When you suffer a workplace injury in Georgia, you could be entitled to receive workers’ compensation benefits, including medical and disability benefits. However, subsequent events while on workers’ comp may obligate you to repay certain workers’ compensation benefits you received to an employer or workers’ comp insurer.
Here are the most common reasons employees receive a notice requiring them to pay back workers’ compensation benefits in Georgia:
Overpayment
Georgia Code §34-9-245 states that a claimant may have to pay back workers’ compensation benefits to the extent the claimant has received an overpayment. Overpayment of benefits can occur when an employer or workers’ compensation insurer overestimates an injured worker’s applicable average weekly wage, miscalculates temporary partial disability benefits (e.g., the difference between the worker’s pre-injury and current wages), or continues paying disability benefits after a worker returns to work.
Third-Party Settlements
Employers and workers’ compensation insurers may have the right to reimbursement of paid workers’ compensation benefits — including medical and disability benefits — when a worker obtains a personal injury award or settlement in a third-party claim for the work injury.
Some workers have third-party personal injury claims when a party unaffiliated with the employer causes their injury. Examples would be if another driver caused a car accident that harmed the worker or when a defective power tool malfunctions and injures an employee. If those legal claims end favorably for the worker, it could trigger the reimbursement requirement.
Waiting Too Long To Return To Work
If the employer or their insurance company believes an employee is fit to work but stays home anyway, they may be asked to repay the disability benefits received during the period in question. In those cases, a second opinion from a doctor may help justify the employee’s case for not working.
Workers’ Compensation Fraud
Workers may have to pay back workers’ comp benefits if they engaged in workers’ compensation fraud. Workers’ comp fraud occurs when an employee knowingly falsifies their claim to have suffered a work injury or occupational illness. Fraud may also happen when a worker exaggerates the severity of their disability or symptoms to stay out of work and continue receiving disability benefits. In some cases, employees conspire with medical providers to engage in workers’ comp fraud by submitting false claims for medical treatment.
Contact a Workers’ Compensation Lawyer Today to Learn More About Payback Rules
If the Georgia Workers’ Compensation Commission has notified you that you must pay back workers’ comp benefits, you need experienced legal counsel to protect your rights and interests. Contact The Law Offices of William F. Underwood, III, P.C., today for a free consultation with a knowledgeable workers’ compensation attorney. We can explain why you received the notice to pay back workers’ comp benefits and potential strategies for challenging the payback demand.
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