Workers’ compensation is a form of insurance provided by nearly every employer in the state of Georgia. Workplace accidents and injuries unfortunately occur at an alarming rate, and the state provides a separate division to handle claims for these injured employees. In 2014, the state paid on nearly 40,000 indemnity claims and 100,000 “medical only” claims. Many minor claims are easily handled on their own, such as small scrapes or twisted ankles.
However, certain injuries may receive different benefits than others, or may be denied coverage upon first review. It is these small differences and hurdles that require an experienced legal counsel to assist you throughout the claims process. A workers’ compensation attorney can additionally help you maximize your benefits after a workplace accident. While recovering from an injury, the last thing you want to do is worry about meeting the statutory deadlines for filing a workers’ compensation action and preparing for a hearing for your claim. An attorney can take this stress from you and allow you to focus on what is important: your recovery.
Workers’ compensation claims have evolved tremendously since the very early days of tort claims in nineteenth century England. During these days, workers had to prove that the employer was the reason for the accident and resulting injury. Any action by the employee which led to the injury would have disqualified the employee from bringing the claim. By the time Georgia enacted the state workers’ compensation law in 1920, the United States had overwhelmingly dropped the requirement that the worker prove that the employer was primarily at fault for the resulting injury. In Georgia, workers can now bring a claim for an injury even if they or a coworker were partially at fault for the injury. However, the injury may not be covered if the injury was brought about through personal grudges between two coworkers.
An employee must report the injury to their employer as soon as possible after the accident occurred, or the injury became apparent. The initial reporting limitation period is only 30 days, so it is important to file the report as soon as possible after the injury. After reporting the injury, the injured employee must then complete Form WC-14 (Notice of Claim) and file with the Georgia State Board of Workers’ Compensation. You must also provide a copy to your employer as well as the workers’ compensation insurance company. This claim must be filed within one year of the date of the accident.
After the Georgia State Board of Workers’ Compensation receives your claim, they will begin their investigation into the claim.
If your claim is denied by the state or if your benefits are less than expected, you have the option to appeal for a hearing before an Administrative Law Judge. Prior to the hearing, you must collect all documentation involving evidence of your injury and the accident. While you do not need an attorney for the hearing, it is helpful to have one throughout this process. The lawyers from both sides will present their arguments and positions before the judge during the hearing.
If the hearing involves an issue relating to compensation benefits, the employee will be asked to testify. Similar to a jury trial, the opposing side’s attorney will cross-examine the employee regarding their injury and any other factual disputes. Either side may present evidence or call upon witnesses during the hearing.
The Administrative Law Judge will not issue a decision at the close of the hearing, Rather, both parties will draft briefs which summarize their positions and evidence provided during the hearing. The judge will then consider the briefs and all evidence when issuing their decision.
The entire process of providing a claim, medical evidence, and ongoing support to the state during this time is not relaxing. You are required to be available throughout this time to assist the state with their investigation, and this may be difficult if you are attempting to recover from your injuries. Additionally, if you are recovering from a catastrophic injury and are bed-ridden or hospitalized, it might be difficult to gather together all the information you need, as well as prepare for the hearing.
If your claim is currently disputed, it is important to contact an attorney who can begin preparing your position. You only get one chance at recovery, and it is important to have all your options open during this time. A hearing before an Administrative Law Judge is very fact specific, although it also requires a deep knowledge of the legal procedure. A lawyer will be able to assist in providing appropriate evidence throughout the hearing and in calling witnesses who will bolster your case.
The issue of whether you are an employee or an independent contractor can have dire consequences for any workers’ compensation claims. An independent contractor is not entitled to receive benefits under the Georgia Workers’ Compensation Act, and certain employers have taken great pains to keep all employees at a contractor level. There are specific procedures which they must accomplish in order to prevent an employee from reaching full “employee” status, and if you have a question regarding your status, you should contact your union attorney.
A union attorney is often provided by your individual union, and will be available to you during the course of your workers’ compensation claim. Union workers are accustomed to filing workers’ compensation claims and will have easy access to your records and employment status. Most union attorneys have experience in handling workers’ compensation claims and will be able to inform you immediately about whether your injury falls within what is covered by the Georgia Workers’ Compensation Act.
If your individual union does not provide attorneys, they may also recommend certain ones with experience and specialty in workers’ compensation. However, any attorney will be able to assist you with your claim, regardless as to whether you are a union member or not.
Georgia provides three separate types of benefits: wage benefits, medical benefits, and permanent partial disability.
Wage benefits provide injured workers with ongoing benefits if they have been injured on the job. This amount is capped at two-thirds of your weekly wage, or up to $550 per week.
Medical benefits are paid directly by your employer and their insurance company and will last up to 400 weeks. These benefits will cover the ongoing treatments you may have to undergo as a result of your injury and any required hospitalization.
Additional benefits may be received in extreme cases where partial disability occurred as a result of the accident. It is important to determine the extent of your injuries early on through a medical professional and file your claim as soon as possible to ensure you do not miss the limitations period.
We all go to work every day and work hard to provide for ourselves and our families. None of us expect a crushing injury to affect our ability to work. However, injuries are far more common than we think, and Georgia has provided employees with the ability to file for claim coverage after a devastating accident prevents them from continuing their employment. Employees should always explore this avenue after an accident or occurs during the course of their employment.
Our legal team at Kaufman Law, P.C. has years of experience in filing workers’ compensation claims and representing our clients at hearings to establish their injury or coverage entitlement. If you have questions concerning your workers’ compensation coverage or the process in filing a workers’ compensation claim, do not hesitate to contact our Atlanta office. Workers’ compensation coverage is an important right that most employees are entitled to receive, and was enacted specifically for the employees of Georgia. It is important that you take advantage of this service if you have been injured during the course of your employment.