Workers’ Compensation was created to prevent employees from suing their employers for on the job injuries. If employees were allowed to sue their employers, the courts would be flooded with civil litigation; therefore, Workers’ Compensation was created under a “no-fault” system where the only criteria for receiving benefits is whether or not the employee was injured on the job. It does not matter whose fault it was that you became injured. It could have been your own fault, it could be your employer’s fault, or it could be nobody’s fault.
In workers’ compensation, if you are injured for any reason other than for personal reasons, like a fight, intoxication or horseplay, then you may collect certain benefits. Please remember that the workers’ compensation benefits you receive will often not be as much as you would get in a civil case such as from a car wreck. In a car wreck case or other personal injury case, you are entitled to be made a whole again by the payment of money, and can receive money for pain, suffering, discomfort, aggravation, etc. In such a case, however, you must prove that your injury was the result of someone else’s negligence. However, in workers’ compensation, you do not receive any money whatsoever for pain, for suffering, for discomfort, for distress, or mental anguish. The only thing for which you may receive money in workers’ compensation is disability (or inability to work), and that will be explained more fully later. In return, you do not need to prove negligence in a workers’ compensation case, although the injured worker does have the burden of proving the essential elements of the claim.
If your employer had three or more full time employees at the time of your accident and you were not an owner-operator or independent contractor, a domestic servant , or a farm worker, then you are most likely entitled to Workers’ Compensation Benefits. The benefits that you are entitled to will essentially fall into three categories: (1) payment of medical bills, (2) payment of a portion of your wages/salary for temporary disability, and (3) payment for permanent partial disability. In order to receive benefits, however, you must report your injury to your supervisor or employer at least within thirty (30) days from the date of your injury. You must also make a claim for benefits with the State Board of Workers’ Compensation within one year from the date of the injury, and to receive permanent partial disability benefits, you must make your claim within four years from the date of the last income benefit. These three statutes of limitation must be remembered in order to preserve your claim. If you retain our firm in time, we will file everything that is needed to ensure your legal rights are not forfeited.
Under Georgia law, an injured worker will not receive pay for being out of work unless he or she misses seven or more days from work. For example, if as a result of an on the job injury you are out of work for only four days, then you would not receive any disability payment, but only payment of medical bills. After you have been out of work for 21 days, you are entitled to receive your first check. After you have been out of work for twenty one consecutive days, you are entitled to reimbursement for the original seven days for which you were not paid.
The amount of money which you are entitled to receive in weekly benefits is called Temporary Total Disability (TTD) Benefits and is calculated at the rate of two-thirds of your regular weekly salary, not to exceed $550.00 per week (effective July 1, 2015). By way of example, if you were making $900.00 per week, two thirds of that salary would be $600.00 per week, but you would only be entitled to receive the maximum of $550.00 per week. By the same token, if you were only making $100.00 per week, then two-thirds of that amount would be $66.66 per week, and that is what you would be entitled to receive. As a result, injured workers will not receive the income to which they were accustomed. It is almost impossible for a man or woman who is supporting a family or a spouse, who is not working, has a house payment, and a car payment, to survive on $550.00 per week or less. Unfortunately, that is the current situation in Georgia which is one of the lowest paying states in the country for Workers’ Compensation Benefits. Workers with non-catastrophic injuries are limited to a maximum of 400 weeks of these benefits. Workers with catastrophic injuries receive workers’ compensation benefits for an unlimited period of time.
You are entitled to receive TTD benefits for as long as your authorized treating physician has you completely disabled from work. In order to receive TTD Benefits, you must have a written statement from your authorized treating physician stating that you are unable to work. Without the statement from your doctor, you cannot receive the benefits. Therefore, you should be sure to ask your doctor for a new disability slip every time you go in for treatment.
Temporary Total Disability Benefit Checks are issued on a weekly basis and often come on the same day of each week once a regular schedule has been set for you. However, so long as the check is mailed during that seven day period, it is considered to have been timely paid. When your authorized physician says that you are able to return to regular or normal duty work, the TTD checks can be suspended, and you should receive a Workers’ Compensation form indicating benefits are being suspended. If you disagree and feel that you are not able to return to work, it is important that you seek a second opinion from another doctor or ask the authorized treating physician to refer you to another doctor for a second opinion. If you do return to work before you are ready, then you may jeopardize your job and be suspended for failure to perform, or you may reinjure yourself by doing something which you should not be doing. We regularly contest return to work releases when it is clear that the client cannot return to work.
Your doctor may put you back to work on a limited duty basis. “Restricted duty” or “light duty” may mean that you are not to be doing any heavy work, or it may mean that you are not to work full days. Make sure your supervisor understands your limitations when you return to work, and remind your employer that you are not to do certain types of heavy duty work. Many times the employer will not have light duty work available for you and will, therefore, return you to Temporary Total Disability status until you can perform “regular or normal duty.” Many times, however, the employer will not inform the insurance company of this. In order to have your TTD Benefits reinstated, it is important that you or your attorney immediately contact the insurance company to advise it that your employer does not have light duty work for you and that your TTD benefits should be reinstated.
In certain circumstances, an injured employee who returns to some kind of work but earns less per week than he/she was making at the time of the injury may be entitled to Temporary Partial Disability (TPD) Benefits. You would be entitled to payment of two-thirds of the difference between what you made before your injury and what you make after you returned to work. There is a maximum payment for TPD of $367 per week for injuries occurring on or after July 1, 2015. For injuries that occurred from July 1, 2013 to June 30, 2015 the maximum rate is $350.00 per week. This benefit is paid weekly, just like TTD. If you have returned to work after an injury and are making less money, you should call us as we may be able to obtain TPD payments for you.
Although the vast majority of Workers’ Compensation cases do not require any litigation, occasionally the parties cannot come to an agreement over an issue and a hearing is required. Hearings are held at the State Board of Workers’ Compensation for cases which are in dispute. One is not permitted to request a Hearing unless there is a bona fide, legitimate dispute for the judge to hear. The dispute could be over non-payment of medical bills, change in treating physician, approval of treatment or testing, over a change in condition from Return to Work status back to Temporary Total Disability status, or any number of things. The Hearing could even be to asses a penalty for non-payment of a benefit.
Hearings are generally scheduled approximately one to two months after the date they were requested. You should be aware, however, that hearings are often postponed by one side or the other. A Hearing can be as short as one-half hour or can last all day depending on the complexity of the case. If the case involves only one small issue, such as non-payment of a doctor’s bill, the Hearing might only take half an hour. Several hearings are scheduled for one day before the same judge since the average hearing lasts one hour. One of the unfortunate realities of workers compensation in Georgia is that even when a hearing takes place, there can be a long wait before the requested relief is obtained. Judges have 60 days to issue the Award (or ruling). Then the losing side has the right to appeal. There are three levels of appeal of a workers compensation Award. These appeals can last many, many months.
One of the most frequent questions we receive is whether an employee can be fired after being injured on the job. The short answer is almost always, “yes”. Even if you are still totally disabled by your doctor, in most circumstances your employer can terminate you. Georgia is an employment “at will” State which means you can be fired for any reason including the fact that you were injured on the job. Exceptions would include having a written contract of employment with your employer or being protected by a union agreement. However, most of the larger employers see the value in retaining a good employee and will not terminate you just because you sustained an injury while working. And firing you while you are still on work restrictions could mean that you become entitled to additional disability benefits.
We hope this information helps you better understand this highly complicated and complex area of the law. We strongly advise that you not to attempt to handle your Workers’ Compensation claim without the assistance of an attorney who has a thorough understanding of Georgia’s Workers’ Compensation law. If you have been injured on the job we sincerely hope that you will allow our firm to put our experience to work for you. We look forward to assisting you, and invite you to contact us.