settlements, TTD (temporary total disability), TPD (temporary partial disability, and PPD (permanent partial disability) benefits are all workers’ compensation benefits that are not taxable, subject to the exception mentioned above.

If I’m on workers’ compensation disability benefits in Georgia, how are my taxes figured?

Per IRS Publication 525, Temporary Total Disability (TTD) benefits in Georgia are not subject to income tax.  Neither are Temporary Partial Disability (TPD) benefits nor Permanent Partial Disability (PPD) benefits.

My Georgia workers’ compensation adjuster cut off my benefits after a light-duty release. Is this okay?

No. I’ve seen several Georgia workers’ compensation insurance adjusters cut off a workers’ comp claimant’s disability benefits after a treating doctor has released him to light duty lately. This is a mistake (or it could be on purpose). Either way, it’s not allowed unless several steps outlined in O.C.G.A. 34-9-240 are followed.

Basically, your authorized treating physician needs to “sign off” on the light-duty job your employer is trying to offer you. Then, notice needs to be sent to you and your attorney via the WC-240 form. A WC-2 also needs to be filed, showing you that your benefits will be discontinued when you return to work.  Finally, you have to get at least 10 days’ notice.

If you try to do the job and can’t, your disability benefits have to start again.

If your workers’ compensation doctor releases you to light duty, and you haven’t seen a WC-240 (or any of the other steps outlined above), the workers’ comp adjuster cannot cut off your temporary total disability benefits. Feel free to call Moebes Law, the Atlanta workers’ compensation attorney, for help with your workers’ compensation questions regarding light-duty releases and return-to-work issues.

Workers’ Compensation Laws and Procedures for Injured Atlanta Workers

What is the Georgia workers’ compensation law?

Georgia’s workers’ compensation law is O.C.G.A. Title 34, Chapter 9. Many articles in the law cover subjects such as administration, insurance, compensation amounts, and case processing procedures.

What is the form for a Georgia workers’ compensation claim?

The form to begin a Georgia workers’ compensation claim is WC-14 Notice of Claim. In addition, be sure to notify the employer immediately when you are injured.

What do I do if I’m hurt on the job in Atlanta?

If you’re hurt on the job in Atlanta, inform your employer immediately. Seek appropriate medical care from the list of care providers given to you by your employer.

How long do you have to file a workers’ compensation claim in Atlanta?

You have one year to file a workers’ compensation claim in Atlanta following the date of injury. However, be sure to report the injury to your employer immediately.

How long do I have to give notice of my workplace injury in Georgia?

Simply put, you should report your workplace injury as soon as possible, but no later than 30 days.

Of course, if your injury is a disease or a repetitive motion injury that developed gradually, you are not expected to be able to identify the exact date on which the condition began and report it within 30 days of that date. However, you should strive to report trauma injuries and other “sudden” injuries within 30 days of the workplace accident.

This begs the question, “What if my boss told me to ‘shake it off’ and keep working, so I didn’t realize how bad it was until 3 months later?” I would still report the injury to your employer and consult an experienced Atlanta “workman’s comp” lawyer, as a technical defense such as “improper notice” is unlikely to, by itself, keep you from getting workers’ compensation benefits with most of the Atlanta Administrative Law Judges.

What happens after I report an on-the-job injury in Atlanta?

Once you report an on-the-job injury in Atlanta, your employer should provide you with a list of authorized medical care providers. You may choose from the list and seek medical care. The insurance company has 21 days to investigate the injury and file a report. If they accept the claim, they should start to pay benefits.

Should I bother filing a workers’ compensation claim in Georgia when my employer has no insurance?

Unfortunately, some employers, despite being required to carry workers’ compensation insurance in Georgia when they have more than two employees, do not have workers’ comp insurance or have let their policies lapse.

If you have been hurt at work in Georgia, and your boss or human resources director indicates the company does not have workers’ compensation insurance, you should still pursue a workers’ comp claim.  There will likely be less money to spend on your indemnity and medical benefits, but pursuing the benefits you deserve is still worth the effort, so that you can get better and return to work.

If I’m hurt at work in Georgia, when will my medical care run out?

If you are hurt at work in Georgia, workers’ compensation will cover medical care related to your injury. Even if you reach maximum medical improvement, continuing therapy, pain management, and other medical care will be provided. Sometimes, an injured worker can have a change in condition for the worse and require additional medical care years after his initial accident at work. While the insurance company may try to argue that an intervening incident caused the change in condition for the worse, medical care should still be provided.

If you hurt yourself at work in the Atlanta area and have had a change in condition for the worse, our office can examine your medical records and employment records together to see if you are entitled to continuing medical treatment for your injury at work, even if several years have passed.

What can I expect at my workers’ compensation IME (independent medical examination)?

Recently, a workers’ compensation client of mine, whose authorized treating physician ordered surgery, went into the doctor’s office for the “pre op,” got mentally and physically ready for the surgery, showed up for the procedure, and then learned that the insurance adjuster had called her doctor’s office to cancel it.  No reason was given; the adjuster just didn’t want to pay for her to get better.

Then, the insurance company ordered an IME:  an “independent” medical examination. These evaluations are hardly independent at all, but are usually the insurance company’s attempt to pay for a doctor to write that the injured worker is lying and has nothing wrong with them.

If your workers’ comp adjuster has sent you a notice that you are to attend an IME with a doctor of their choosing, attend the appointment, bring any X-rays, MRIs, and other films you have, and be polite and honest during the evaluation.  Just don’t expect it to bring anything good to your medical health or your claim.

What if I disagree with the insurance company’s determination of my workers’ compensation benefits?

If you disagree with the insurance company’s determination of workers’ compensation benefits, you may file Form WC-14 and request a hearing. The State Board of Workers’ Compensation will conduct an administrative hearing to determine your right to benefits.

Does the insurance company have to settle my workers’ compensation case?

The workers’ compensation insurer does not have to settle your workers’ comp claim in Georgia, but it usually will at some point. Because an accepted workers’ comp claim (i.e., one in which you have received disability benefits) means you are owed medical care related to your injury for the rest of your life, absent some subsequent accident or injury, most insurance adjusters want to “close out” their files at some point to avoid a change in condition for the worse popping up years in the future after you’ve reached maximum medical improvement (MMI).

So, while your claim doesn’t have to settle, and you are not owed a settlement, and you can’t force a settlement, it’s normally in the best interest of all the parties to eventually settle and close an open workers’ compensation claim in Georgia.

If the Georgia State Board of Workers’ Compensation sends my case to mediation, do I have to accept?

Most of the time, if you and the employer and/or insurer have been scheduled to mediate your Georgia workers’ compensation claim, it is arranged by agreement of both sides and by filing a Board Form WC-100 with both sides’ signatures.

However, you cannot be forced to accept a settlement offer from the insurance company. You may be forced to attend a mediation and attempt to settle your case, but if the best offer given is not good enough for you, you may walk away. If you would like help with evaluating and pricing your workers’ compensation claim in Georgia, feel free to call my Atlanta law office for a consultation.

Can you appeal an Atlanta workers’ compensation decision?

If you disagree with a workers’ compensation decision in Atlanta, you can appeal the case to the Appellate Division of the State Board of Workers’ Compensation. You have 20 days to make the appeal.

How do you win a workers’ compensation hearing in Georgia?

To win a workers’ compensation hearing, you must present evidence and arguments that prove your right to benefits. Be prepared to present medical documentation and other information needed to address the issues in the case.

How long will it take to start receiving workers’ compensation benefits?

This will depend on the complexity of your case and the strength of your evidence. If there are gaps in evidence, the insurer may try to dispute your claim to avoid a large payout. This could prolong the proceedings.

Your lawyer can, however, help you to gather strong evidence to back up your claim and try to mitigate disputes. Your recovery time may also influence how soon you can expect to receive benefits.

Your lawyer may advise you to wait until maximum medical improvement before accepting a settlement offer because you may require additional medical treatment if you do not yet know the full effects of your injuries. This will ensure that all medical expenses, past and future, are included as part of your claim.

Can I have a workers’ compensation attorney in Atlanta manage my case?

Yes. In fact, you should always have an attorney in a workers’ compensation case. Getting the compensation you deserve is extremely important. By handling the case on your own, you may not know what to do. It may not be clear if you are receiving the correct benefits or if the insurance company is telling you misleading things. You have the right to an attorney, and our law firm can represent you from start to finish in your case.

My workers’ compensation claim’s hearing was postponed. Is that normal?

It is normal for a workers’ comp hearing to be postponed. Unfortunately, the Georgia State Board of Workers’ Compensation has a few Administrative Law Judges and many, many Georgia workers’ compensation claims to be heard at each calendar call. In my experience, at least 99% of “first set” hearings are postponed for at least 30 days. More often than not, even “second set” hearings are postponed.

Why are workers’ comp hearings postponed?

When we file a WC-14 Request for Hearing, we also send discovery requests to your Employer and Insurer.  They have 45 days to respond when these are sent with the hearing request.  Once a defense attorney is appointed by the insurance company, he or she will send my office discovery requests as well, and we will have 30 days to respond.  If the defense attorney wants to take your deposition, he/she will likely want to request medical records from doctors named in the deposition, and these doctors will have 30 days to respond. By the time all these Requests for Production of Documents and Interrogatories have been sent, and responses have been mailed, about 2-3 months may have passed.  Hence, the postponed hearings.

In order to try and “fix” this, I work to get my clients’ depositions scheduled as quickly as possible with the defense attorney after we file a hearing request. Generally, once your deposition is taken, the case begins to move toward settlement or trial.

What should I do if I receive a notice for a workers’ comp hearing?

Don’t show up for a workers’ compensation hearing without your attorney. Sometimes you may receive a notice of a court date even if your attorney has said that the hearing has been postponed. Contact your workers’ comp lawyer to get clarification.

Can a Georgia workers’ comp claimant pursue late penalties that are 10 years past due?

Does an employer’s blatant violation of statutory regulations governing when payments are due and utter disregard for the penalties resulting from said violation constitute a change in the employee’s “condition”? No, according to the Georgia Court of Appeals.

What can I do if someone associated with my workers’ comp case violates my health information privacy rights?

When you file a workers’ compensation claim in Georgia, you’ll need to sign a WC-207 release that allows the workers’ compensation employer/insurer to access medical records reasonably related to your injury at work.  Medical records may, of course, be shared between different doctors and specialists.  However, sometimes medical information that is protected is shared with parties that should not get this information, such as companies or organizations where an injured worker is being sent pursuant to a return to light duty under O.C.G.A. 34-9-240.

If this occurs, you can file a complaint with the U.S. Department of Health and Human Services for violations of your HIPAA rights.

In short, your complaint must:

1. Be filed in writing, either on paper or electronically, by mail, fax, or e-mail;
2. Name the covered entity involved and describe the acts or omissions you believe violated the requirements of the Privacy or Security Rule; and
3. Be filed within 180 days of when you knew that the act or omission complained of occurred. OCR may extend the 180-day period if you can show “good cause.”

Can I borrow money from my workers’ compensation attorney in Georgia?

The Georgia State Board of Workers’ Compensation Rules prohibit attorneys from lending money to their clients. Sometimes, unscrupulous attorneys will try to draw clients to their firms with promises of monetary loans or gifts in exchange for signing up to be represented by their firms.  However, this is an ethical breach and is clearly against the governing rules for workers’ compensation claims in Georgia.

In short, one should seek representation elsewhere if a potential workers’ comp lawyer tries to get your business by promising you loans from his/her law firm in exchange for giving them your business.

What are the mistakes that can totally ruin my workers’ comp case in Georgia?

Although workers’ compensation benefits may seem untouchable when they begin to flow in for the first few weeks, it is important to consult with an Atlanta workers’ compensation lawyer to make certain that, as an injured individual, incapable of working, you are taking all steps necessary to keep your checks coming while you recover. In order for the checks to keep coming, make sure to abide by these few necessary suggestions (or, ignore them if you want to totally screw up your case):

1. Do not go to work for another employer while you are receiving checks from your old employer. After a workplace injury, your income may decrease, and you may be tempted to take a second job. Even if the new job requires little (or no) physical work, according to the law, taking it while on Temporary Total Disability benefits (TTD) is not permitted. If you had a second job before your injury and it is not as physically demanding as your primary job, you might be able to continue working that job. However, it may cause your workers’ comp benefits to be adjusted since you are able to perform some type of work. If your injuries prevent you from working both jobs, your workers’ comp benefits will calculate both of your incomes to determine your TTD benefit amount.
2. Do not make things difficult for your employer or your authorized medical physician, because this can compromise your benefits. This is not to say that you must agree to every recommendation for medical treatment, including surgery, given by your doctor. However, you must abide by the workers’ compensation laws when consulting with either of them. Keep in mind, if you don’t feel you’re getting the level of medical care you need, you may be able to change doctors or get a second opinion.
3. Always make sure to apply for your workers’ compensation claim as soon as possible, so that you do not lose your entitlement to benefits. In the state of Georgia, if you do not apply for benefits within a year of your accident, you will lose your right to benefits.  Also, give notice to your employer of the injury within 30 days!

These are not the only workers’ comp mistakes you could make to lose your right to Temporary Total Disability benefits, but hopefully, these few tips will give you some idea of how to keep your claim alive while you heal from your injuries!

Answering the FAQs in your Workers’ Compensation Case

These FAQs are a brief guide to workers’ compensation in Atlanta. There may be more specific issues and questions that are important in your situation. You may also have additional questions.

We know the process can be daunting. At Moebes Law, we pride ourselves on our effective representation. Our experienced workers’ compensation lawyers aim to secure fair compensation for our clients.

Call us today to schedule a free initial consultation with one of our skilled Georgia workers’ compensation lawyers. This will allow you the opportunity to discuss your case with someone who understands the claims process, ask any questions you may have, and learn what common mistakes to avoid when filing a claim.

We can be reached at 404-354-5432 or via our online contact form.

Sources:

Georgia State Board of Workers’ Compensation Employee Handbook

State Board of Workers’ Compensation, Home, Frequently Asked Questions

Georgia Workers’ Compensation Statutes