Workplace injuries can create financial stress, especially if you’re unable to perform your job. This may leave you wondering how much of your wages you may be able to recover. In general, no, you do not get full pay when you’re injured at work, and the amount of money you do receive depends on a wide range of factors.
You should understand that no matter what the insurance company offers, you may have other options. If the initial offer is not enough, an Atlanta workers’ compensation lawyer can help you seek a settlement that better covers your medical treatment costs.
Below, we’ll break down what you need to know about getting paid after a workplace injury.
Does Workers’ Compensation Provide Full Pay if You’re Injured at Work?
If you’re hurt on the job, whether you’ll receive full pay depends on the circumstances of your unique situation. It can be affected by the severity of your injury, your employer’s policies, and the workers’ compensation laws in your state.
Though you’re unlikely to get full pay through workers’ compensation, these benefits are designed to provide financial support. They’ll cover specific costs when an employee is injured on the job or develops a work-related illness. These benefits may include:
- Medical Expenses
- Ongoing Care
- Partial Lost Wages
- Funeral Costs
- Disability Benefits
It’s important to note that workers’ compensation does not cover injuries or illnesses that occur outside of work. It also excludes situations where an employee is intoxicated at the time of an accident or intentionally causes harm to themselves.
Medical Expenses
Workers’ compensation medical benefits help cover medical costs associated with work-related injuries or illnesses. This includes emergency care, surgeries, prescriptions, and other necessary treatments. For instance, if an electrician sustains a hand injury while working at a client’s home, workers’ comp can help pay for their hospital visit and related medical expenses.
Ongoing Medical Care
Some work-related injuries or health conditions require long-term treatment. Workers’ comp can help cover these ongoing care expenses, such as physical therapy or rehabilitation. For example, if a warehouse worker injures their back while lifting heavy items, workers’ compensation can help pay for their physical therapy sessions to aid recovery.
Lost Wages
If an injured worker needs time off to recover from a workplace injury or illness, workers’ comp provides partial wage replacement. For example, suppose that a chef suffers a burn injury from a pot of boiling water and is unable to work for two weeks. Workers’ compensation can replace a portion of their lost income during that period.
Disability Benefits
Severe work-related injuries can result in temporary or permanent disability. Workers’ compensation provides benefits to help disabled employees cover medical costs and replace part of their lost income.
For instance, if a foreman loses the use of a leg due to a workplace accident and cannot return to their job, workers’ compensation can help with ongoing treatment and provide financial support through disability benefits.
Funeral Costs
In the tragic event that an employee dies due to a work-related accident, workers’ compensation can help cover funeral expenses. It may also provide death benefits to the employee’s dependents or beneficiaries to ease the financial burden during a difficult time.
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Weekly Workers’ Compensation Benefits
If your job injury prevents you from working for more than seven days, you should be eligible for weekly benefits. Under Georgia compensation laws, these are paid at two-thirds (or 66%) of your average weekly wage (AWW) and cap out at $575 per week (Georgia Code §34-9-261).
This amount may vary in other states, and the weekly cap can change per year. Your AWW is calculated by figuring your average earnings over a certain number of weeks prior to your work injury.
So, workers’ compensation benefits do not provide full pay while you’re away from work for your injuries. They do, however, account for two-thirds of your regular wage.
Permanent Disability Benefits vs. Temporary Disability Benefits in Georgia Workers’ Compensation Claims
In Georgia, workers’ compensation provides two main types of disability benefits to support injured employees: temporary and permanent. Within this, you have access to short and long-term disability compensation.
Temporary and permanent benefits differ in purpose, duration, and eligibility.
Temporary Disability Benefits
Temporary disability benefits are designed to provide financial support while an injured worker recovers and cannot perform their job duties. Here’s a look at how they work:
- Purpose: Covers lost wages during the recovery period
- Eligibility: Applies to injuries like broken bones or sprains that temporarily prevent work
- Payment: Provides a portion of the worker’s average weekly wage
- Duration: Ends when the worker completes treatment and can return to work
Permanent Disability Benefits
Permanent disability benefits apply when an injured worker reaches Maximum Medical Improvement (MMI) and their condition is unlikely to improve further. Here’s how they function:
- Purpose: Compensates for the long-term impact of the injury on earning capacity
- Partial Disability Benefits: Based on the impairment rating and other factors
- Total Disability Benefits: Weekly payments for severe, permanent injuries
- Payment: Calculated based on Georgia’s State Board of Workers’ Compensation guidelines, depending on the affected body part
Payment Timeline
Injured workers may receive weekly benefits for up to 400 weeks after the injury, depending on its severity. Payments may continue until the worker is able to resume work, subject to state limits.
Understanding the difference between these benefits ensures injured workers get the compensation they need during and after recovery. For more information, consult an experienced workers’ compensation attorney.
Exceptions Where Full Pay May Be Possible
While workers’ compensation does not provide full pay in most cases, there are certain situations where you might receive full or additional compensation:
- Employer-Sponsored Disability Insurance: Some employers offer supplemental short-term or long-term disability insurance that can cover a portion of the remaining wages not included in workers’ compensation.
- Full-Pay Policies: Certain employers, especially in government or unionized jobs, may have policies that provide full pay for a limited time during your recovery.
- Third-Party Claims: If a third party is liable for your injury, you may be able to file a personal injury claim against them to recover additional damages, including lost wages and other costs.
What Situations Qualify for Workers’ Compensation Coverage?
Workers’ compensation is intended to cover a range of work-related injuries and illnesses. These include:
- Injuries Occurring at Work
- Work-Related Illnesses
- Repetitive Stress Injuries
Workplace Injuries
Workers’ compensation provides coverage for injuries that happen on the job. For example, if an employee trips and breaks their ankle at your business, workers’ comp can cover their hospital bills and any necessary physical therapy.
Work-Related Illnesses
Exposure to harmful chemicals, allergens, or hazardous conditions at work can lead to illness. If an employee becomes sick due to their working environment, workers’ compensation can help pay for medical treatment and ongoing care.
Repetitive Stress Injuries
Not all workplace injuries result from sudden accidents. Conditions like carpal tunnel syndrome, caused by repetitive motions over time, are also covered. For instance, if a receptionist develops carpal tunnel syndrome after years of typing without ergonomic equipment, workers’ comp can help pay for treatment and long-term care.
Workers’ compensation plays a critical role in helping employees recover from work-related injuries or illnesses while providing financial stability during their recovery. If you have questions about your eligibility or need help with the claims process, don’t hesitate to seek legal guidance.
What Is a Third-Party Claim in a Work Injury Case?
When you’re injured at work, you typically rely on workers’ compensation to cover your medical expenses and lost wages. However, workers’ comp benefits are often limited and don’t provide payment for pain and suffering or other non-economic damages.
In some cases, a third party, meaning someone other than your employer or co-worker, causes or contributes to injuries. If that happened in your case, you may have the option to file a third-party claim in addition to your workers’ compensation claim.
Understanding Third-Party Claims
A third-party claim is a personal injury lawsuit filed against an individual, company, or entity whose negligence caused or contributed to your workplace injury. While workers’ compensation is a no-fault system that doesn’t require proving negligence, a third-party claim allows you to pursue additional compensation by holding the responsible party accountable.
Who Can Be Held Liable in a Third-Party Claim?
Potential third parties in a work injury case can include:
- Contractors or Subcontractors: If you’re injured by the negligence of someone working for a different company on the same job site
- Property Owners: If unsafe conditions on a property caused your injury, such as a slippery floor, broken equipment, or poor maintenance
- Manufacturers of Defective Equipment: If a defective tool, machine, or product caused your injury
- Drivers in Work-Related Accidents: If you’re injured in a car accident while performing work duties, and the other driver was at fault
Key Differences Between a Workers’ Compensation Claim and a Third-Party Claim
A this-party claim is distinct from the workers’ comp system in several major ways, including:
- Fault: Workers’ compensation doesn’t require proof of fault, whereas a third-party claim is based on negligence or liability.
- Compensation: Workers’ compensation only covers medical expenses and a portion of lost wages. A third-party claim can provide additional compensation for pain and suffering, emotional distress, and other damages.
- Legal Process: Workers’ compensation claims are handled through an administrative process, while third-party claims are pursued as civil lawsuits, which may involve court proceedings.
What Damages Can a Third-Party Claim Cover?
A third-party claim allows you to seek compensation beyond what workers’ compensation provides, including:
- Medical Expenses: Both current and future medical costs related to your injury
- Lost Wages: Full wage replacement, including potential future earnings if you’re unable to return to work
- Pain and Suffering: Compensation for physical pain, emotional distress, and loss of enjoyment of life
- Property Damage: If personal property, such as a vehicle, was damaged in the incident
Do You Need a Lawyer for a Third-Party Claim?
Third-party claims can be complicated, especially when they overlap with workers’ compensation. An experienced work injury attorney can:
- Investigate the circumstances of your injury to identify all liable parties.
- Gather evidence to prove negligence or fault.
- Calculate the full extent of damages you’re entitled to pursue.
- Represent your interests in negotiations or court.
Can You File Both a Workers’ Compensation and a Third-Party Claim?
Yes, you can file both claims simultaneously. However, it’s important to understand how they interact. For example:
- Subrogation: If you win a third-party lawsuit, your employer’s workers’ compensation insurer may have the right to recover some of what they paid in benefits from your settlement or award.
- Coordination of Benefits: An attorney can help ensure that filing both claims doesn’t negatively impact your overall compensation.
What Are My Legal Rights if Injured at Work in Georgia?
You are legally allowed to pursue a workers’ compensation claim without fear of retaliation from your employer. A workers’ compensation lawyer can ensure your legal rights are protected against your employer and their insurance company. These rights include:
- Filing a workplace injury claim for your injury or illness in workers’ compensation court or Georgia civil court
- Securing medical treatment
- Returning to your job if you are released to return to work by your physician
- Receiving disability compensation if you are unable to return to work, whether permanently or temporarily, because of your injury or illness
- Appealing the decision of your employer, their insurance company, or the court
- Being represented by an attorney
In understanding your rights as an employee, you must take note of your right to refuse certain requests or offers. For example, if your employer encourages you to use your own health insurance or offers you some incentive in an attempt to persuade you against filing a workers compensation claim, you have the right to say no.
What Happens if Your Employer Denies Full Pay or Benefits?
Unfortunately, some employers or insurance companies may dispute your claim or deny benefits altogether. Common reasons for disputes include:
- Allegations that the injury didn’t happen at work
- Claims that you were at fault or violated safety protocols
- Disputes over the severity of your injury or your ability to work
If your claim is denied or delayed, it’s crucial to speak with an experienced workers’ compensation attorney. We’ll review your case, explain your rights, and fight to ensure you receive the benefits you’re entitled to.
Need to Talk to a Workers’ Compensation Lawyer for Free?
After being injured at work, you have the right to seek benefits from your employer’s workers’ compensation insurance. While workers’ comp may not pay the full amount you were making before, it should cover a portion of your weekly pay, and you may be able to seek higher compensation through a settlement.
The workers’ compensation lawyers at John Foy & Associates can help. Our team can guide you through every step of the process, from filing a claim to appealing a denial. Contact us today for a free consultation to go over your case and the best options for you.
(404) 400-4000 or complete a Free Case Evaluation form