A workers compensation lawyer will tell you that the first question you need to ask after suffering an injury on the job is, does your employer carry workers’ compensation insurance? According to the Georgia State Board of Workers’ Compensation, all businesses with three or more workers are required to carry workers’ compensation insurance.
If you are unsure about your workers’ compensation eligibility or whether or not your employer has workers’ compensation insurance, Bader Scott Injury Lawyers can help. We invite you to take advantage of our firm’s free initial consultation where a professional workers compensation lawyer will verify your employer’s coverage as well as your right to receive benefits.
Who is not eligible for workers’ compensation in Georgia?
As mentioned above, employers with three or more employees are required to carry workers’ compensation insurance. However, there are some exceptions to this rule. Those who are generally not covered under Georgia workers’ compensation laws include the following workers:
- U.S. government employees
- Farm laborers
- Domestic servants
- Railroad workers
- Those who are self-employed
Are both injuries and illnesses covered under workers’ compensation?
The short answer is yes – both injuries and illnesses are covered under workers’ compensation insurance. In regard to illnesses, the Georgia State Board of Workers’ Compensation Employee Handbook states that if a disease meets certain tests imposed by the law, then an employee can be compensated for that disease. However, a good workers compensation lawyer will know there must be a relationship between the disease and the worker’s employment, i.e., the worker’s employment must be a cause of the disease.
For covered injuries, the state of Georgia generally has two different ways to classify accidents: catastrophic and non-catastrophic.
Injuries resulting from both catastrophic & non-catastrophic accidents are covered, but different benefit types may be paid.
Examples of catastrophic injuries that are covered under workers’ compensation include:
- Severe paralysis
- Severe head injuries
- Severe burns
- Injuries severe enough to prevent employees from returning to work
Non-catastrophic injuries are most other types of injuries; that is, injuries which do not permanently and totally prevent an injured worker from returning to some type of work.
Other Situations Affecting Workers’ Compensation Eligibility
If the injury or illness was self-induced or caused intentionally, caused by the worker’s drug or alcohol intoxication or impairment, or was caused by willful misconduct, then workers’ compensation benefits may be denied.
If your employer denies your claim and argues that you were impaired at the time of the accident. However, if your alleged impairment was not the cause of your accident, then you may request a hearing with help from an experienced workers’ compensation lawyer.
In summary, you will likely be eligible for Georgia workers’ compensation benefits assuming you:
- were not intoxicated or otherwise impaired at the time of the accident;
- did not intentionally cause the accident;
- are employed by an employer who carries workers’ compensation insurance; and
- have incurred an injury or occupational disease that is the result of your job.
When Workers Are Ineligible for Workers’ Compensation
In addition to some classes of workers being ineligible for workers’ compensation, such as independent contractors, farm laborers, railroad commission workers, longshoremen, and some domestic workers, there are certain acts that can make an otherwise eligible worker ineligible for workers’ compensation benefits.
The Georgia State Board of Workers’ Compensation does not provide workers’ compensation benefits to injured workers who are willfully or negligently at fault for causing their workplace accident. There is a difference between an accident in the workplace, that could have happened to anyone in the exact same situation, and being willfully or negligently responsible for causing an accident in the workplace.
A normal accident is one that would happen to any worker in your position, it just so happened that you were the victim of the accident. The accident arises out of or occurs as a result of his or her normal job duties. The accident occurs when the employee is working and is in some way related to his or her regular course of work.
However, an accident that the worker causes due to his or her willful misconduct, gross negligence or ridiculously inappropriate behavior in the workplace could have been avoided if not for the worker’s terrible lack of good judgement. As such, workers whose work-related injuries are the byproduct of their own bad actions are ineligible for workers’ compensation benefits.
Some examples of a worker’s bad acts that could render him or her ineligible for workers’ compensation benefits include:
- Violations of the employer’s employee code of conduct. If the employer has provided workers with a code of conduct, which includes workplace rules for safety, and if a worker’s injuries result from an accident that is the byproduct of the employee failing to comply with the employee code of conduct, the worker might be rendered ineligible for workers’ compensation benefits.
- Getting into a physical altercation with a coworker or boss. The injuries sustained from a fight in the workplace that was brought on by the worker’s own taunting, teasing, fighting words, etc., will most likely render the worker ineligible for workers’ compensation since the worker’s own misconduct, i.e., instigating a fight in the workplace, is not an accident.
- Working while intoxicated. When a worker is intoxicated at work, either by drugs or alcohol, and the worker suffers a work-related accident and injuries, the worker will most likely be considered ineligible for workers’ compensation benefits since the worker exercised poor judgement by being intoxicated on the job. There is a difference between a worker’s willful and voluntary intoxication, and a worker who becomes intoxicated by exposure to chemicals or toxins in the workplace. The former would be ineligible for workers’ compensation benefits if he or she became injured on the job, but the latter scenario worker would be eligible since the intoxication, and thus the resulting injuries, were not the result of the worker’s willful actions.
- Horseplaying in the workplace. Horseplay in the workplace is inappropriate and can be very dangerous. A worker who is injured as a result of his or her own horseplay or prank, will likely be ineligible for workers’ compensation benefits. However, an unsuspecting victim of the horseplay or prank who is not a willing participant in the horseplay, will likely be eligible for workers’ compensation benefits upon suffering an injury in the workplace, since the horseplay or prank was not his or her own doing and he or she is merely a victim of a coworker’s actions.
- Off the clock accidents. A worker involved in workplace accident, who is off the clock may be ineligible for workers’ compensation since they are on the worksite when they are not supposed to be. For instance, workers who are on their lunch break, or are on a smoke break, are engaging in activities that are not work related. If workers who are on break suffer an injury while on break, they are often ineligible for workers’ compensation. However, there may be facts and circumstances that would entitle an off the clock worker who is injured on the work site to workers’ compensation benefits. Consult with an experienced Atlanta workers’ compensation lawyer.
- Workers who are on the clock, but have deviated from their normal duties. Some workers may be on the clock when they are injured, but their injuries might be the result of something that is a gross deviation from their normal work duties. These injuries might not be eligible for workers’ compensation since the worker was doing something outside of the scope of his or her job without authorization. For instance, a worker who is a delivery driver that makes a personal stop at a store while on the clock and has an accident leaving the parking lot will most likely be ineligible for workers’ compensation benefits since his or her actions were not within the scope of his or her job duties.
Our Atlanta Workers’ Compensation Lawyers Can Help You
Understanding eligibility for workers’ compensation benefits can be confusing, especially if you work for a small company or are unsure whether or not your employer carries workers’ compensation insurance. You might have questions about your injury being covered, particularly if it happened during work hours but off of the job site.
For answers to all your legal questions regarding workers’ compensation eligibility and how to apply, the workers compensation lawyers at Bader Scott Injury Lawyers, can help you. To meet with our legal team today, call 678-562-5595 to schedule your free consultation.