Employers purchase a workers’ compensation insurance policy to provide benefits for employees in the event of an injury at work. Workers’ comp can vary between states, but most places offer four types of workers’ compensation benefits to workers. Your employer as well as personal injury lawyers in your area can explain what all your plan covers and how you can receive a monetary recovery.
If you or a loved one were hurt at work, it’s vital to understand the different types of potential benefits available. These are the four main categories of workers’ compensation benefits.
1. Medical Benefits for Your Treatment
When you are injured at work and file a workers’ compensation claim, you should receive compensation for your medical costs. These include:
- Doctor visits
- Hospital stays
- Medical tests
- Prescription medications
- Medical equipment, such as wheelchairs or crutches
- Physical therapy
- Mileage reimbursement for travel to and from doctor appointments
Any costs that result from your work-related injury should be covered through workers’ compensation. You should be covered until you are fully recovered and able to return to work. However, you will need to see the right medical provider to qualify for compensation.
Choosing From the Provider Network
Under Georgia Code § 34-9-201, your employer must provide a list of “at least six physicians or professional associations or corporations of physicians” for you to choose from for medical care. The doctors or other providers in this network are typically contracted with the employer or insurance company to provide discounted services.
These providers must also be reasonably accessible to you. You also have the option to make one change between physicians as long as they are still covered under your employer’s policy.
It’s very important to see a doctor who is authorized under your employer’s workers’ comp policy. Otherwise, you may miss out on some or all of the medical benefits available to you. If you still experience problems with getting medical benefits, contact a Georgia workers’ compensation lawyer as soon as possible.
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2. Disability Benefits Through Workers’ Compensation
If your work injury affects your ability to work, you may be eligible for disability benefits through workers’ compensation. These benefits typically fall into one of four different categories:
- Temporary total disability
- Temporary partial disability
- Permanent total disability
- Permanent partial disability
Temporary Total Disability
Many injured workers are able to receive temporary total disability for a certain period of time. In Georgia, you must be unable to return to work for at least seven days to qualify for temporary total disability payments. If you are away from work for at least 21 consecutive days, you will also receive payment for the first seven days you are away.
Temporary total disability benefits equal two-thirds of the average weekly wage you were earning before your work injury (capped at $675 per week). You also can’t receive these benefits for over 400 weeks unless you have a catastrophic injury.
Temporary Partial Disability
Sometimes, you are still able to work after a work-related injury, but at a lower capacity. You might have to work fewer hours, take on a less-demanding role, or earn a lower wage because of your work injuries. If this happens, you can receive temporary partial disability benefits.
Temporary partial disability benefits are paid at two-thirds of the difference between the average weekly wage you were making before and the average weekly wage you can now earn. This number cannot exceed $450 per week. It can also only be paid for up to 350 weeks from the date you were injured.
Permanent Total Disability
Under workers’ compensation, you should receive treatment until you’ve reached maximum medical improvement (MMI). At that point, the doctor treating you will evaluate your situation. If they determine you have a permanent disability, you will likely receive permanent and total disability benefits.
Permanent total disability benefits are often paid at the same weekly rate as temporary total disability, but for life. In some situations, you might be able to get a lump sum settlement to account for your future payments. Only very serious and severe injuries, such as loss of two limbs or total blindness, qualify for permanent total disability.
Permanent Partial Disability
Permanent partial disability payments are paid at the same as the temporary total disability rate for a certain amount of time. How long you will receive these benefits depends on:
- The body part that is disabled
- The percentage of disability for that body part and
- The maximum number of weeks the state of Georgia allows benefits for that body part
A list of the maximum weeks per body loss is provided in Georgia Code § 34-9-263. A Georgia workers’ compensation attorney can also help you determine what your benefits should be based on your disability.
3. Rehabilitation Benefits for Career Support
Your work injury might prevent you from returning to the same position or place of employment at all. If this happens, workers’ compensation benefits should help with vocational rehabilitation and other career support services.
Rehabilitation benefits are meant to help you maintain employment through the necessary training or other services needed to return to work.
4. Death Benefits for Dependents
No one wants to think about getting killed from a work injury. However, if it happens, it’s good to know that any dependents will be taken care of. Workers’ comp provides death benefits to the deceased worker’s minor children, spouse, and other dependents they may have. These are provided at two-thirds of the worker’s average weekly wage before their accident.
Death benefits also cover funeral and burial costs.
Benefit Limitations Through Workers’ Compensation
Although workers’ compensation can help you get back on your feet, it doesn’t fully compensate you for what was lost. The wage benefits are only a portion of what you were making before, and the weekly cap can mean you are receiving a lot less than you were before at a high-paying job. You also cannot collect for any pain and suffering that came along with your injuries.
The advantage of workers’ compensation benefits is that you do not have to prove fault or pursue a lawsuit to get compensation. This is meant to protect both you and your employer from expensive legal cases. That being said, workers’ comp is not perfect. You may run into issues with your employer or the insurance company.
A workers’ compensation lawyer can help you seek the benefits you need and deserve after your work injury.
How Workers Compensation Is Calculated
You have a limited amount of time to file a workers’ compensation claim. Your attorney can work with this statute of limitations and help you calculate what you should be paid. Your workers’ compensation is calculated based on several factors, including:
- Class code: These are assigned by the National Council on Compensation Insurance (NCCI) or your state. Each employee gets a unique code based on the type of work they do.
- Payroll: Business owners will need a certain amount of workers’ comp insurance based on every $100 of payroll.
- Experience modification number: This amount takes into consideration your business’ experience and loss history. The safer your business, the lower your experience modification number. These numbers can change based on state requirements.
A general equation to help you estimate your business’ workers’ compensation insurance cost:
Workers’ Class Code Rate X Claims Experience Modifier X (Payroll / $100) = Premium
The Cost of Workers’ Compensation Insurance
Your cost for workers’ compensation insurance depends on your business’s unique risks. There’s no standard cost for workers’ compensation insurance, also known as workers’ comp. Insurance companies use different factors to determine workers’ compensation insurance costs. This can include your:
- Claims history
- Years of experience
Talk to a Workers’ Compensation Lawyer in Georgia for Free Today
John Foy & Associates has been helping injured workers get the benefits they need for over 20 years. We can help you too. To get started, call us at (404) 400-4000 or contact us online for your FREE consultation.