Accidents can happen in the safest workplaces. That’s why most Georgia employers must carry workers’ compensation coverage for their employees. To help local workers understand their rights and responsibilities after a job injury, the Law Offices of William F. Underwood, III, P.C. prepared the following guide to workers’ compensation in Albany. If you have specific questions about an injury, call or contact us to discuss your case with an experienced workers’ comp lawyer.
Employee Guide to Workers’ Compensation
Georgia requires most employers operating to carry workers’ compensation insurance or qualify as self-insured on behalf of their employees. Limited exceptions include:
- Employers with fewer than three regular employees
- Employers of common carriers (transportation workers)
- Employers of railroad or farm employees
- Employers of domestic servants
- Specific licensed real estate agents and brokers
Even though those employers are exempt from state workers’ comp requirements, they can still choose to purchase coverage. If an employer carries workers’ comp insurance, injured workers usually cannot file personal injury lawsuits directly against the employer for a work injury.
Any part-time or full-time employee should be covered from their first day on the job if their employer provides workers’ comp insurance. This includes undocumented workers. However, there are certain types of workers who are typically ineligible for workers’ comp coverage, including:
- Independent contractors
- Unpaid volunteers
- Unpaid interns
- Seasonal workers
- Casual employees
Employers who provide workers’ comp insurance must post a panel of approved physicians in a prominent location in the workplace. This panel should contain a list of doctors and facilities pre-authorized to treat injured employees. A minimum of six physicians or facilities must be listed, including:
- At least one orthopedic surgeon
- No more than two industrial clinics
- At least one minority physician
When a covered employee suffers an occupational injury, they must select a provider from the list unless they need emergency care. If an employer’s assigned panel does not meet statutory requirements, injured workers may choose to visit any provider at the employer’s or insurance provider’s expense.
Procedures for Filing a Workers’ Compensation Claim
Here’s what to do after a workplace injury:
- Notify your employer within 30 days of the incident. If the employer is already aware of the accident, providing additional notice is not required. But we encourage employees to provide notice in writing and keep copies for their records.
- Employers should report employee injuries promptly. Employers should complete a WC-1 (First Report of Injury) form when an employee reports an injury, seeks treatment, or misses work due to the condition.
- Cooperate with the insurance provider. The insurer will investigate the claim and request copies of documents like accident reports, statements, and payroll records.
- File claim paperwork requesting benefits. Benefits include reimbursement for medical expenses, lost wages, and disability. Employees must complete and submit a WC-14 (Notice of Claim) form to the State Board of Workers’ Compensation (SBWC) within one year of the date of the initial injury.
Hiring a lawyer is not required to file a workers’ comp claim. However, asking an attorney to review your case before submitting any paperwork is smart. Small errors can cause big delays when it comes to workers’ compensation in Georgia.
What Does Workers’ Comp Cover?
Workers’ compensation policies provide three main types of benefits, including:
- Medical benefits – Injured employees can receive benefits that cover reasonable and necessary costs for medical treatment for work-related conditions. In most cases, the doctor’s office bills the workers’ comp insurance company directly.
- Lost wage benefits – Workers’ compensation includes payment for a portion of your lost wages while you cannot work. These benefits pay employees two-thirds of their average weekly wages if they miss up to seven or more days at work, up to certain statewide maximums. If employees can perform light-duty or part-time work for less than their usual wages, these benefits can pay up to two-thirds of the difference.
- Permanent disability benefits – If a work-related injury or illness leaves an employee with a permanent disability, these benefits compensate the worker based on an impairment rating assigned by a doctor. These benefits are typically calculated by multiplying two-thirds of an employee’s average weekly wage by a certain number of weeks, which can vary depending on the affected body part.
What Isn’t Covered?
The workers’ compensation system benefits employers and employees. However, it does have certain limitations. Common types of injuries and scenarios that Georgia workers’ comp policies may not cover include:
- Scarring and disfigurement
- Workplace accidents due to intoxication or willful misconduct
- Job injuries that occur during unpaid lunch breaks
- Common conditions such as heart attacks, strokes, or the seasonal flu
- Pre-existing conditions, unless a workplace incident exacerbates them
- PTSD or other psychological injuries without an accompanying bodily injury
- Pain and suffering
Challenges in Receiving Workers’ Compensation Benefits
The workers’ compensation system should provide injured employees with an efficient means to recover compensation after a job injury. However, the system is not perfect. Common challenges injured employees face when seeking workers’ comp benefits include:
- Claims denials
- Delayed benefit payments
- Low payouts
- Pressure to settle for less
- Disputes over whether the injury is work-related
- Allegations that a disability is not permanent
- Misclassification as an ineligible worker
Talk to an Albany, GA Workers’ Compensation Lawyer
If you suffered a workplace injury or have been diagnosed with an occupational disease, contact a skilled workers’ compensation attorney at the Law Offices of William F. Underwood, III, P.C. Our consultations are always free, and there’s no obligation. Call or contact us online to get started.
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