Workers’ Compensation

An Overview

Workers’ Compensation is an insurance program aimed at protecting injured workers. In Georgia, employers with three or more employees are required to provide workers compensation insurance. “Workman’s Compensation” or “Workers’ Comp,” as it is also known, ensures that an employee who is injured at work obtains proper medical treatment, recovers lost wages caused by on-the-job injuries, and rehabilitation and retraining if necessary to return to the labor force. Should an employee be killed while working, family members of the deceased are usually entitled to substantial death benefits.

In Georgia, workers’ compensation is what is called a no-fault system; that is, the employee is protected if he or she is injured on-the-job. Workers are not required to establish fault on the part of the employer to recover. However, since it is a no-fault system, the worker cannot sue the employer for negligence because of injuries sustained on-the-job. But workers can make claims against third parties who are not their co-workers or employers. Third-party liability claims, as they are known, can be undertaken at the same time as a workers’ compensation claim. In fact, many of the third-party claims such as products liability or negligence on the part of a non-employer entity are worth substantially more than the workers’ compensation claim. The key to successfully pursuing these claims is timely investigation and pursuit of the claim. That is why, if you have been injured on the job, you should not delay in contacting a lawyer. Call us today (800) 613-1923 for a free case evaluation or if you simply have a few questions about your case and what it might be worth.

Types of Benefits

Temporary Total Disability Benefits

If a worker is fully disabled temporarily and incapable of returning to work of any sort, the worker ought to collect Georgia’s Workers’ Compensation Temporary Total Disability Benefits (TTD) which is equal to two-thirds of the average income the worker was earning at the time of the accident, but not exceeding $500 per week.

Temporary Total Disability Benefits are paid weekly and the first payment should be received within fourteen days of the date that the employer was notified of the injury. While there is no limit on the number of weeks during which a worker may receive Temporary Total Disability Benefits (TTD) the benefit usually ends when the worker is medically able to go back to some kind of work when he or she reaches “maximum medical improvement” or “MMI.”

An employee reaches “maximum medical improvement” when regular treatment by a physician is no longer necessary and the employee’s condition has improved to such an extent that a fairly reliable determination of the extent of the employee’s disability can be determined.

Temporary Partial Disability Benefits

Temporary Partial Disability Benefits (“TPD Benefits”) is paid to injured employees when they return to work in a job that pays less because of an on-the-job accident. These benefits are paid at two-thirds of the difference between the injured employee’s before accident average weekly salary and after accident average weekly salary, but cannot go beyond the maximum rate obtainable by law on the date of the accident. An injured employee is limited to 350 weeks of TPD Benefits commencing on the date of the accident.

Permanent Partial Disability

Permanent Partial Disability Benefits (PPD) are minimum levels of benefits available to employees who suffer certain types of serious, disfiguring injuries, even if they don’t miss any significant work time. The employee’s percentage of disability is determined by American Medical Association guidelines. The rating is then applied to a pre-determined formula to establish the number of weeks of PPD Benefits an injured employee is entitled to. This workers’ compensation benefit is also paid to the employee on a weekly basis. Many injured workers meet the requirements for PPD Benefits, but those who are not diagnosed with a permanent impairment do not. This makes getting to qualified medical professionals who are not aligned with the employer’s insurance company critical.

Death Benefits

Death benefits are to be paid to the qualified dependents (a dependent spouse or minor children) of an employee whose on-the-job accident or injuries caused death. Death benefits are paid at the rate of two-thirds of the deceased employee’s average weekly wage at the time of the accident, but not to be more than the maximum allowed by law for all entitled dependents. Death benefits also include funeral costs that are paid up to the limit allowed by law as of the date of the accident.

Catastrophic Injury

Under Georgia workers’ compensation law, a catastrophic injury involves one of the following types of injuries:

  • An injury to the spinal cord that involves severe paralysis of an arm, a leg, or the trunk
  • An amputation of an arm, a foot, a hand, or a leg and the subsequent loss of use of that appendage
  • A severe head or brain injury
  • A second or third degree burn that covers over 25 percent of the body or third degree burns to at least 5 percent of the face or hands
  • Total or industrial blindness
  • Any other type of severe injury preventing an employee from performing his or her preceding work or another job for another employer

The employee’s attorney and the attorney for the employer/insurer, or a State Board Judge can agree upon catastrophic designation after the issue has been heard. However, it should be noted that a catastrophic designation is not a permanent determination. The designation can be changed if the treating physician returns the employee to work, or if the State Board judge rules in opposition to the employee in a hearing.

Wrongful Death in the Workplace and Survivor Benefits

Each year, approximately 15,000 employees die from workplace injuries. Work related wrongful deaths can occur as a direct result of a workplace accident, or as a result of serious injuries that resulted from a workplace accident. Dependents of the deceased employee are eligible for death workers’ compensation benefits; however, they cannot bring a claim against the employer for damages. A surviving spouse will receive a burial expense up to $7,500 and two-thirds of the usual weekly earnings of the deceased employee up to $500 a week from workers’ compensation. A dependent spouse with no children can receive up to $150,000 in weekly payments until he or she remarries or lives with someone of the opposite sex. And dependent children of deceased employees are entitled to weekly payments until age 18.

Medical Treatment

An employee who is injured on the job is entitled to obtain medical treatment for his or her injury until the treating physician decides that the employee is at “maximum medical improvement.” This means that medical care is at a point where the employee’s condition will stay the same and is not expected to improve.

Medical treatment might also be necessary after achieving “maximum medical improvement” in order to continue functioning at that level. In this event, the employer’s insurance company is also liable for any additional medical treatment that may prevent the employee’s condition from worsening. However, the employer is allowed to select the physician who will provide the care.

The employee should also be compensated for all medical-related costs pertaining to the injury. These additional costs include travel to and from the physician’s office, over-the-counter medicines and prescription medications.

Hiring an Attorney

When deciding whether or not to hire an attorney to represent you in your workers’ compensation claim, you should think of hiring an attorney as an investment to make sure that you obtain the most workers’ compensation benefits that you’re entitled to. Time and again, employees obtain larger benefits, even after paying attorney fees, than if they opted not to retain a lawyer, merely because lawyers know and can guide employees through the complexities of the workers’ compensation system. Don’t be penny wise and pound foolish. You may save the attorneys’ fees by choosing to pursue your Georgia Workers’ Compensation claim on your own, but you also may settle your case for a fraction of what it is worth and not realize that you have other valuable claims because you didn’t have an experienced Georgia lawyer on your side.

Contingent Fees

A contingent fee agreement means that an attorney will take a percentage of the amount of workers’ compensation benefits an employee receives if he or she wins. Usually, the attorney doesn’t obtain payment until the case is won. If the attorney doesn’t win the case, the attorney isn’t compensated. You may have noticed a lot of lawyers advertising the contingent fee arrangement as “No Fee Unless We Win” and that is what it boils down to.

In Georgia, the State Board of Workers’ Compensation controls attorney fees. The Board limits fees to 25% of the weekly benefits or settlements recovered by the attorney. The attorney cannot charge for recovery of medical care or compensation of medical expenses. If an injured employee only wants to talk about his claim and get advice and counseling but not representation, an attorney is allowed to charge an hourly fee of no more than $100 without prior approval from the Board. However, not many qualified Georgia lawyers would charge such a fee.

When Injured in a Workplace Accident

If you were injured in a workplace accident, you may be wondering what to do. Here are some suggestions:

  1. The injury should be reported to your supervisor without delay. Not reporting the injury within statutory deadlines may endanger your rights.
  2. Get medical attention immediately. And then inform your employer of your condition and possible date of return.
  3. A First Report of Injury has to be filed by your employer.
  4. Benefits will either be paid or denied within 14 days.

If Denied Benefits

Given all the paperwork and red tape involved, applying for workers’ compensation benefits can be a daunting task. An employer might deny that the injury was sustained at work. Or your benefit award may not cover all the medical care needed. You may even be faced with having to return to work before you are fully recovered. With our experience and understanding, we can maximize your benefits and uncover other causes of action that you may not have been aware of. We will guide you through the entire process so you can attain the most compensation possible.

If you would like to discuss the facts of your case with an experienced Workers’ Compensation Benefits attorney, call Robert J. Fleming at (404) 525-5150 or you can contact us online. We are here to help.

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