Most workers in Georgia are eligible for workers’ compensation insurance from the first day of their job. Workers’ comp is meant to compensate you for medical bills, lost wages, and provide other benefits if you are hurt at work. While this can help you recover and supplement your income until you can return to your job, you might need the assistance of a Georgia workers’ compensation lawyer to get the full benefits you deserve.
At John Foy & Associates, we have been helping injured workers get the money they need as they recover for more than 20 years. We know how insurance companies and employers can make it difficult, often pressuring you to return to work sooner than you’re able. We can protect your legal rights and make sure you are treated fairly.
Call us at (404) 400-4000 or contact us online for a FREE consultation to discuss your options. There is no risk to contact us or work with us. We do not take a fee unless we win your case. Call (404) 400-4000 now to get started with your FREE consultation.
What Workers’ Compensation Means
Workers’ compensation, or workers’ comp, is a type of insurance employers must purchase to cover their employees in the event of a work injury or accident. Here’s what you should know about workers’ compensation in Georgia:
- Employers with three or more regular employees (including part-time, full-time, and seasonal) must carry workers’ compensation, according to the Georgia State Board of Workers’ Compensation (SBWC).
- Workers’ comp provides medical benefits, supplemental income (if you are unable to work for at least seven days), vocational rehabilitation benefits, and compensation for dependents if you are killed by a work injury.
- Unlike personal injury cases, fault does not matter in workers’ comp claims. If the injury happens at work, it’s covered.
Since workers’ comp is a “no-fault” system, there’s no need to prove how the accident happened. This protects your employer from expensive lawsuits and should ensure that you get benefits when a work injury occurs. Unfortunately, you can still run into problems when seeking workers’ comp coverage.
Insurance companies, including those that provide workers’ compensation, do not like paying out much on claims. They will look for ways to reduce how long they provide you with coverage. That may include pressuring you to return to work (and end your disability benefits) before you’re fully able and downplaying the severity of your injuries.
To legally protect yourself after a work accident, it’s best to contact a Georgia workers’ compensation lawyer as soon as you can. They can examine your case, make sure you understand your options, and prevent you from getting taken advantage of during the claim process.
Disability Benefits Through Georgia Workers’ Compensation
Your work injury must prevent you from working for at least seven days to be eligible for disability benefits (Georgia Code § 34-9-220).
While you are receiving treatment and unable to work, you can receive temporary total disability (TTD) benefits. These are paid at about two-thirds of the amount you were making before your injury, up to $675 per week. You cannot receive TTD for more than 400 weeks, but most employees are recovered far before that time.
If you can return to work but your injury forces you to take a lower-paying job, you can receive weekly benefits for two-thirds of the difference between your former and current job’s wages. Finally, if you become fully disabled because of your injury, a doctor will evaluate you for the possibility of total permanent disability benefits, which may last for life.
What Does Workers Compensation Pay in Georgia?
Georgia workers’ compensation pays for the following benefits:
- Compensation of medical costs
- Medical care
- Supplemental income
- Rehabilitation support
- Death benefits (for your dependents if you are killed in a workplace accident)
All of your medical costs resulting from your work injury should be covered through workers’ compensation. You are also eligible for vocational rehabilitation if your injury forces you to adapt to a new line of work or skill. In addition, if you are disabled from working for a certain period of time, workers’ comp provides benefits to supplement your income.
There are three main types of disability benefits you may be eligible for through workers’ compensation in Georgia.
Temporary Total Disability (TTD) Benefits
If you cannot return to work for at least seven days after your work injury, you can receive temporary total disability (TTD) benefits. Here’s what you need to know about TTD:
- They provide two-thirds of your average weekly wages.
- TTD benefits are capped at $675 per week (with a minimum of $50 per week).
- You may be able to receive them for up to 400 weeks or until you reach maximum medical improvement (MMI).
- Once you return to work as before, these benefits will stop.
- TTD benefits are meant to provide income support while you recover, with the intention of making you well enough to go back to work.
Temporary Partial Disability (TPD) Benefits
Workers’ comp provides temporary partial disability (TPD) benefits if you are able to return to work but at a lower-paying job. Your work injury might disable you from performing certain types of work actions. Your employer may offer you another position, often at a reduced wage. Thankfully, TPD benefits help account for the discrepancy:
- TPD benefits are equal to two-thirds of the difference between the average weekly wages you made before your accident and the weekly wages you can earn after the accident.
- You can receive these benefits for up to 350 weeks from the date you were injured.
- TPD benefits are capped at $450 per week.
Permanent Disability Benefits
Permanent disability benefits are reserved for workers with very serious and debilitating injuries. Your doctor will evaluate you for permanent disability after you have recovered as much as possible with medical treatment.
You may have a permanent total disability or a permanent partial disability. Permanent total disability benefits are provided at the same rate as temporary total disability benefits—but you may be able to receive them for life.
Permanent partial disability benefits are calculated based on the percentage of your disability and where on your body you are disabled. Figuring out the full value of your benefits can be tricky, so it’s best to contact a Georgia workers’ compensation lawyer for help.
Problems with Obtaining Workers’ Compensation Pay
Since workers’ compensation is a no-fault system, you will not have to prove fault to make a claim for benefits. However, there are ways your employer or their workers’ comp insurance company may try to reduce what you’re paid. They will want you to return back to work as soon as possible, since paying benefits without having you at work is costly.
A workers’ compensation lawyer can make sure you are legally protected during your claim.
How Long Can You Receive Workers’ Compensation in Georgia?
The amount of time you can receive Georgia workers’ compensation depends on the severity of your injury and how long it takes you to return to work. There are also various benefits you may receive.
Disability Benefits You Can Receive
If you are unable to go back to your job after a work injury for at least seven days, you can begin receiving temporary total disability benefits. You’ll be paid weekly wages at two-thirds the amount of your average weekly wage (or up to $675 per week).
When you get treated and return to work, your temporary total disability benefits will cease. You cannot receive those benefits if you are earning money. However, if you are able to return to work but in a lower-paying position, you may be able to receive money to account for the wage change.
Once you start the lower-paying job, you’ll receive two-thirds of the difference between your former weekly wage and your current one (capped at $450 per week). Now, if your work injury permanently disables you from working, you may be able to receive benefits (at the two-thirds rate) for much longer—maybe even for life.
Medical Benefits You Can Receive
All medical costs you experience because of your work injury should be compensated through workers’ compensation. Therefore, the amount of compensation you receive for your medical expenses will depend on your total bills. Medical costs may include:
- Doctor visits
- Hospital bills
- Prescription medications
- Physical therapy
- Gas for travel to and from doctor appointments
To make sure you receive all of the medical benefits you’re entitled to, you’ll need to see the right doctor(s) for your treatment. If you need emergency medical treatment right after your injury, you should see the nearest ER or urgent care. Otherwise, you’ll need to choose from a list of authorized physicians provided by your employer.
If you do not see a doctor covered under your employer’s workers’ compensation policy, you could lose your access to benefits.
As you can see from the above information, how long you can receive workers’ compensation depends on the nature of your injuries and how long it takes you to return to work. However, you will need to take the correct form of action to begin receiving benefits in the first place.
Maximizing How Long You Can Receive Workers’ Compensation in Georgia
Unfortunately, it’s common for insurance companies to provide you as little as possible in a claim—and workers’ compensation is no exception. Medical costs and disability benefits can get pricey quickly, so insurers may look for ways to reduce what they owe you. However, you should know that workers’ comp is your legal right as an employee in Georgia.
To make sure you are protecting your legal rights and seeking the full compensation you deserve, you should:
- Report your accident to your employer right away.
- Get medical treatment from an authorized doctor as soon as possible.
- Follow the treatment plan prescribed by your doctor.
- Keep track of all expenses related to your work injury.
- Call a Georgia workers’ compensation lawyer
Does Workers’ Compensation Pay Full Salary in Georgia?
No, workers’ compensation in Georgia does not pay the full salary you were making before you became injured. However, it does pay a portion of your wages to provide you with income until you’re able to return to work. If you end up with a permanent disability, you may be able to receive benefits for longer.
If your injury keeps you from working, you’ll need to know the following:
- You can receive weekly payments at two-thirds of your average weekly wage, up to $675 per week.
- You’ll have to be away from work for at least seven days to begin receiving these benefits.
- The max amount of time to receive disability payments is 400 weeks unless you are found to have a permanent disability.
Even if you have a permanent disability, most workers’ compensation pay is two-thirds of your full salary.
Workers’ Compensation Settlements
It’s also important to know that sometimes, pursuing a workers’ compensation settlement is the best option for you. While two-thirds of your weekly wages (up to $675 per week) can help keep some workers on their feet, it’s also not a lot of money. Some people cannot live on that long-term. Seeking a settlement amount may actually be more advantageous for your future income needs.
A Georgia workers’ compensation lawyer can help you decide whether or not a settlement is better for your situation versus weekly disability payments and medical benefits. It’s more likely to be the best option if you have a very serious, disabling condition as a result of your work accident.
Other Benefits Through Workers’ Compensation
So, workers’ compensation in Georgia does not pay full salary—but there are supplemental income benefits you can receive if you are unable to work for at least seven days. Thankfully, there are other benefits available to you, as well.
After your injury, workers’ comp covers:
- Medical costs, including current and future care
- Rehabilitation support
- Death benefits for your dependents
Medical benefits should cover the full costs of medical expenses you face for the treatment of your injuries. This includes future costs you are expected to have. If your injury prevents you from performing the actions of your current job, you may have to adjust to an alternative career path of type of work. Workers’ compensation can provide vocational rehabilitation to help you transition to a new position.
Workers’ comp also provides death benefits for workers who die from a work injury or illness. Death benefits provide the worker’s dependants with two-thirds of the worker’s wages before they passed away. Death benefits also include compensation for funeral and burial costs.
How to Support Your Claim
Although workers’ compensation does not pay full salary after a work accident, it can help compensate you for a lack of income while you’re getting better. You may also have to fight for some of your rights, as some employers and insurance companies look for ways to reduce workers’ claims.
If you are worried about getting the full benefits you deserve from your workers’ comp claim, contact a Georgia workers’ compensation lawyer today for help.
Who Qualifies for Workers’ Compensation in Georgia?
Most workers in Georgia qualify for workers’ compensation. If your employer has three or more employees, they must carry workers’ compensation insurance. If the business is incorporated, officers count as employees towards the minimum requirement, even if they waive their own coverage.
Unless you work for an incredibly smart startup business, you are likely covered by workers’ compensation. Part-time, full-time, and seasonal workers count as long as they work as employees on a regular basis. You are also covered immediately, from the first day you start your job.
Workers’ Compensation Exemptions
There are a few types of workers who are exempt from workers’ compensation. They include:
- Railroad carriers
- Farm laborers
- U.S. government agencies
- Domestic servants
These workers are typically covered for work injuries in other ways. Sole proprietors and contractors are seen as employers under Georgia law, not employees, but they can elect to be covered through their insurance company.
Disqualifications from Workers’ Compensation
There are certain situations where an injury might not be covered even if you are eligible for workers’ comp. If your injury happens while you were using alcohol or drugs or during a non-work-related fight, you might lose your right to benefits.
What You Get if You Qualify
As you can see, most employees qualify for workers’ compensation if they are regularly employed by a business in Georgia. When you are covered by workers’ compensation, you can receive the following benefits after a work-related injury.
Medical costs you might have from a work accident include:
- Doctor bills
- Hospital bills
- Travel to and from appointments
- Prescription medications
- Test, surgeries, and other things your doctor orders
- Physical therapy
Through workers’ compensation, all your medical costs should be covered. This includes future medical care you may need to treat the same injury.
Many workers are unable to return to work right away. You might need to get proper treatment and rest before you are well enough to perform the duties of your job. This would qualify you for weekly income benefits if you are away from work for at least seven days.
You can receive two-thirds of your average weekly wage, paid weekly and capped at $675 per week. The maximum you can receive these benefits is 400 weeks, but most employees are fully recovered well before that time. Others are pressured by their employer into returning to work before they’re ready, which would require help from a workers’ compensation lawyer.
If you must take on a new job because of your work injury, workers’ comp may provide vocational rehabilitation to help you adjust to a new career path. You might also need help adjusting to certain disabilities your injury has left you with.
If you qualify for workers’ compensation, you’ll need to make sure you receive the full benefits you deserve after a work accident occurs. A Georgia workers’ compensation lawyer can help you with your case from the beginning and stand up to the insurance company if they try to reduce what they should pay you.
Do All Workers’ Compensation Cases End in a Settlement?
Not all workers’ compensation cases end in a settlement, but many can. You do not have to pursue a settlement to receive benefits through workers’ compensation, though. As an employee in Georgia, you are already covered by workers’ comp from the first day of your job.
After a work injury, you will need to file a workers’ comp claim with the Georgia State Board of Workers’ Compensation (SBWC) and send a copy to your employer and their insurance company. You should be eligible for:
- Compensation for all your medical expense
- Weekly wage benefits if you are unable to work for at least seven days
- Vocational rehabilitation if your injury forces you to adjust to a new line of work
- Death benefits for your dependents
You can receive temporary wage benefits (at two-thirds of your regular weekly wage) for as long as you are out of work. However, if you return to work, those benefits will cease. If your work injury leaves you with a permanent disability, you may be able to receive weekly income benefits for longer.
The problem with disability benefits through workers’ comp is that they don’t provide you with a lot. The weekly income benefits you can receive are capped at $675 per week, which isn’t a lot, especially for workers who have a family to support. Your medical costs are covered, but what if you have ongoing future medical expenses that are very costly?
Seeking a lump sum settlement in workers’ compensation case may allow you to account for more money than you would receive from weekly workers’ comp benefits. However, you will want to work with a Georgia workers’ compensation lawyer who can make sure any settlement amount you accept is fair.
Be Careful Accepting First Settlement Offer
Once a workers’ comp case has been settled, you will lose any chance of seeking more compensation. It’s best to wait until you have reached what is called maximum medical improvement (MMI). This is the point at which you have recovered as much as you are going to with medical treatment.
Once you have reached MMI, your doctor will evaluate you for a permanent disability. They will also be able to give you an idea of your future prognosis. You and your lawyer can then determine what your future and ongoing costs will be as a result of your work injury to come up with a fair settlement.
Insurance companies are known for offering a settlement upfront—but one that is a huge lowball. Make sure you do not accept any settlement until you’ve worked with a lawyer who can tell you if it’s actually a good one for your situation.
Factors in a Workers’ Comp Settlement
When calculating what your workers’ compensation settlement should be worth, you and your lawyer will need to consider:
- How serious your injuries are
- Whether or not you’ll be able to continue working
- Future medical costs and other losses from your accident
From there, you can know what is fair to accept and what warrants further fighting for your rights.
Should I Hire a Lawyer for a Workers’ Compensation Claim?
It’s almost always best to hire a workers’ compensation lawyer for help with your claim. You should make sure you work with an attorney who has years of experience in the workers’ comp realm. That way, they will have a full understanding of your type of case and how to handle its complexities.
Below are some of the main situations when you should hire a lawyer for your workers’ compensation claim.
1. Claim Denial
Workers’ compensation benefits are expensive, so it’s not uncommon for insurance companies to deny claims hoping the employee won’t fight it. A lot of workers are afraid of doing anything to upset their employer or jeopardize their jobs, so they will be worried about contesting a denial or trying to get more from their benefits.
In reality, having a workers’ compensation lawyer can make all the difference. You have the right to seek compensation for the injury you suffered.
2. Pressure to Return to Work
Your employer will want to get you back into work as soon as possible after your accident. But you should know that when you start working again, your temporary total disability benefits (that provide weekly income as you recover) will cease. You may also lose your chance to seek further benefits from your workers’ comp claim.
A lawyer can help determine when you are actually fit to return to work so you don’t go back too soon.
3. Being Unable to Work As You Could Before
You are eligible for weekly wage benefits if you cannot work for at least seven days because of your injuries. In the best-case scenario, you would receive these payments until you’re able to return to work in the same capacity.
Unfortunately, work injuries sometimes leave you unable to perform work as you could before. You might be completely disabled from working, or you might have to take on a lower-paying job. Either way, you will likely be eligible for other workers’ comp disability benefits.
Insurance companies do not like to pay out much when it comes to disability, so they will look for ways to limit how long you can receive your benefits. That’s why it’s good to get a workers’ compensation lawyer on your side as soon as possible.
4. You’re at Risk of Being Fired
While employers cannot fire you just because you filed a workers’ comp claim, you are still under “at-will” employment. That means your employer can terminate you without a reason. If you are worried your employer may let you go before you’re able to return to your job, you will need the help of workers’ compensation lawyer.
These are just a few of the reasons why a Georgia workers’ compensation lawyer can be so beneficial to your claim. After a work injury, you have the right to seek benefits as you recover. An experienced lawyer can make sure you are seeking the fullest possible benefits from your claim.
It’s a good idea to contact a lawyer soon after your work injury happens so they can be there from the beginning.
What Does TTD Mean?
TTD is short for “temporary total disability.” TTD is the most common type of disability benefits you can receive after a work injury. Workers’ compensation insurance companies provide TTD benefits to workers who cannot return to their job for at least seven days because of their injuries.
TTD benefits typically continue until you are able to return back to work. They are meant to act as temporary income supplementation while you’re away from work recovering. Here’s what else you need to know about TTD:
- Benefits are equal to about two-thirds of the weekly wages you were making before your work injury.
- You can receive up to $675 per week for TTD benefits, and the minimum is $50 per week.
- The maximum amount of time you can receive TTD benefits is 400 weeks.
Although TTD benefits are temporary and typically only provided until you are working again, you may be eligible for longer-term disability benefits if your injury if you can no longer work as you did before. You may be able to get permanent partial or permanent total disability benefits, depending on your situation.
Filing for TTD Benefits
To start getting temporary total disability benefits, you will need to:
- Have an employer who must carry workers’ compensation (those with three or more regular employees).
- Report your work injury to your supervisor within 30 days of your accident (although immediately is best)
- File a workers’ compensation claim with the Georgia State Board of Workers’ Compensation (SBWC), then send a copy to your employer and the workers’ compensation insurance company
- Get treatment for your injury through an authorized physician listed by your employer.
How TTD Works
To be eligible for TTD, your work injury must prevent you from working for at least seven days. After that, you can begin receiving TTD benefits. If you cannot work for 21 consecutive days, you can also get benefits for the first seven days you were out of work.
TTD benefits are paid weekly, often by check or direct deposit. You will need to set up the details with your employer and the insurance company. Then, you will keep receiving TTD benefits until your doctor says you’re okay to return to work or until you have reached maximum medical improvement (MMI). MMI is the point where you’ve improved as much as it can with treatment.
If you receive TTD for 400 weeks, your benefits will also stop at this point. However, most workers recover well before 400 weeks have passed.
You’ll want to be absolutely sure that you are healed enough to work before you return to your job. This can be difficult to determine, especially if your employer is pressuring you to return sooner than you’re ready. Insurance companies have also been known to work with doctors who will clear you for work earlier, which decreases how much the insurer has to pay.
A Georgia workers’ compensation lawyer can make sure you seek the full benefits you deserve. They’ll help protect your rights and deal with the insurance company (and your employer) if they give you trouble.
What Are the Four Types of Workers’ Compensation Benefits?
Most businesses in Georgia must purchase workers’ compensation insurance for their employees. Workers’ comp helps provide medical benefits, income supplementation, and more for employees who are injured at work. In most states, there are four types of benefits available through workers’ compensation.
1. Medical Benefits
Workers’ compensation should cover the medical costs you face because of your work injury. That includes expenses for:
- Doctor visits
- Hospital bills
- Prescription medications
- Physical therapy
- And more
You will have to choose the doctor(s) you see from a panel of at least six physicians provided by your employer. It’s very important that you see the right doctor because you could otherwise lose out on your benefits. If you are worried about which doctor to see or suspect that yours is biased, contact a workers’ compensation lawyer right away.
2. Disability Benefits
Workers’ compensation can also provide you with weekly disability benefits if you can’t work. If you can’t return to your job for at least seven days after your work injury, you are eligible for temporary total disability benefits
Temporary total disability pays two-thirds of your average weekly wage, capped at $675 per week, for up to 400 weeks. After you return to work, these benefits will stop, so they are meant to supplement your income until you can start earning money again.
There are other types of disability benefits, too. If you can return to work but must take a lower-paying job because of your work injury, you can receive two-thirds of the wage differences between your past and current job. If you end up with a permanent disability that prevents you from working at all, you may be able to receive weekly benefits for life.
3. Rehabilitation Support
For workers with serious injuries that force them to adjust to a new type of work with their disability, vocational rehabilitation may be available. You may have access to career support services through workers’ compensation to help you maintain employment with a disability.
4. Death Benefits
Although no one wants to think about getting killed during the course of a job, it can sometimes happen. If a worker dies because of a work injury, their dependents are typically eligible for death benefits.
Death benefits are weekly benefits paid to the deceased worker’s children, spouse, or other dependents. These benefits also cover funeral and burial costs. It can bring a worker peace of mind to know that if anything happens to them, their family will continue to receive a portion of the pay they were making.
Getting Help with Workers’ Compensation Benefits
Workers’ compensation does not fully account for everything that was lost during your work injury, but it can help make things easier as you recover. Pain and suffering damages are unfortunately not available through workers’ compensation, but your medical costs and a portion of your income should be covered.
Thankfully, you do not have to prove any fault to get workers’ comp benefits. As an employee, they should be covered. The problem is that sometimes it’s hard to get the full benefits you deserve—but that’s where a workers’ compensation lawyer can help.
The Difference Between Workers’ Compensation and Disability
Workers’ compensation and disability insurance provide similar benefits, but they have different purposes and are provided for different reasons. In some situations, you might be able to receive both.
How Workers’ Comp Works
Workers’ compensation is a type of insurance available to most employees through their employers. Workers’ comp provides medical benefits, supplemental income, and more after an employee becomes injured at work. As an employee, you are covered through workers’ compensation from your first day of employment.
If you are away from work for at least seven days because of a work injury, you can receive temporary total disability benefits, which pay about two-thirds of the weekly wage you were making before their injury. Temporary total disability benefits may be provided for up to 400 weeks. If you become permanently disabled, you may be able to receive permanent disability benefits for much longer.
How Social Security Disability Works
Disability insurance is provided by the Social Security Administration (SSA). Workers pay into Social Security Disability Insurance (SSDI) through a portion of each paycheck. To receive SSDI, you must:
- Be unable to work in any capacity
- Have a disabling condition that is expected to last at least one year (or result in death)
- Have earned enough work credits through the SSA
SSDI is an option for those who meet the above criteria, but it is not easy to obtain. The SSA is very strict in its approval of Social Security Disability (SSD) applicants, which leads many people to fall through the cracks. Therefore, it’s usually best to work with a lawyer who understands SSDI cases and can help you with your application.
Receiving Both Workers’ Compensation and Disability
In some situations, you may be able to get both workers’ comp and disability benefits at the same time. When you return to work after filing for workers’ compensation, those benefits typically stop. However, sometimes you are unable to work at all and need long-term benefits.
With a permanent disability, you can continue receiving workers’ compensation for a certain amount of time. But if those benefits top, Social Security benefits can help provide additional income if you cannot work.
Getting the Benefits You Need
Both workers’ comp and SSD are meant to help you if you cannot continue working to support yourself and your family, even though they are obtained through different means. Unfortunately, both workers’ compensation and SSD applicants often run into issues when they try to get the benefits they are legally entitled to receive.
Insurance companies do not like to pay out much on claims, and that includes workers’ compensation. In addition, the SSA has many reasons that they deny an SSD applicant their disability benefits. For each type of assistance, you will need to have a strong case demonstrating your disability and how it prevents you from working.
A Georgia workers’ compensation lawyer can help you get the benefits you need and deserve. At John Foy & Associates, our lawyers are greatly experienced in both workers’ comp and Social Security Disability laws. We can make sure you are building the strongest case possible.
What Is the Average Settlement for a Workers’ Compensation Claim in Georgia?
There is no way to give a set average settlement for a Georgia workers’ compensation claim because every situation varies a lot. However, we can discuss the different elements of a workers’ compensation case and how you can seek a fair settlement.
When you work for an employer that carries workers’ compensation (which, in Georgia, encompasses most businesses), you have benefits available to you if you are injured at work. If your work injury prevents you from working for at least seven days, you can get temporary total disability benefits. Here’s a breakdown of temporary total disability:
- Provides a weekly wage equal to about two-thirds of what you were making before your injury
- Capped at $675 per week (and a minimum of $50 per week)
- Can be provided for up to 400 weeks unless you return to work sooner
These benefits are meant to supplement your income until you can get back to making money at your job. Employers will often pressure injured employees to return to work sooner rather than later. If this happens, you should talk to a workers’ compensation lawyer right away. If you go back to work but must take a lower-paying job, you can get weekly benefits totaling two-thirds of the difference between what you made before and what you now make after your injury.
Besides the income benefits, workers’ compensation also covers your medical costs for your work injury. Any medical bills, medications, or long-term treatments should be covered. You will need to see an authorized physician provided from a list from your employer for your treatment. Otherwise, you might not be able to get all of your benefits.
Calculating a Workers’ Compensation Settlement
The main factors in determining the value of your workers’ compensation case are:
- The severity of your injury and
- How much (and how long) your injury disables you from working
Since these factors can be so different per person, there is no true average settlement amount. This is why it’s best to work with a Georgia workers’ compensation lawyer who understands local workers’ comp laws and cases. Your lawyer can evaluate your case and determine how much your settlement may be worth.
Once your condition has improved as much as it can with medical treatment, your doctor will evaluate you for a permanent condition. If you are found to be permanently disabled, you may be able to receive further disability benefits. Permanent disability will look at the body part(s) that is disabled and what percentage of a disability you have.
Seeking a Settlement
While you can receive workers’ compensation without a lump sum settlement, you and your lawyer may determine that a settlement is the best option for you. The weekly disability benefits you can receive through workers’ comp can be very helpful, but they do not provide a lot of income. This can be very difficult if you are disabled for a long period of time.
Pursuing a settlement may help ensure you are better compensated for your losses, including future medical care.
How Do Workers’ Compensation Payments Work in Georgia?
There are a few different ways you can receive payment through workers’ compensation in Georgia. After a work injury, you are eligible for benefits like:
- Compensation of medical costs like doctor visits, surgeries, medications, and physical therapy
- Disability payments while you’re away from work
- Vocational rehabilitation
- Death benefits for your dependents
Payments for Medical Costs
To get compensation for your medical costs, you will need to see a doctor from a list provided by your employer. In Georgia, employers with workers’ compensation policies will need to provide a panel of at least six authorized physicians for injured workers to choose from. These doctors should be within a reasonable distance of you, and you have the option to switch doctors once.
You will need to include your medical expenses in your workers’ comp claim to they can be covered.
When it comes to disability benefits, those are paid on a weekly basis. Your benefits will be about two-thirds of the average weekly wage you were making before your injury, up to $675 per week. You can receive these up to 400 weeks or until you are able to return to work.
Workers’ comp disability payments may be provided through cash, check, or direct deposit, depending on the arrangement you make with your employer. You can begin receiving these payments if you are unable to work for at least seven days after your injury. And, if you cannot work for 21 consecutive days, you’ll also get paid for the first seven days you were away.
The main types of disability benefits available through workers’ compensation include:
- Temporary total disability
- Temporary partial disability
- Permanent partial disability
- Permanent total disability
Permanent disabilities will affect your entire life long-term. Workers’ compensation can provide benefits to support you if you must take a lower-paying job or are unable to continue working at all.
In some situations, workers’ compensation will provide you with vocational rehabilitation. Very serious, catastrophic work injuries can force you to adjust to a new way of life. If you have a disability now, you might need assistance finding a new line of work that accommodates your new work baseline.
Workers’ compensation should help you with vocational rehabilitation services if you need them.
If you are killed because of a work-related injury or illness, your dependents are eligible for workers’ compensation payments in Georgia. They can receive two-thirds of the average weekly wages you were making to help support their living expenses. This amount is typically capped at $150,000 and also includes funeral and burial costs.
In some situations, you may be able to receive a lump-sum payment through workers’ compensation. This can happen when a worker is expected to have serious rehabilitation needs or experience big hardships because of their work injuries.
A workers’ compensation lawyer can help you determine the best route for you. They’ll help you file your workers’ comp claim and fight for your rights to the full benefits you need to recover.
Who Is Not Covered By Workers’ Compensation?
Most workers in Georgia are covered by workers’ compensation insurance through their employers. However, some are exempt from benefits because they receive certain coverage through other means. We’ll look at some employees who typically do not get covered by workers’ compensation.
Railroad employees are exempt from workers’ compensation, but they are covered by the Federal Employers’ Liability Act that protects railroad employees who are hurt at work. This Act provides benefits like medical care, lost wages, and more.
Farm laborers include those who work in the raising, feeding, and care of wildlife animals. The employer of farm laborers can elect to offer workers’ compensation coverage, but farm laborers are often exempt from workers’ comp.
Federal employees include civil officers and employees of any of the three United States government branches. Federal employees are covered under the Federal Employee’s Compensation Act (FECA) that helps cover medical costs, disability benefits, vocational rehabilitation, and death benefits. Through this Act, federal employees have access to benefits similar to what is provided through workers’ comp.
Longshoremen work to build, unload, or load ships. While these workers are exempt from workers’ compensation benefits, they have access to support through the Longshore and Harbor Workers’ Compensation Act.
Freelancers, consultants, and other independent contractors are considered to be employers rather than employees in Georgia. They pay their own income tax and are typically not covered under workers’ compensation. There are certain situations where an independent contractor may have access to workers’ comp benefits, but it’s rare.
Some Business Owners
Incorporated businesses in Georgia must count officers as employees when it comes to workers’ compensation. Officers can elect to exempt themselves from coverage, but they are still counted towards the “three or more employees” requirement for workers’ compensation coverage.
Volunteers are not paid through an employer, so they are not covered under a workers’ compensation policy. On the other hand, certain workers who fall under volunteer states, such as firefighters or fire responders, may still have access to workers’ compensation benefits.
If you are not sure whether or not you are covered by workers’ compensation, it’s best to contact a Georgia workers’ compensation lawyer for help. They will have detailed knowledge of the state’s workers’ comp laws and requirements. You’d be surprised how many employers do not have workers’ compensation insurance when they are legally supposed to carry it.
Injuries Not Covered By Workers’ Compensation
Almost all injuries that happen at work are covered by workers’ compensation, but there are some rare exceptions. An injury might not be covered if it happens when:
- You are under the influence of drugs or alcohol
- It’s related to a fight at work
- Illegal activities were taking place
In addition, you can lose your right to workers’ compensation benefits, no matter how badly you were injured, if you do not report the accident to your employer, file a Form WC-14 with the State Board of Workers’ Compensation (SBWC), and get treatment with an authorized physician.
Does Worker’s Compensation Cover Pre-Existing Conditions?
Workers’ compensation in Georgia does cover pre-existing conditions if they are aggravated by a work injury and they lead to a disability. On the other hand, injuries caused by pre-existing conditions (and not caused by the work injury) would not qualify for workers’ compensation.
What a Pre-Existing Condition Means
A pre-existing condition typically refers to a diagnosed condition you had before signing up for a certain type of coverage, such as health insurance.
When it comes to workers’ comp, a pre-existing condition is a condition that you had before your work injury occurred. Many pre-existing conditions that are aggravated by work accidents happened years before. Some may have even been related to the same type of work.
Pre-Existing Conditions and Workers’ Compensation
As mentioned above, a pre-existing condition can be covered under workers’ compensation if the aggravation of said condition is the cause of your disability. You may only receive coverage for as long as the pre-existing condition is the case of your disability.
After you are injured at work, you will need to see an authorized doctor who can evaluate your condition. They will determine how your pre-existing condition might be related to the work injury you suffered. This can be a tricky area since you are relying on the doctor’s opinion for your coverage.
If you suspect that your doctor is wrong about whether or not your previous condition is related to your work injury, contact a workers’ compensation lawyer right away. Your lawyer is the only person in this situation who will truly have your best interests at heart. Call John Foy & Associates today to get a FREE consultation with a workers’ compensation lawyer at (404) 400-4000 or contact us online.
Common Pre-Existing Conditions Affected By Workers’ Comp
There is no limit on or rules regarding which pre-existing conditions can be covered under workers’ compensation. A workers’ compensation lawyer can help you determine whether or not your situation applies. However, some of the pre-existing conditions we often see aggravated by work conditions include:
- Knee injuries
- Shoulder injuries
- Neck or back injuries
- Degenerative disc disease
Some conditions might even result from a previous work accident.
You will need to show that issues with your condition worsened because of your employment. Unfortunately, insurance companies will see a pre-existing condition as a way to try and reduce how long they pay you benefits—if they do at all. This is why we so strongly recommend working with an experienced attorney from the get-go.
Filing Your Claim for a Pre-Existing Condition
After your injury, you will need to file a Form WC-14 with the Georgia State Board of Workers’ Compensation (SBWC) before sending a copy to your employer and their insurance company. Also, make sure to see the correct doctor and follow their treatment advice closely. If you do not get the proper medical care, you may lose any chance of getting the benefits you need.
Having a pre-existing does not exempt you from workers’ compensation, but it can make your claim more complicated. You might also need to fight harder for your rights—which is where a workers’ compensation attorney can help.
Can You Get Pain and Suffering with Workers’ Compensation?
Unfortunately, pain and suffering compensation is not an option through workers’ compensation. Since workers’ comp is a “no-fault” system, there are limitations on the types of benefits you can receive. This can pose an issue for many workers who experience mental or emotional “injuries” after a work accident.
Definition of Pain and Suffering
“Pain and suffering” refers to physical and emotional stress an injured individual can experience after an accident. Examples of pain and suffering include:
- Scarring or disfigurement
- Emotional distress
- Loss of interest in things you used to enjoy
- Fear, humiliation, or anger
Pain and suffering damages are often purely psychological or emotional, but they still must result directly from a physical injury. In personal injury cases, injury victims can seek pain and suffering damages as part of their insurance claim. However, that is not the case with workers’ compensation claims.
You Cannot Get Pain and Suffering with Workers’ Compensation
Just as you cannot sue your employer for damages when covered by workers’ compensation, you also can’t make a claim for pain and suffering. Instead, you can seek benefits for:
- Medical costs
- Lost wages
- Rehabilitation support
- Death benefits
You’ll want to seek the fullest benefits possible through your workers’ compensation. Although you can’t get compensation for pain and suffering, medical compensation and income supplementation can help reduce the stress of a work injury and missing work.
We highly recommend working with a workers’ compensation lawyer to make sure you are getting all of the benefits you need through your claim. They can work with the limitations of workers’ compensation and protect your rights within those criteria.
Other Pain and Suffering Options
Although you can’t get pain and suffering compensation through your employer’s workers’ compensation policy, there are situations where it may be available through other means.
If your work accident involved a third party, unrelated to your work, such as a car accident, you might be able to file a personal injury claim against that third-party. If the other driver was at least partially at fault for your injuries, they may be liable for some of your damages.
You’ll want to discuss your options with an experienced lawyer after a work-related accident involving a third-party. Your workers’ comp coverage may limit how much you can get from a personal injury claim, but you still might be eligible for pain and suffering compensation.
Protecting Yourself After a Work Accident
Even though pain and suffering are not available through workers’ compensation, it’s important that you take the necessary steps to file your claim. This will ensure you meet deadlines and don’t miss out on the benefits you can receive. Be sure to:
- Report your work injury to your supervisor within 30 days (but we recommend doing so right away)
- File your workers’ compensation claim within one year
- Contact a Georgia workers’ compensation lawyer who can help you with the process
- Keep track of all expenses related to your work injury
- Get medical treatment from a doctor authorized under your workers’ compensation coverage, and keep up with all treatments
Do I Have to Go Back to Work After My Workers’ Compensation Ends?
Recovery is key after any injury, but especially when it comes to a work-related injury. If you are covered by workers’ compensation through your employer, you will need to be very careful about when you go back to work. Returning too soon could have negative impacts on your future care and well-being.
You also might wonder if you need to go back to work after your workers’ compensation benefits end. Under Georgia workers’ compensation, your benefits typically continue until you return to work. Here’s what you should know:
- You can begin receiving temporary total disability benefits if you are unable to return to work for at least seven days.
- Temporary total disability is paid at two-thirds of the weekly wage you were making before your accident (capped at $675 per week).
- You can receive these benefits for up to 400 weeks or until you go back to work.
- Most workers stop receiving benefits far before the 400-week mark.
The purpose of workers’ comp temporary disability benefits is to provide you with income while you are recovering—with the intention of you returning to work. Therefore, your workers’ comp should ideally not end until you are back at work and earning an income.
If you were unable to work for more than 400 weeks, however, your employer could terminate your benefits at that point. You might then be eligible for permanent disability benefits, though.
Returning to Work Too Soon
Paying for an injured worker who cannot immediately continue at their job is expensive for workers’ compensation insurance companies. Employers might also not be thrilled about paying benefits while you are unable to work for them. Therefore, a lot of injured workers feel pressured to come back to work before they are fully comfortable.
Even if you feel pressured, it’s very important that you not go back to work until you are completely recovered or have received as much medical treatment as you need. We say this because when you return to work, you will lose your temporary total disability benefits through workers’ comp.
Working with Your Doctor
Ultimately, the doctor you’re seeing for the treatment of your injuries will dictate when you are well enough to return to work. While you want to trust your doctor has your best interests at heart, it gets complicated under workers’ compensation.
Through your employer’s workers’ compensation policy, you will need to see certain doctors to be eligible for medical compensation. Your employer should provide you with a list of at least physicians to choose from. If your employer does not do this, contact a workers’ compensation lawyer.
You’ll need to see an authorized physician for coverage of your costs. However, if you feel that your doctor is clearing to return to work when you are not fully recovered, you’ll want to tell your lawyer immediately. You may need to get evaluated by another doctor for a second opinion.
You might also get cleared to work again—but under certain restrictions. You might be offered a “light duty job” with your company. Your benefits will stop if you take this lighter job, but they will be reinstated if you are unable to do the job and must stop within 15 days.
What Are the Statute of Limitations for Workers’ Compensation in Georgia?
A statute of limitations is vital in any legal case in Georgia, including workers’ compensation. Statutes of limitations refer to the maximum amount of time you have to bring a legal case after suffering an injury. For workers’ compensation, the statute of limitations is shorter than other types of cases.
You have one year from the date of your work injury to file a claim for workers’ compensation. Not filing your claim within this timeframe typically means you will lose your chance at benefits. However, you will need to keep track of this deadline while also being mindful of other important deadlines along the way.
There are also certain situations where the clock is “tolled” on your workers’ compensation case, giving you a little more time. It all depends on the following statutes of limitations for Georgia workers’ compensation.
Georgia Workers’ Compensation Statute of Limitations
The primary statute of limitations for workers’ compensation in Georgia is one year from the date of your injury. If you, as the worker, are killed from a work-related injury or illness, your dependents would also have one year from that date to file a claim for death benefits through workers’ compensation.
Your deadline for filing might be extended if:
- Your employer pays for your medical costs and/or
- You receive weekly disability benefits from your employer
If you receive either of the above, you would need to file your claim within a year from the last date you received medical treatment or within two years from the day you received your last disability benefit.
Change in Condition Statute of Limitations
Through workers’ compensation, you can receive temporary total disability benefits or temporary partial disability benefits if your injury prevents you from working or forces you to work at a lower capacity.
After you stop receiving either of these benefits, you will have two years from that date to seek additional disability benefits. After this two-year statute of limitations has passed, you will have no way to seek more benefits in relation to this specific work-related injury.
Medical and Mileage Reimbursement Statute of Limitations
This deadline is mostly for your employer. When you get medical treatment for your injuries, you’ll need to submit those bills (and the mileage you used driving to those appointments) to your employer with a year of the treatment dates.
After your employer receives this information, they will have 30 days to pay your medical costs and 15 days to pay for mileage reimbursement.
Don’t Miss the Statute of Limitations
The most important statute of limitations in a Georgia workers’ compensation claim is the one-year deadline to file. However, the other matter too if you want to receive all the benefits you’re legally entitled to get.
An experienced workers’ compensation lawyer can remove a lot of the stress by keeping track of these statutes of limitations for you and making sure you don’t miss anything. Thankfully, most workers’ comp lawyers do not take a fee unless they win your case—so there is no additional financial strain for working with them.
What Is a Retro Workers’ Compensation Policy?
A retro (or retrospective) policy is a type of workers’ compensation rating plan based on losses during the current policy period. It’s an alternative workers’ compensation system that has its pros and cons. In some situations, employers may be able to reduce their overall costs by using a retro workers’ compensation policy plan.
How It Works
At the beginning of a retrospective insurance policy, a premium is initially paid based on what the losses are expected to be. When the policy period has ended, the premium is adjusted based on the actual losses that are experienced.
This type of policy uses a complicated formula to determine a minimum and maximum premium, and the amount can change within that range depending on losses associated with the policy.
Retrospective Versus Guaranteed Cost Policy
In contrast to a retro workers’ compensation policy, the most common type of policy is known as “guaranteed cost.” In a guaranteed cost policy, the premium does not change in response to how many claims are made or the cost of claims during the set policy period. A guaranteed cost plan can change in between policy periods, but not during them.
How Retro Premiums Are Calculated
A certain mathematical formula is used to calculate the retro workers’ compensation policy premium. The insurance company will total up the policy’s basic premium and converted losses, then they will multiply that total by a tax multiplier. Sometimes, there are other factors that adjust that total. Otherwise, this formula will produce a retro premium.
To come up with the company’s minimum and maximum premiums, the standard premium will be multiplied by a minimum and maximum premium factor. When minimum and maximum premiums are determined, the retro premium cannot go outside of these ranges.
The adjustments to a retro policy are usually:
- Six months from the policy expiration
- Twelve months after that expiration date
- And another 12 months after that
The insurer will use these periods to look at total losses and make changes to the premium based on those losses.
Types of Retro Workers’ Compensation Plans
The main types of retro workers’ compensations plans include:
- Incurred Loss
- Paid Loss
- Depressed Payroll
Paid Loss and Incurred Loss retro plans are the most common. Incurred Loss plans are more affordable, while Paid Loss plans are often reserved for very large companies who can pay high premiums.
Pros and Cons of Retrospective Workers’ Compensation
Businesses looking at retro policies will need to weigh the pros and cons. If a company does not have many losses, they could end up paying less than if they had a guaranteed loss policy. They might also be able to provide a premium that is more in line with their actual losses.
Retro plans might also push employers to get injured back to work sooner to control their losses. While this is advantageous for an employer, it often pressures workers into returning to work too soon. A retro plan may also lead a company to lose money if their losses are higher than they anticipated.
Can You Collect Workers’ Compensation and Disability at the Same Time?
Yes, you may be able to get workers’ compensation at the same time as disability benefits. If you qualify for both, you might receive them concurrently. However, you’ll need to know that receiving disability benefits can impact how much you get through workers’ compensation.
Workers’ Compensation Versus Disability
Workers’ compensation is a type of insurance policy provided through your employer by the state of Georgia. If you are hurt at work, you should be covered under workers’ comp, which helps by paying your medical costs and providing income benefits if you cannot work for an extended period.
Georgia employers must carry workers’ comp if they have three or more regular employees. You are also covered from your first day of employment. You are eligible for benefits if your injury happens at work or while performing duties for your employer.
On the other hand, disability benefits (known as Social Security Disability or SSD) is provided federally through the Social Security Administration (SSA). You pay into Social Security through your income taxes, and benefits are available to those who are totally disabled and have paid enough credits into Social Security. You must also have a disabling condition that is expected to last for at least a year.
Collecting Workers’ Comp and Disability
Since each of these programs is provided through different means, you are not disqualified from receiving both at the same time. Many workers will receive workers’ compensation if they become disabled and are waiting for SSD approval. There are limitations on what you can collect from both, however.
The total benefits you are receiving from workers’ comp and SSD cannot exceed 80% of the income you were earning before you became disabled. Your Social Security Disability benefits will likely be reduced if you are paid both at the same time so that you don’t go above the maximum.
Your workers’ compensation benefits might also end while you are still receiving SSD. If this happens, you’ll need to notify the SSA because you might become eligible for higher benefits through Social Security.
Definitions of Disability
Workers’ compensation and Social Security Disability also have different definitions of “disabled.” If your work injury prevents you from returning to your job, you are considered to be disabled through workers’ compensation. You can get temporary total disability benefits through workers’ comp, which assumes you are temporarily unable to work but will return after treatment.
SSD is provided to those who are totally disabled and can no longer perform any type of work—past, present, or future. Plus, simply begin unable to work is not enough to qualify for SSD. You must also have a condition that the SSA recognizes as “disabling” and have paid into Social Security long enough (and recently enough).
A workers’ compensation lawyer can help you navigate the waters between workers’ compensation and Social Security Disability so you can know exactly what you are eligible to receive. There are important deadlines to remember when applying for each, and a lawyer can help you keep up with each step of the process.
What Types of Injuries Are Covered by Workers’ Compensation in Georgia?
Almost all injuries are covered by workers’ compensation as long as they happen at work. There are exceptions, though. If your employer is saying an injury you suffered at work is not covered by workers’ compensation, you should contact a workers’ compensation lawyer to be sure.
Georgia Workers’ Compensation Laws
In Georgia, any business with three or more regular (including part-time, full-time, and seasonal) employees should carry workers’ compensation insurance. Most injuries that happen at work are covered by workers’ compensation because it’s a no-fault system. You do not need to prove fault to be able to file a claim and get your injury costs covered.
Common Injuries Covered By Georgia Workers’ Compensation
Any physical injury that you sustain while at your job should be covered by your employer’s workers’ compensation policy. This can include common work-related injuries like:
- Slip and fall accidents
- Vehicle accidents
- Industrial accidents
- Repetitive motion or overexertion injuries
- Machine-related injuries
- Falling objects
You also don’t need to have a “dangerous” job to qualify for workers’ compensation coverage. Even those who work a desk job are covered if they suffer a work injury—and it happens more often than you would think.
Your employer or their insurance company may try to discourage you from filing for a certain injury or downplay how bad your injury was. If this happens, it’s vital that you get a Georgia workers’ compensation lawyer on the phone right away. You will need a legal professional who can advocate for your legal rights as a worker.
Injuries NOT Covered By Workers’ Comp
There are some instances where work injuries are not covered by workers’ compensation. For one, you can lose benefits if you do not file your claim within the statute of limitations, which is one year from the date of your injury. Make sure you report your accident, see a doctor and file your claim in a timely manner.
Other than meeting the statute of limitations for filing, you might not be eligible for workers’ comp benefits if:
- You were on alcohol or drugs when the injury occurred
- Safety rules were not being followed
- You were hurt during a personal fight not related to work
- Safety devices were not being used
- The injuries were caused by horseplay or practical jokes (unless you were the victim)
Pain and suffering are also not covered under workers’ compensation. Pain and suffering refer to physical or emotional suffering that results from a physical injury. These “injuries” can include anxiety, depression, loss of enjoyment of life, disfigurement, scarring, or humiliation related to your physical injuries.
Lastly, you are not covered for most injuries that take place outside of work, such as on your lunch break or while driving home from work. However, you may be covered if you were performing duties for your job or as requested by your employer. Injuries during work trips are also typically covered by workers’ comp.
If you’re not sure whether or not an injury is covered by workers’ compensation, contact a Georgia workers’ compensation lawyer for help.
Talk to a Georgia Workers’ Compensation Lawyer for Free Today
For help with your workers’ compensation case in Georgia, contact John Foy & Associates for a FREE, no-risk consultation. Call (404) 400-4000 or contact us online now to get started.