Now and then we speak with a potential client who has been told they were ineligible for workers’ compensation benefits in Georgia. By the time they leave our office, they understand that they are in-fact eligible.
Georgia’s laws make the workers’ compensation process overly complex, but most people who are employed in Georgia are entitled to workers’ comp benefits if they are injured on the job. This is crucial to understand because workers’ compensation pays all of an injured worker’s medical bills, a portion of their wages as they recover, and benefits for any permanent disability.
In addition, the dependent family members of a worker who dies because of a job-related injury or illness are eligible for workers’ compensation benefits in Georgia that pay for burial expenses and a portion of lost wages.
Employers and workers’ comp insurers often dispute employees’ injuries to save money on insurance payouts. But Georgia’s workers’ compensation law is enforceable. An Augusta workers’ compensation lawyer at Gregory Smith Law can help you pursue the workers’ comp benefits available to you by law.
Attorney Gregory Smith has practiced workers’ compensation law exclusively for more than 25 years. Please contact us for a free consultation if you have experienced a work-related injury or illness in Georgia and your employer or the insurance adjuster has disputed your claim.
When is Workers’ Compensation Required in Georgia?
Almost anyone who is employed in Georgia should be covered by workers’ compensation. All Georgia employers that have three or more full-time or part-time employees must carry workers’ compensation insurance. Coverage begins the first day of employment.
Exceptions to coverage requirements include railroads and U.S. Government agencies (where employees are covered by federal programs), farm laborers and domestic servants. Agricultural and domestic workers have traditionally been exempted from U.S. labor laws, though some states offer farmworkers some legal protections.
Now that you know your employer is required to provide workers’ compensation insurance, how do you qualify to receive benefits?
Workers’ Compensation Injuries Must Be Work-Related
Anytime an employee is injured while performing assigned job duties during work hours, the employee is eligible for workers’ compensation. This applies to a work-related injury, occupational illness, or a death arising in the course of employment. The worker is immediately entitled to medical benefits. The employee is entitled to weekly income benefits once he or she has more than seven days of lost time due to an injury.
Injuries are not covered if they occur:
- While engaging in unassigned duties outside the scope of employment
- During the employee’s normal commute to or from work.
Georgia’s workers’ compensation is a no-fault system. It does not matter who caused a job-related accident that left you injured. Even if you were at fault, you still qualify for benefits. Even injuries resulting from haste and inattentiveness are covered. There are a few exceptions to the no-fault rule, however.
Workers’ compensation does not provide benefits for an injury or accident resulting from an employee’s willful misconduct, such as:
If you are injured by the willful act of a third party for personal reasons, that injury may not qualify for workers’ compensation.
When you have suffered an eligible injury or been diagnosed with a work-related illness, you should report to your employer promptly after the accident or diagnosis. We suggest reporting work-related injury as soon as possible to your supervisor or foreman and then in writing within 30 days to the company’s human resources office to be sure that it is on the record.
You actually have one year to apply for workers’ compensation benefits. Most people file as soon as their injury has kept them out of work for more than seven days and they qualify for income benefits. Bills for medical treatment, which start immediately after most injuries, are paid by the insurer. You should never see the bills.
Maintain Your Qualification for GA Workers’ Compensation
Once you are in the Georgia workers’ compensation system, there are rules and regulations you must follow, or your continued benefit could be jeopardized. Here are some of the bigger issues you may encounter:
- You must see a doctor / medical care provider authorized by your employer. This requirement does not apply to emergency care. Your employer is required to post a list of at least six doctors or the name of a certified WC/MCO that provides medical care for work-related injuries. You may choose a doctor from the list and make one change to another doctor on the list without the permission of your employer.
- You must follow the authorized treating physician’s orders for medical treatment and rehabilitation. Disregarding the doctor’s instructions and failing to keep follow-up appointments may cause suspension or termination of your workers’ compensation benefits. If you have a real disagreement about your course of treatment, you need to speak to a workers’ compensation attorney.
- You must attempt any job approved by the authorized treating physician, even if the pay is lower than the job you had when you were injured. If you do not attempt the job, your benefits may be suspended.
If you are found to be working a second job for another employer while receiving Temporary Total Disability Benefits – paid when the authorized treating physician says you are unable to work – your benefits will be discontinued, and you could be charged with insurance fraud.
Get Legal Help for a Workers’ Comp Claim in GA
Georgia’s workers’ compensation laws provide benefits to employees who have been injured or become ill while on the job. But there are many protections for employers and insurers, as well. It’s easy for an injured worker to make a mistake that could jeopardize a claim. Seek the guidance of a knowledgeable workers’ compensation lawyer.
At Gregory Smith Law, LLC, we can help you file your claim and ensure you meet all necessary deadlines, requirements, and restrictions to qualify for workers’ comp benefits. If you are new to the Georgia workers’ compensation system, call us today or reach out to us online to schedule a free consultation.