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Filing a Workers’ Compensation Claim in Georgia

When you sustain injuries on the job or develop an occupational illness, you are generally entitled to certain benefits through your employer’s workers’ compensation insurance company. In order for your benefits to kick in, you will need to file a claim with the Georgia State Board of Workers’ Compensation (SBWC).

Before filing your claim, it is advisable to have a workers’ compensation lawyer review your case and help you with the documentation. Bader Scott Injury Lawyers can help ensure you do not make mistakes on your claim and that you get the full amount of benefits to which you are entitled. Call us at 678-562-5595 and request a free consultation.

Am I eligible to file a claim for workers’ compensation?

Workers’ compensation covers most Georgia workers whenever they sustain an on-the-job injury or develop a work-related disease. There are a few basic requirements you will need to meet.

  • You need to be an employee. Workers’ compensation does not cover independent contractors or self-employed individuals.
  • The injury must have occurred in the scope and course of employment. In other words, your injury or illness must be work-related.
  • You must not have been intoxicated when you were hurt; you must not have been involved in horseplay; and you must not have purposely injured yourself.

In a nutshell, that is really all that is required in order to qualify to file for workers’ compensation benefits. Of course, these cases can become more complex when insurers try to find ways to deny claims, so make sure you have the help you need.

How long do I have to file my workers’ compensation claim?

In most cases, workers have one year from the date of injury to file a claim. However, numerous factors can affect your time limit, and by no means should you wait until the last moment to file. The sooner you file, the better – not only because you will get your much-needed benefits sooner rather than later, but you will avoid accidentally overstepping the statute of limitations on filing for recovery.

Nevertheless, the actual time limit for filing your particular claim is not always cut-and-dry. The time limit may differ depending on the unique circumstances of your case. For instance, if your employer paid for remedial treatment for your work injury during the last year, you actually have one year from the date of your last treatment to file your claim.

If you have developed an occupational health condition, which sometimes takes time to manifest, your time limit is slightly different, as well.

  • You have one year from the time your health condition manifested, or from the time you reasonably should have known that your job contributed to it, to file a claim.
  • If a doctor diagnosed you with asbestosis or mesothelioma due to asbestos exposure, the one-year clock begins ticking on your first date of disability.
  • If your disease developed years after exposure to work-related hazards, you have to file your claim within seven years from the date of your last exposure to the hazard.

Note: These statutes of limitations on formally filing a claim for workers’ compensation are not synonymous with the time limit on informing your employer about your injury. While you may have a year to file a claim with the SBWC, the Board specifies that you must inform your employer about your injury within 30 days from the date you sustained it.

What kinds of benefits will I receive?

After you file your claim, your employer’s insurer will review your records and either approve or deny your claim. If the insurer approves your claim, you will have access to both medical benefits and income benefits.

Medical benefits include all reasonable and necessary medical care and transportation expenses for your work-related injuries. This includes diagnostic tests, hospital bills, specialist appointments, and follow-up care. If your injury causes you to miss time from work, you will also receive a weekly income replacement check, calculated at two-thirds of your average pre-injury wages. With serious accidents, you may also have access to certain rehabilitation benefits.

While these benefits will certainly be a godsend when you are recovering from your injury, they obviously do not fully compensate you. After all, workers’ compensation benefits only cover a portion – not 100 percent – of your lost wages and it does not cover certain damages such as pain and suffering.

TIP: There is a chance that you may be entitled to additional compensation outside of the workers’ compensation system. If a third party contributed to your accident (e.g., a driver, an elevator company, a cleaning crew, etc.), you might be able to file a third party liability claim. Your attorney can review your case and determine if you qualify.

What is the Deadline for Filing Workers’ Comp?

You should know that there is a deadline for filing a workers’ comp claim. The State Board of Workers’ Compensation requires you to notify your employer within 30 days of the workplace accident of any injuries that occurred.
It is imperative that you report your injuries to your employer as soon as possible. If you delay reporting past the 30-day mark, you will not qualify for benefits under workers’ comp no matter how extensive your injuries were from your workplace accident.

How Much Will I Get Paid for Workers’ Comp?

While every injury is different and the payments for workers’ comp in are also different, your injury may be long-term, or it may be a temporary injury that only means a few days of missed work. Payment is 2/3 of your average wage to a maximum of $575 for temporary injuries that cause you to miss work.
Compensation for more extensive injuries is awarded based on the schedule from the Board of Workers’ Compensation. These awards are based on the type of injury as well as the long-term disabling effects of your injury. The State Board of Workers’ Compensation will determine what your compensation will be according to the schedule they have set.

How Long Will I Get Workers’ Comp Benefits?

Just like the payment amount differs, the amount of time that you will receive workers’ comp for also varies. According to the program for workers’ comp, you could receive benefits for as long as 400 weeks if you have a temporary disability. More severe injuries may pay for a lifetime while partial permanent disabilities pay for as long as 350 weeks.
Your workers’ comp benefits may end if you are released by your doctor to return to work. At this time, you have a medically-improved disability, and you can work and earn wages. You would no longer need the assistance of workers’ comp.

How Long Does it Take to Get Payment for Workers’ Comp?

The payments for workers’ comp do not occur immediately as you might hope. There is a seven-day waiting period which is unpaid unless you miss a total of 21 days.
If your injury requires you to miss less than seven days of work, you will not receive compensation for your lost wages during this time. Only recovery times that extend past the 21-day mark include payment from the first day of missed employment. Over seven days of missed work but less than 21 days are paid starting on day eight. It takes approximately 21 days to receive your first check from the State Board of Workers’ Compensation.

How Do I Know If I Have Workers’ Comp Insurance?

The majority of employers have workers’ comp, but you need to be sure your employer carries the insurance to protect yourself. Under the law for workers’ comp, an employer that has three or more employees must provide workers’ comp to all of its employees. Employers with less than three employees are not required to carry the insurance for workplace accidents.
Employers are also required to cover all of their employees regardless of status at the company. This means that no matter if you are part-time or full-time, you can still receive workers’ comp coverage.

What Happens if I Receive a Denied Workers’ Comp Claim?

If you receive a denial claim for workers’ comp, you have a right under the law to file an appeal regarding their decision. You will need to submit in writing a WC-14 form requesting a hearing. Here, you get the opportunity to present your case before an administrative law judge. They will determine if you qualify for benefits based on the information presented and will decide within 30 days of the hearing if you get benefits.
Once you submit a request for a hearing to appeal the decision of the State Board of Workers’ Compensation, a hearing gets set within 60 dates of your submittal. It will be held in a trial court within the county that you live.
You may want to have a workers’ comp attorney present with you at the time of your hearing. They can represent you in court and make sure your case is heard properly before the judge. This gives you the best opportunity for approval and payment of compensation for your injuries.

Get Help Filing a Work Injury Claim

If you are in need of counsel for filing a workers’ compensation claim, contact our team at Bader Scott Injury Lawyers for a free consultation. Call us today at 678-562-5595 and see how we may be of service to you.

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