This is intended to be a comprehensive guide to Georgia Workers’ Compensation benefits. Applicable in Atlanta and throughout the state, workers’ compensation guidelines protect the rights of employees to a range of benefits in the event of a workplace injury.
Overview of the Workers’ Compensation System
The problem with work injuries
More than 78,000 people were hurt on the job in Georgia in 2019 (U.S. Bureau of Labor Statistics). 2.5% of employees are injured at work each year. When these injuries are serious, workers may need medical attention, and they may not be able to work.
While traditional personal injury laws are in place in the state, this negligence-based system is inadequate to meet the needs of injured workers. The injury may not be anyone’s fault, or the employer may not be at fault. The worker is in an unequal position to the employer regarding access to information about what happened and legal resources. An employee can’t wait through a lengthy legal proceeding to receive relief.
Help for Injured Workers
The Georgia workers’ compensation system aims to provide solutions to these problems. Laws require employers to have workers’ compensation insurance. This insurance provides paid medical care, replacement income, and other benefits. Injured workers should know their rights and responsibilities to ensure they take full advantage of available benefits under the program.
Rights of the Injured Worker to Benefits
Workers’ compensation covers a range of benefits that fall into four broad categories: medical care, wage replacement, permanent disability, and death benefits.
If you are injured on the job, you have the right to medical care. Your rights include:
- Treatment for injuries at no cost to you
- The option to choose from a list of healthcare providers authorized by your employer
- Physical therapy and appropriate rehabilitative measures
- Medical care until the worker has reached maximum medical improvement
- Care without co-insurance, and you should never see a medical bill
- Reimbursement for travel to medical care
In the event of an emergency, you may seek and obtain care from any provider until the emergency is over. Then, you must choose from the list of employer-sponsored providers.
When injuries keep an employee from working, they may claim replacement income. Wage replacement begins when the employee misses seven days of work. If they miss more than 21 days in a row because of the injury, they may also receive back pay for the first seven days.
Wage replacement benefits are:
- 2/3 of the employee’s average weekly wage
- If the employee can work in a reduced capacity, 2/3 of their lost earnings
- The current maximum weekly compensation payments are $725.00
- Benefits may continue for 400 weeks for non-catastrophic injuries
- Wage replacement continues until the person can return to work in full capacity
If you can’t work, benefits are known as temporary total disability (TTD) benefits. If you work in a reduced capacity, your benefits are known as temporary partial disability (TPD) benefits.
Permanent disability and loss of use benefits
Sometimes, a work injury doesn’t fully heal. If that’s the case, it’s only fair that the injured worker receives compensation. Permanent partial disability benefits are paid for permanent injuries.
With different injuries varying in severity, the question is how to compensate each injured person fairly.
The person is given an impairment rating by their doctor. That’s the percentage of disability that they have. The physician must use the 5th Edition of the American Medical Association publication Guides to the Evaluation of Permanent Impairment to determine the disability rating.
Then, the injury rating for the type of injury is identified. The rating is a number of weeks. For example, if the injury is to the body as a whole, the rating is 300 weeks. If it is to the big toe, the rating is for 30 weeks. There are different ratings for different body parts, and they vary considerably.
Using the average weekly wage, impairment rating, and injury rating, permanent partial disability benefits are calculated.
A worker’s average weekly wage is $700 per week; the workers’ comp rate is then $466.67 per week. They are injured at work, resulting in the loss of the big toe. Their physician rates them as 100% disabled. The big toe rating is 30 weeks.
Permanent partial disability benefits are calculated as follows:
$466.67 X 100% X 30 = $14,000.10 ($466.67 in benefits for 30 weeks)
The person receives $14,000.10 total compensation for the loss of their big toe.
Benefits may be paid in a lump sum or weekly.
When a work-related injury results in death, the victim’s dependents may receive death benefits.
- Benefits are a calculation of replacement income, 2/3 of the person’s average weekly wage up to the maximum
- A victim must have been financially dependent on the injured worker for a period prior to the injury
- Stepchildren may qualify
- Funeral and burial costs are payable up to a maximum amount
- For children, benefits continue until age 18 or 22 if they’re enrolled in school
- If a child has a disability, benefits may continue indefinitely
- A maximum period applies for a spouse with no dependent children. Remarriage or cohabitation cuts off benefits for a surviving spouse
Benefits are payable for both occupational illness and disease.
Responsibilities of the Injured Worker to Preserve Their Right to Benefits
An injured worker has obligations in the Atlanta workers’ compensation system.
These duties include:
- Reporting the accident or occupational illness to the employer as soon as possible. Failing to report within 30 days may compromise benefits. The best practice is to make a report in writing
- Cooperate with medical providers. Attend all medical appointments. The victim may not refuse reasonable medical treatment and rehabilitation
- Keep the insurance company notified of address changes
- Tell the insurance company if you are cleared to work part-time and how much you are making
- If the physician authorizes you to work in a lower-paying or restricted capacity, you must attempt it in good faith
- Submit mileage reimbursement requests to the insurance company promptly, not more than one year after the date of travel
- Avoid making any false or misleading statements
Employees must follow safety procedures put in place by the employer. Workers’ compensation is not payable for injuries resulting from intentional employee misconduct.
If you do not receive the benefits you deserve, you have one year to submit a claim.
Atlanta-Based Attorneys to Guide You Through Workers’ Compensation Benefits
At Moebes Law, our attorneys are here to help you understand the benefits you deserve and guide you through the process of receiving them.
Have you been injured at work? You may be entitled to workers’ compensation benefits. Let our attorneys guide you through the entire process. Contact us today for your free consultation, and start your case today.