Workers’ Compensation and Fault
One of the central points of workers’ compensation insurance is that it is no-fault based; workers have the right to seek damages for their injuries regardless of whether or not they contributed to them. In exchange for no-fault benefits, the worker forfeits their rights to sue their employer. This means that even if you did something to contribute to the occurrence of your injury, you can still file a claim for workers’ compensation insurance; your employer cannot bar you from recovering benefits because you were (partially) to blame. It also means that your employer is shielded from tort liability, so even if your employer was to blame for the injury, you cannot sue them.
The only time that a worker may not qualify for benefits is in the event that their willful misconduct was the cause of the injury (i.e. fighting with another employee or being intoxicated while on the job).
What Are Your Rights Under Atlanta, Georgia, Workers’ Compensation Law?
The first thing you need to know when you are seeking workers’ compensation benefits in Atlanta, Georgia, is what
your actual rights are. This includes your right to medical coverage, your right to wage benefits, and your right to see a company approved physician and seek a second opinion. You also have a right to coverage for any emergency room treatment if your injury required urgent care.
As far as your right to medical treatment, this includes your right to coverage for surgeries, physical therapy or rehabilitation, prescription medications, and follow up appointments with the company approved physician. If you require medical devices, such as braces, crutches, or other medical devices, then you have a right to coverage for these expenses as well. If you must travel a long distance to get to your appointments (greater than 10 miles round trip), then you also have a right to request that your mileage also be covered.
When it comes to your wage benefits, for injuries that occurred after July 1, 2016, you have a right to receive payments at two-thirds of your former average weekly wage (up to $575 for up to 400 weeks in non-catastrophic injury cases), or two-thirds the difference between current and former wages in cases where you are able to return to a light duty position (up to $383 for up to 350 weeks). In cases where you suffer from a catastrophic injury, you may be eligible for lifetime benefits. You will not receive wage benefits, however, until you’ve been out of work for at least seven days. The first seven days will only be covered if you have to miss 21 days of work.
Common Mistakes that Could Compromise Your Atlanta, Georgia, Workers’ Compensation Claim
There are thousands of workers’ compensation claims filed every year in Georgia, but not all of them get approved. Some will be initially denied, fought, and ultimately approved, while others are never approved. This is where it is essential to be aware of the common mistakes that could compromise your workers’ compensation claim in Atlanta, Georgia. These include:
- Missing doctor’s appointments.
- Failing to cooperate with medical advice.
- Exaggerating injuries.
- Failing to disclose pre-existing conditions.
- Posting information about your injury on social media.
- Posting information about your life on social media.
- Failing to seek the advice of an Atlanta, Georgia, workers’ compensation attorney.
- Hiring an attorney without first seeking an in-person consultation.
Do Not Miss Doctor’s Appointments when Seeking Workers’ Compensation in Atlanta, Georgia
Missing a doctor’s appointment for any reason could compromise your claim. If you absolutely must reschedule, be sure to do so as quickly as possible and don’t miss the next one. Even when you no longer need to see your doctor as frequently, you need to schedule and keep regular appointments to stay in touch and ensure that your claim is not compromised by failing to seek regular medical care.
Always Follow Medical Advice when Seeking Workers’ Compensation in Atlanta, Georgia
Failing to follow medical advice is another big mistake. It is common in cases where a doctor tells you to wear a brace or use another medical device that you don’t want to use. You may feel that a neck brace, for example, is uncomfortable and that you can keep still without it. You might just take it off for a little while. Yet, if you are seen without it, then there will be questions about whether you really need it.
Never Lie About or Exaggerate Injuries in a Workers’ Compensation Claim
Some people fear that they won’t be taken seriously when filing a workers’ compensation claim. They then make the mistake of exaggerating or telling outright lies about symptoms. This is a big mistake that could prevent you from recovering compensation that you would otherwise be owed. Failing to disclose pre-existing conditions is another mistake that many people are tempted into out of fear that they will be denied benefits because of the pre-existing condition. You could be accused of workers’ compensation fraud if you hide or exaggerate anything, which is not a good position to be in.
Do Not Post About Anything on Social Media Accounts when Filing for Workers’ Compensation
Posting about your work related injury or your day to day life on social media accounts could compromise your Atlanta, Georgia, workers’ compensation claim. You may think that it is an innocent post, but it could easily be used against you. Whether you appear to be having fun or appear to be enjoying your usual activities, this can look bad when you seek benefits. Avoiding posting on social media at all for the duration of your workers’ compensation claim is a wise idea.
Atlanta Workers Comp Attorney explains – What Type of Injury Qualifies for Workers’ Comp?
Workers in the state of Georgia are not only eligible for benefits when they sustain an acute injury; acquired injuries and illnesses also qualify a worker for benefits. Assuming that the injury, illness, or death arose out of and in the court of employment, the worker suffering from the injury, illness, or death is eligible for workers’ compensation insurance.
Who Qualifies for Workers’ Compensation in Georgia?
According to the Georgia State Board of Workers’ Compensation, all of those employers with three or more regular employees/workers are required to carry workers’ compensation insurance. Employees can be part-time, full-time, minors, or any other person who is working under contract of hire, written or implied. This means that even if you are a part-time employee, are not yet a legal adult, or are working without proper authorization, you have the right to workers’ compensation insurance when you are injured on the job.
How do Georgia employers benefit from offering workers’ compensation coverage?
While many employers may not like this extra burden, having workers compensation is a two-way street with benefits for both the employee and the employer. Employees obtain benefits irrespective of who was at fault. In return, employers are protected from litigation by injured workers seeking financial compensation for any injury, emotional trauma, pain, and suffering. In other words, it is a form of “compensation bargain” through which both the employee and the employer are protected in the event of an unfortunate accident. Employees no longer have to go through legal battles to get benefits and employers can avoid getting involved in a negligence lawsuit.
The laws regarding workers’ compensation are fairly comprehensive and provide specific benefits to workers who suffer an illness or injury related to work. These benefits range from the recovery of lost wages, death benefits, medical expenses, rehabilitation, and outpatient clinic visits. For employers who fail to have workers compensation insurance for their workers, this can result in the employer not only being penalized heavily by the state but also having to personally pay for any medical injuries suffered by the employee.
In Rome, GA, the same rules apply for all employers who employ 3 or more people. Every employer must meet the worker’s compensation obligations by purchasing an insurance policy from a private insurance company. Georgia, like other states, follows a no-fault system when it comes to workers’ compensation. This means that no matter who is at fault if a worker suffers a work-related injury, the employer is required to compensate him for medical expenses and income replacement.
Benefits Available Under Workers’ Compensation
An Employee Handbook provided by the Georgia State Board of Workers’ Compensation provides a detailed explanation of the benefits that a worker injured in the state of Georgia is entitled to receive. These benefits include:
- Medical benefits. A worker who is injured on the job is entitled to all necessary and reasonable medical benefits, including doctors’ visits, hospital visits, surgeries, rehabilitation, medications, and more. You do not have the right to visit your own physician, but instead must select from a list of physicians provided by the workers’ compensation insurance provider.
- Income benefits. In the event that your injury forces you to miss work, you may be eligible to recover income benefits. Income benefits are available to those workers who miss seven or more days of work due to a workplace accident. In the event that your time missed from work extends to more than 21 days, then you will also receive pay for the first seven days of missed work. If your injury is catastrophic, you are eligible to receive benefits for the entirely of the time that you are unable to return to work; if your injury is non-catastrophic, wage benefits are paid up to 400 weeks.
- Death benefits. In some cases, a workplace injury can result in death. If this is the case, your dependents are eligible to receive death benefits, including benefits for burial and funeral expenses and lost wages.
As a note, workers who are eligible to receive income benefits will do so at a rate that is equal to ⅔ of their average weekly wage, up to the maximum allowable amount.
What is not covered under Georgia Workers’ Compensation Law?
As far as the employer’s responsibility is concerned, they are to compensate all employees who incur injuries while performing a job-related task at the workplace or elsewhere. However, there are certain exemptions which include:
- If the employee was drinking or drunk at work and got injured
- If the employee was using illicit drugs and got injured while using heavy equipment
- If the injury is self-inflicted
- If the injury occurred because of horseplay
- If the injury occurred as a result of an altercation with another employee
- If the injury occurred as a result of criminal activity at work
- If the injury occurred at work but during off work hours
- The injury is claimed after the worker is terminated
- If the injury occurred while the employee was freelancing.
What Are the Georgia Employer’s Responsibilities for Workers’ Compensation?
The employer’s responsibility does not simply end at purchasing the coverage for employees. The employer still has other responsibilities that include the following:
- Must place notices in the workplace that provides workers of their rights and benefits.
- The notice should also provide the name of the insurance carrier, a toll-free number and how to file in case of an injury.
- Must let the employee know that they have the right to seek medical treatment but only by approved doctors that have been contracted. Employees who seek outside medical care may not be compensated.
- The notice should provide information on all the potential benefits for workers compensation. If an injury has been reported, the employer has to file an application with the insurance carrier.
How to File a Claim for Workers’ Compensation Insurance – Atlanta Workers Comp Lawyer explains
In order to ensure that your right to benefits is protected, it is important that you take action quickly from the moment that your workplace accident occurs. If you delay, you may forfeit your right to compensation.
As an injured employee, you have the responsibility to report the accident to your employer immediately. In fact, you must report the injury within 30 days’ time after the injury occurs.
After you have reported the injury to your employer, your employer is required under law to file a First Report of Injury or Occupational Disease form. If your employer does not report your injury, they may face civil penalties. If your employer refuses to report your injury, it is important that you seek legal counsel as soon as possible – otherwise, time may run out. You may file a claim with the State Board of Workers’ Compensation on your own; the time limit for doing so is one year from the date of your workplace accident.
Appealing a Denied Claim
If your employer or the insurance carrier responsible for providing you with workers’ compensation denies your claim, you have the right to take legal action. It is within your best interest to secure the counsel of an experienced Atlanta workers’ comp lawyer to help you appeal a denied claim.
If your claim is denied, the State Board of Workers’ Compensation will send you a notice explaining the denial. At this point, you have a right to request a hearing before the State Board of Workers’ Compensation.
During a hearing, you will have the opportunity to present evidence that supports why you deserve workers’ compensation benefits. Evidence that you are allowed to present includes your own testimony, expert testimony (from medical experts), testimony from any other relevant witnesses, and any other evidence that may be essential to your case. A hearing takes place before judge, who will issue their decision about your claim.
Even if the judge who presides over your hearing issues a decision that is not in your favor, your claim is not necessarily over. In fact, you have the right to file an appeal with the Appellate Division of the State Board of Workers’ Compensation insurance. You must file this appeal within 20 days’ time of receiving notice that your workers’ compensation claim has been denied.
How Workers’ Compensation Lawyers Are Paid
Many workers’ compensation lawyers work on a contingency basis. This means their fee (or payment) is based on whether or not they succeed at representing you and obtaining the recovery you need. These charges can seem high at first, but it is important to note that with a contingent fee, the lawyer takes all the risk. If they lose, they collect nothing for all their time. If they win, they get paid.
Other workers’ compensation attorneys will charge an hourly rate. This is less common for workers’ compensation attorneys, but there are some who still do it this way. There can be benefits to this type of representation, and in some cases clients actually prefer it. With this type of payment, the lawyer charges an initial deposit (“retainer”), which they hold in a separate bank account called a “trust” account. As the lawyer does work, a bill is generated. The money held in the trust account is then used to pay the lawyer as the work is completed. One obvious downside of this type of agreement is that you may end up spending more than your case is even worth. Further, workers’ compensation cases can be costly to file and litigate, and when you are out of work and hurting financially, it can be very difficult to come up with large fees upfront.
How Much Should I Expect to Pay?
This is a very difficult question, because it depends on so many factors. This is similar to asking how much an expensive car is. The answer depends on which car and what you consider expensive. However, there are some basic things to consider:
- If the lawyer charges a contingent fee, what is the percentage charged?
- Is your lawyer advancing costs upfront so you do not have to pay them?
- Can your lawyer use his knowledge and experience to leverage your case and get it resolved quickly without lengthy and protracted litigation?
What Is the Typical Contingent Fee Charged in Georgia?
According to Board Rule 108, a Georgia workers’ compensation lawyer can charge up to 25 percent of the total weekly benefits recovered, provided there is no board hearing required. However, this number goes up as workload increases. According to the rule, once your lawyer has to engage in significant work toward preparing for a hearing, such as issuing or responding to discovery, then he may charge up to 30 percent of weekly benefits recovered. Finally, if a board hearing is required, the fee can go up to as much as 33.33 percent.
What Is a Board Hearing?
A hearing is much like a court appearance, only instead of the typical image of a judge on a bench with a black robe, you go before an administrative judge who works for the Georgia Workers’ Compensation Commission. His or her job is to adjudicate your claim. Simply put, this “ALJ”(Administrative Law Judge) is charged with hearing the evidence and making a determination. This is a formal process without a jury and can feel less formal than court. However, it is absolutely every bit as important to your case. You should take it seriously and treat it like just like you would any other court matter.
Filing an Atlanta Workers’ Compensation Claim and a Third Party Liability Claim
You are barred from filing a civil action against your employer after being injured on the job (unless your employer willfully or wantonly caused your injuries). However, you may file a civil action against a negligent third party who caused or contributed to your injury. This might include the manufacturer of a defective product, the owner of a dangerous property, the driver of a vehicle that hit you, or anyone else whose negligence directly caused/contributed to your harm. In some cases, you may be able to file both a third party liability claim and workers’ compensation claim for benefits. A third party liability claim allows you to recover noneconomic benefits, like compensation for pain and suffering.
Why You Need a Workers’ Compensation Attorney in Atlanta
Some workers’ compensation claims are straightforward. Consider the following: a worker falls on the job and suffers a cut, for which they seek stitches. They take the rest of the day off, as well as the following day, but return to work the third day. They immediately notify their employer of the injury and medical treatment received, who then files a First Report of Injury. The workers’ compensation insurance carrier quickly reimburses the employee for the money they spent on stitches. The claim is settled.
But other workers’ compensation claims are just the opposite. An employer may deny an employee coverage, an employer may be released back to work before they are ready, or there may be a dispute over whether or not an employee caused their injuries due to reckless or wanton conduct. When this is this case, and a workers’ compensation claim is more complex, it is within an employee’s best interests to hire a workers’ comp lawyer.
A workers’ compensation attorney will ensure that all paperwork and necessary forms are filed within a timely manner. They will also help you to gather evidence, appeal a denied decision, and recover your full benefit amount. The best part about having a workers’ comp attorney is that you have someone who will advocate for you and who doesn’t charge a fortune; Georgia law limits the amount of money a workers’ compensation attorney can receive to 25 percent of the worker’s income benefits.
Atlanta Workers’ Compensation Attorneys Serving You
At Bader Scott Injury Lawyers, our experienced Atlanta workers’ compensation attorneys are just a phone call away. If you are looking for an advocate who will get to work on your case immediately, who will put your needs first, and who will not give up until your case is settled, contact our law firm as soon as possible. You can reach us by phone or by using our online contact form.