FREQUENTLY ASKED QUESTIONS

Following are the most frequently asked questions (and answers) about work-related injuries:

• What do I do after I have been injured on the job?
• Do I need a lawyer?
• How do I select an attorney?
• Why are there workers' compensation laws?
• Who can collect under the workers' compensation laws?
• What types of benefits are available through workers' compensation?
• What if my claim is contested?
• What is the history of workers' compensation in Georgia?

What do I do after I have been injured on the job?

If you are injured on the job:

• As soon as you possibly can, report the accident to your supervisor, even if you think the injury is minor. (If you wait more than 30 days, you may not be entitled to benefits.)
• Make sure your employer makes a written report that includes the details of the accident or injury. Ask for a copy of this report. Review the report and ask your employer to make corrections to any factual errors. (Do not “demand” that your employer make changes.)
• Ask a supervisor, or someone from the Human Resources department, if the company has posted a “Panel of Physicians” (a list of at least six doctors or the Workers' Compensation Managed Care Organization (WC/MCO) the company has selected for you to see for work related injuries). If so, request a copy. If not, request a note from your employer stating your employer does not have a posted Panel of Physicians. For information about the importance of seeing a doctor of your choice, see “Company Doctor versus My Doctor.”
• Make an appointment with a doctor. Make sure you tell the doctor what happened and that the visit is to be billed to your company’s workers’ compensation insurance company. Do not mistakenly bill this visit or any related expenses to your conventional group health insurance provider.
• Ask your doctor to give you a written assessment of your ability to work and a detailed explanation of anticipated treatment.
• Keep your employer informed.
• Notify your workers’ compensation carrier of your claim. The carrier’s contact information is usually listed on the posted panel.

It may be a good idea to consider legal representation if, after an injury, you encounter any resistance from your employer.

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Why are there workers’ compensation laws?

Workers' compensation laws were designed to protect employees and employers. The workers’ compensation laws protect employees when they have an injury at work. (The laws provide that the workers receive certain benefits when they are injured at work or elsewhere while on the job.) The workers’ compensation laws also protect employers from general negligence lawsuits (which could potentially have much higher awards).

Workers' compensation is an accident insurance program paid by your employer that may provide you with medical, rehabilitation, and income benefits if you are injured on the job. These benefits are provided to help you return to work. It also provides benefits to your dependents if you die as the result of a job-related injury.

Insofar as the law is concerned, it does not matter how the workplace injury occurred (even if the injury was caused by the negligence of the worker). In Georgia, as long as the injured employee was hurt while on the job, while working for the employer, workers’ compensation laws apply.

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Who can collect under the workers’ compensation laws?

In Georgia, employers are required to carry workers’ compensation insurance if they employ three or more workers. If you are unsure if your employer carries or is required to carry workers’ compensation insurance, you might wish to speak with an attorney who regularly practices workers’ compensation law.

To be eligible for workers’ compensation benefits (to be covered under workers’ compensation laws), you need to have been injured in the course of your employment while doing work that was a normal part of your job. In some cases, you may receive benefits if you were injured while going to, or returning from, your job.

Under Georgia law, employees are covered from their very first day on the job (if they work for an employer who is required to provide workers’ compensation coverage).

If a covered employee dies from a work-related injury, dependants are generally eligible to receive benefits.

There are several categories of workers who are specifically exempted from the workers’ compensation law: federal government employees, railroad employees, farmers and farm laborers, and domestic servants.

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What types of benefits are available through workers’ compensation?

There are three categories of benefits:

Wage Benefits (also called “Income Benefits”)

Medical Benefits, and

Rehabilitation Benefits

Not every injured worker is entitled to benefits in all three categories. There are specific and exacting rules and qualifications for each of the benefits you might be entitled to receive. You may want to check with a workers compensation lawyer who can help you determine to which benefits you may be entitled. Your attorney can also help you to make sure you receive all the benefits for which you are eligible.

Under Georgia workers’ compensation law, injured workers are entitled to a wage benefit of 66 percent (two-thirds) of their average wage, up to a maximum of $425 per week. In order to collect wage benefits, you do not necessarily have to be completely unable to work. However, you must be under the care of a physician.

The full wage benefit is given to those injured workers who are totally unable to work, either temporarily or permanently. If you are still working but your hours have been reduced, or you have been reassigned to light duty or some alternative assignment that pays a lesser wage, you may be entitled to receive a reduced wage benefit to help make up the difference between what you used to make (before the injury) and what you currently make (with lighter duties or reduced hours). Your workers’ compensation attorney will explain how the wage benefits are calculated.

Under Georgia law, injured workers do not qualify for wage benefits unless they are disabled for a minimum of seven days. (Though your employer may pay you wages if you miss work for one or two days as a result of a minor injury, workers’ compensation wage benefits do not become effective until after seven non-working days.) If you are disabled and cannot work for more than twenty-one consecutive days, you are entitled to wage benefits including the first seven days.

Another category of benefits available to employees who are injured on the job is medical care.

If you are injured on the job, you should seek medical attention appropriate for your injury. Clearly, if you have an injury that requires immediate attention, a visit to an emergency room would be appropriate. Though emergency room visits are not covered under workers’ compensation law for non-emergencies, your employer is required to pay for an emergency room visit if such a visit is appropriate for the injury.

If your employer is required to carry workers’ compensation insurance, your employer is also required to post a list of six doctors or a Workers' Compensation Managed Care Organization (WC/MCO) that your employer (or your employers’ workers’ compensation insurance carrier) has made arrangements with for treatment. Therefore, if you see your personal doctor for your work-related injury, you will be personally responsible for payment. 

Employers who provide coverage for their workers under Georgia’s workers’ compensation law are required to post a list of six doctors not associated with each other or a Workers' Compensation Managed Care Organization (WC/MCO) that you are permitted to see for treatment. On the surface this may sound like a benefit to you as an employee. (After all, why would employers be required to post a list if it was to their benefit to do so?)

Unfortunately, many of the doctors on these lists tend to be conservative in their evaluations of the extent of injuries and quite liberal in their evaluations of an injured person’s ability to work. The listed doctors are often selected to be on the lists because they make conservative evaluations. Conservative evaluations save the insurer money and reduce the amount of benefits the injured workers receive. Some of these doctors also have histories of minimizing treatment and getting workers back to work at the earliest possible date, even when they are not fully recovered.

There are ways your attorney may be able to get you authorized to see a more objective physician or specialist. A more objective doctor will see that you get all the care, therapy, and time to rehabilitate that you need.

Rehabilitation Benefits

The third category of benefits available to employees who are injured on the job is rehabilitation. (Rehabilitation benefits are not available for all injuries.)

In the event you need rehabilitation (either physical therapy or training for a different kind of work), your attorney can help you to get into a program that is most beneficial to you.

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What if my claim is contested?

If facts concerning a claim are contested or liability is questioned, either the employee or the employer/insurer may request a hearing before an Administrative Law Judge to resolve the issues.

If either party is dissatisfied with the decision, a party may request a review by the Appellate Division. Further appeals may be taken through the court system; however, the courts can review only disputed questions of law, while Administrative Law Judges and the Appellate Division determine both factual and legal issues.

If your claim is contested, it might be wise to speak with an attorney who is experienced with workers’ compensation law in Georgia.

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What is the history of workers' compensation in Georgia?

Established in 1920 by the Georgia legislature, the State Board of Workers' Compensation serves over a quarter of a million employers in Georgia and over 3.8 million workers.  The State Board is funded by assessments from insurance companies and self-insured employers.  An employee that is injured on the job and is covered by the law may be eligible for replacement of a portion of lost wages, medical payments, vocational rehabilitation services and other benefits.

Prior to the passage of the Workers' Compensation Act, an employee who was injured on the job could not expect benefits from the employer. Men, women, and children were often subjected to harsh and oppressive working conditions with little or no recourse for work-related injuries. Courts often denied recovery to employees by holding that employees assumed risks in taking the job, were negligent, or were barred from recovery by the negligence of a fellow employee. Filing a suit in court was also unsatisfactory because trials were expensive and often lengthy. This posed a problem to an employee who needed money immediately to pay for medical expenses and replace lost wages. A successful suit could also force a small company out of business.

Today, the workers’ compensation law provides for specific benefits to be paid to employees for injuries arising out of and in the course of employment, without regard to negligence or fault, and at the same time, provides the employer with limited liability. In Georgia, employers obtain worker’s compensation coverage through private insurers or programs of self-insurance. The rights granted an employee under the law preclude any other legal remedies against an employer by an employee due to a work-related injury.

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