Did you suffer an injury on the job in Georgia? You could be entitled to workers’ compensation benefits to cover the costs of your medical expenses and part of your lost wages. Workers’ compensation insurance provides no-fault benefits, which means an eligible employee is entitled to benefits no matter who caused the workplace accident.
Applying for workers’ compensation in Georgia involves detailed paperwork, specific procedures, and tight deadlines. It only takes a small error to set back your case. Knowing how to apply for benefits can help ensure you present the best case to the Georgia State Board of Workers’ Compensation (SBWC).
Hiring a lawyer is not required to apply for workers’ comp. But getting an attorney’s assistance can prevent your claim from getting stuck in the red tape that prevents many employees from receiving timely benefits after a work injury. At the Law Offices of William F. Underwood, III, P.C., we are committed to pursuing maximum workers’ comp benefits for our clients. Contact us now for a free consultation with a workers’ compensation attorney.
Who Can Get Workers’ Compensation?
Under Georgia law, most employers with three or more regular employees operating in the state must carry workers’ compensation insurance. Exceptions to this rule include:
- Most employees in the railroad industry
- Farm laborers
- Federal government employees
- Domestic servants
- Independent contractors
Eligible workers are covered by their employers’ insurance policies from their first day on the job. If a qualified worker suffers an injury or illness while performing work-related tasks, they can receive compensation for the costs of medical treatment, travel expenses related to their injuries, and a portion of their lost wages. If an eligible employee dies due to a work-related injury or condition, their surviving spouse or children may be entitled to death benefits.
Steps to Apply for Workers’ Comp
If you are entitled to workers’ compensation after a work-related injury, take these steps to file a claim for benefits:
- Notify your employer – Unless you require emergency medical care, your first step should be to notify your employer of the injury or illness. If you cannot alert them, ask a trusted friend or relative to do it for you. It’s best to notify your employer as soon as possible but no later than 30 days after the incident. Reporting the incident to an immediate supervisor, manager, foreman, or another employer representative should satisfy the requirement. Submit your notice in writing, signed and dated, and keep a copy for your records.
- Seek medical care – Georgia employers can select your medical provider for treatment in two ways. An employer can identify a panel of at least six doctors, including one orthopedic physician, for an employee to choose from. The employee may change from one doctor on the list to another once without notifying their employer. Alternatively, an employer can contract with a Workers’ Compensation Managed Care Organization (WC/MCO) to provide medical services to injured workers. A WC/MCO representative will help an employee schedule an appointment with an eligible medical provider. Workers may switch to another eligible physician one time without the employer’s permission.
- Gather documentation – Once you notify your employer, begin gathering the documentation you need for your claim. This includes a WC-14 Form (Notice of Claim/Request for Hearing/Request for Mediation for the SBWC, proof of your injuries (e.g., medical records), and documentation of your employment (e.g., pay stubs).
- Contact a workers’ compensation attorney – Many injured workers consult workers’ comp attorneys before submitting their claims. A knowledgeable attorney can help you file all paperwork quickly and accurately.
- File a workers’ comp claim – Complete the WC-14 form in detail. Explain the nature and extent of your injuries, and describe the benefits you wish to claim. Contact the SBWC and your employer’s workers’ comp insurance provider once the form is complete.
If your claim is denied, an experienced workers’ compensation lawyer can help you file an appeal and represent you during the appeals process.
What is Covered by Workers’ Compensation Insurance?
Workers’ comp insurance should cover any work-related injury or occupational disease. This includes injuries and illnesses that arise in the course of assigned job duties during designated work hours. However, it may also include injuries that occur when employees engage in work-related activities during non-work hours, perform work-related responsibilities that were not specifically assigned, or even work outside the usual workplace.
In addition to full coverage for reasonable and necessary medical care, eligible workers can receive weekly wage loss benefits equivalent to two-thirds of their pre-accident wages if they cannot work for more than seven days. If they miss more than 21 consecutive days of work, they will also be paid for the first week of missed work. Workers with permanent impairments may also be entitled to disability benefits.
Keep in mind that workers’ compensation may not cover all injuries that occur at work. According to the law, you must suffer injuries while performing duties within the course and scope of your employment. For example, you probably wouldn’t qualify for benefits if you got hurt during your lunch break.
How Long Do I Have to File for Workers’ Compensation Benefits?
Assuming you reported the injury to your employer within the required 30-day period, you have one year from when you suffered the injury to apply for benefits. If you have already started receiving weekly benefits or receive remedial care for your workplace injury and want to file an additional claim, you must do so within two years of the date of your last weekly benefit payment or last remedial treatment.
What Happens if My Claim is Denied?
Once you notify your employer of an occupational injury, their insurance provider should investigate your case and file a report with the SBWC within 21 days. If the insurance company or employer chooses to deny your claim, you will receive a letter explaining the denial. You can request a hearing with the SBWC if you wish to appeal. A skilled Workers’ Comp attorney can help you fight back against unfair claim denials.
Talk to a Workers’ Compensation Lawyer in Albany, GA
If you have questions about applying for workers’ compensation benefits in Albany, GA, contact the Law Offices of William F. Underwood, III, P.C. today. Call or contact us now for a free strategy session.
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