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Practice Areas : Georgia Workers Comp FAQs
Helping injured Georgia citizens get the medical
and income benefits they need for over 18 years.
Georgia Workers’ Compensation Attorneys
The following questions and answers address many of the most common questions you might have about Workers Compensation in Georgia. Please feel free to contact us if you have a question that is not covered here.
Q: What benefits can I expect?
A: You are entitled to three basic benefits.
1. Wage Benefits. Wage benefits are payable to you at the rate of two-thirds of your weekly wage. This is usually computed by averaging your wages for the 13 weeks before your accident. The maximum benefit is currently $500 per week. There are other ways to determine your average weekly wage (AWW), so please ask us about that. There is no cost of living increase of weekly benefits after the amount of your benefit is determined. Remember, weekly wage benefits are not payable to you until the authorized treating physician has placed you on a “No Work” status. Wage benefits may also be started if the doctor puts you on limited or light duty and your employer declines to provide limited or light duty work for you.
2. Medical Benefits. Medical benefits are payable by your employer and their insurance company. There is no deductible for you to pay. The doctor or hospital should not bill you directly. Medical benefits include mileage to and from the doctor and prescription payments. Please let us know if you are billed for medical expenses.
3. Permanent Partial Disability. When your doctor returns you to work and you are as well as you can get using modern medical practice, your doctor should, but is not required to give a Permanent Partial Disability (PPD) rating that will provide an end benefit to you.
Q: When will I get benefits?
A: The insurance company has 21 days to investigate your case. In 75% of the cases, the investigation is on time but sometimes the insurance company can be slow to investigate your claim and start your benefits. In a situation where the insurance company refuses to pay your claim, it could take us six months or longer to get your benefits started. The insurance company is not required to pay you for the first week you are out unless you have been out for the first 21 consecutive days after your injury. Remember, your authorized treating physician must have you on a “No Work” status before you can receive a weekly disability check. The insurance company may start paying benefits if the authorized doctor places you on light or limited duty and your employer declines to offer such light or limited duty. The issues can be complicated, so please ask us for more information or clarification if you are not sure how this might affect you.
Q: I’m receiving the maximum benefit. What happens if the maximum is increased? Will I receive more?
A: No. Your maximum weekly benefit is determined by the weekly benefits in effect on the date of your accident.
Q: Do I have to stay in Georgia to get Workers’ Compensation benefits?
A: No. You can continue to receive benefits wherever you are living. The insurance company must provide you with a doctor who is convenient to your new location.
Q: Can I be fired for making a Workers’ Compensation claim?
A: Yes. Georgia is an employment at will state. That means that unless you have an employment contract or are the victim of discrimination, you can be fired for any reason. That does not mean, however, that you cannot receive workers’ compensation benefits if they are due you. This is a complicated situation and requires a knowledgeable expert to help you through the process.
Q: I think the insurance company is watching me. Can they do that?
A: Yes. Surveillance is legal. The insurance company may be watching you to see if your injury is less restrictive than you and your doctor say it is. They may even videotape your activities to show that there is nothing wrong with you.
Q: What if my employer refuses to pay my benefits?
A: If your employer and their insurance company refuse to pay you medical and wage benefits, we can ask for a hearing before an Administrative Law Judge. The hearing process will be scheduled about two months from the date that we ask for a hearing and is very often rescheduled a second or even a third time. Understand that it could take as much as four to six months to get a hearing, so it is important for you to be patient.
Q: What doctor can I see?
A: Your employer is required to keep a posted panel of doctors. This panel is usually located next to a time clock or in a break room. In order to get medical bills paid by your employer, you must go to one of their panel doctors. You are permitted to change from one panel doctor to another only once. If your employer has no panel doctors, then you can go to a doctor of your choice. Click the link to see a sample posting form. Important: It is extremely important for you to find the panel doctors and hospitals posted in your workplace and give that information to us exactly as it appears in the posting.
Q: Do I get paid for prescriptions and mileage to the doctor?
A: You are entitled to 40 cents per mile going to and from the doctor and if you keep your parking receipts, we will get you reimbursed for those, too. Many insurance companies will set up an account at a drug store for the prescriptions given by the authorized doctor. If you pay for prescriptions, send a copy of the prescription to us with the receipt and we will send it to the insurance company.
Q: What can I do to help my case?
A: In addition to being patient, there are three things you can do to help your case.
1. Stay in touch with your lawyer. Call every time you see your doctor and try to get a work status form every time you see the doctor.
2. Be careful who you talk to about your case. If someone calls, tell that person to call your lawyer.
3. Find out about the panel of doctors. Go to your employer and ask about the panel and see if you can find it. Please call us about your findings.
Q: Is there a time limit for filing my claim?
A: Yes. You must report your injury to your employer within 30 days. In addition, if you haven’t received a weekly disability check, then you must file with the State Board of Workers’ Compensation within one year of the date of the accident, or if you have continuous medical treatment, the claim must be filed within a year of the date of your last remedial (treatment of injury) medical treatment. If you have received a weekly check and the insurance company has stopped paying you because you returned to work or your doctor has returned you to normal work, it will become difficult or impossible to obtain additional benefits for you after the expiration of two (2) years. The issue is complicated. For further information, contact your lawyer.
Q: Can I get a jury trial to settle my case?
A: No. There are no jury trials under the Workers’ Compensation procedure. Hearings are held before an Administrative Law Judge and they are held in various offices throughout the State. The issues are related to the three basic benefits to which you may be entitled and it usually takes 4 to 6 months to get a hearing. Be patient. An insurance company cannot be forced to settle your case. Insurance companies only settle when it makes sense for them economically.
Q: Can I sue my employer for my injury?
A: No. Georgia law makes it impossible to sue your employer for your injury. Your employer only has to pay Workers’ Compensation Benefits and there is no pain and suffering payable under workers’ comp for your injury. If you are injured by a person other than your employer or a co-employee, you may be able to sue that person. The rules are technical, so please ask us if you have a question.
Q: Can I borrow money from my lawyer?
A: No. Georgia law does not allow a lawyer to loan money to his client. A lawyer may advance some expenses but he cannot lend his client money.
Q: What if my weekly check is late?
A: You should contact us immediately and also do your homework. Keep a record of your checks and the date you received them. Save the check stub and the envelope. If the check is not mailed by the last day of the weekly period, then it is considered late and we can get you a 15% penalty. Many times the insurance company will send your check but it will get lost in the mail. Before the insurance company will mail another check, they will have to stop payment and this usually takes a minimum of ten days from the date they mailed it. Please try to keep money in reserve in case your check is late.
Q: How do I pay my lawyer?
A: All fees over $100 must be approved by the State Workers’ Compensation Board. Our fee is 25% of the weekly check if we have to take action to get your benefits started. If the insurance company starts your weekly check without our assistance, we are not entitled to any part of your weekly check. You will also be required to pay any expenses advanced by your lawyer to pursue your case. Expenses vary widely based upon the nature of the case, however they are not usually over $100. We will be more than happy to discuss our fees and expenses with you.
Q: How long will my weekly checks be paid?
A: The length of time depends entirely on your doctor. If he has you off work then the employer and insurer will be required to pay you for 400 weeks. If the doctor sends you back to work, the insurance company will give you ten days’ notice and stop your weekly check. Your entire case rests in the hands of your authorized doctor. In other situations, the insurance company can reduce your weekly check one year after your doctor returns you to light or limited duty but your employer offers no light duty work. In some cases, the Workers’ Compensation Board will determine the case “catastrophic” and, in that event, you could qualify for lifetime benefits. The catastrophic determination requires the loss of two eyes, an arm and a leg or two arms and two legs. In addition, a severe neurologic injury can cause a catastrophic designation. Check with your attorney about the definition of catastrophic. Qualifying for Social Security Disability may result in your case being determined catastrophic.
Q: What does my attorney handle for me?
A: Unless you have a contract specifying otherwise, we only represent you in your Workers’ Compensation case. We do not handle discrimination cases or cases under the Americans With Disabilities Act. We have no expertise in Social Security cases or Wage and Hour Cases.
Q: What happens if my doctor returns me to light duty work?
A: Call us immediately and let us know! Do not go back to work until you talk to us. There is a special procedure under Georgia law that requires the employer to obtain in writing from your doctor exactly what “limited to light duty” you can do. We call this a 240 Procedure and they must give you ten days’ notice of the job offer and you are given 15 days to try the job. Normally, if you determine that you cannot do the job, then you should be able to quit and the insurer should restart your weekly benefits. The insurance company will then ask for a hearing before an Administrative Law Judge to re-stop your benefits. The concepts are complicated, so please ask us about the process. Remember that the employer and insurer do not always follow the law and it could take some work to get your benefits restarted. Click the link to view a special message from Vic Alexander about what to do if your doctor returns you to light duty work.
Q: What happens if my doctor returns me to normal work?
A: Your employer and their insurance company will suspend your weekly benefits within 10 days’ notice. There is really no requirement for your employer to offer you a full duty position after the doctor has returned you to full duty. This should explain to you the importance of having a good, caring doctor.
Q: What if I return to light duty or limited duty work but make less money?
A: If you make less money because of your injury and are on light or limited duty, you may be entitled to two-thirds of the difference at a maximum of $375 per week. For example, if you averaged $400 per week before the accident and because of your injury you are on limited duty and only make $200 per week, you would be entitled to two-thirds of the difference or $133.33 per week. The maximum benefit you can receive is $233.33 per week.
Q: What if I have more questions?
A: We will be more than happy to answer any additional questions related to the legal aspects of your case on your next visit to our office. Please remember, we are your lawyers and can offer you expertise only in this area.
Q: How do I get to your office?
A: Directions to our office are shown below. Click the link to download these directions to your computer or get exact directions from your location.
Our offices are conveniently located at:
6065 Lake Forrest Drive, Suite 200B,
Atlanta, Georgia 30328
Please see the map below for additional detail:
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6065 Lake Forrest Drive, Suite 200B, Atlanta, Georgia 30328