Workers' Compensation

WORKERS' COMPENSATION: WHAT EMPLOYEES SHOULD KNOW ABOUT THEIR RIGHTS

As a general rule, any employer that has, regularly in service, three or more employees, must have workers' compensation insurance coverage.

Georgia workers' compensation laws do not apply to the following categories of employment:
1. Certain employees of the United States Government;
2. Railroads;
3. Farm laborers;
4. Domestic servants;
5. Licensed real estate sales persons with written contracts of employment providing for services as independent contractors.

If an employer who is subject to the Georgia Workers' Compensation Act has the requisite number of employees and fails to provide workers' compensation coverage, the employer can be held personally liable for the benefits due under the Workers' Compensation Act and may, under certain circumstances, be required to pay penalties and the employee's attorneys' fees if the case is found to be compensable.

BENEFITS AVAILABLE UNDER
THE WORKERS' COMPENSATION ACT:

The primary benefits available to an injured worker under the Workers' Compensation Act are as follows:

(A) TEMPORARY TOTAL DISABILITY WEEKLY INCOME BENEFITS:
If you are injured and begin losing time from work, you are entitled to receive 2/3 of your average weekly wage up to a maximum of $300.00 per week. The first seven days of compensation are not payable until or unless you have missed 21 days from work. In other words, you are not entitled to weekly benefits if you miss 7 or less days from work. If you miss at least 21 days from work, you will be paid for the first 7. The first payment of weekly benefits, including the first 7 days, is due on the 21st day of disability.
For non-catastrophic injuries occurring on or after July 1, 1992, there is a maximum period of 400 weeks from the date of the injury for entitlement to this benefit. A catastrophic injury is defined as one of the following:

1. Spinal cord injury involving severe paralysis of an arm, a leg, or the trunk;
2. Amputation of an arm, a hand, a foot, or a leg involving the effective loss of use of that appendage;
3. Severe brain or closed head injury as evidenced by :

a) Severe sensory or motor disturbances;
b) Severe communication disturbances;
c) Severe complex integrated disturbances of cerebral function;
d) Severe disturbance of consciousness;
e) Severe episodic neurological disorders;
f) Other conditions at least as severe in nature as any condition provided in subparagraphs a) though e) of this paragraph;

4. Second or third degree burns over 25% of the body as a whole or third degree burns to 5% or more of the face or hands.
5. Total or industrial blindness;

For catastrophic injuries there is no limit to the number of weeks that you may draw benefits.

(B) TEMPORARY/PARTIAL DISABILITY BENEFITS:
If you are able to return to work but because of your injury you are not able to earn as much money as you were prior to the date of your on-the-job injury, then you are entitled to receive 2/3 of the difference between what you made before you were injured and what you are able to make after your injury up to $192.50 per week. This benefit is payable for a maximum of 350 weeks.

(C) PERMANENT/PARTIAL DISABILITY BENEFITS:
If you have sustained a permanent impairment or loss of use of any part of your body as a result of your on-the-job injury you are entitled to be compensated for that permanent impairment. The amount that you are entitled to would depend on the percentage of permanent impairment that your doctor assigns. The Workers' Compensation Act assigns maximum values (denominated as weeks) to various parts of the body such as a leg, hand, eye, arm, etc... The Act also assigns a maximum value to the body as a whole (300 weeks).

Example: If you have sustained an injury to your back, have reached maximum medical improvement, and have been assigned a 10% permanent impairment rating to the body as a whole, then you are entitled to receive 10% of 300 weeks (the maximum assigned value of the body) or 30 weeks. If your compensation rate is $300.00 then you would multiply $300.00 times 30 weeks for a total of $9,000.00.

(D) MEDICAL BENEFITS:
The employer/insurer is obligated to pay 100% of the cost of medical treatment required to effect a cure or give relief to an injured worker; however, the employer/insurer also has the right, within limitations, to designate the provider of that treatment.

By law, an employer must post a panel list of 4 doctors in a prominent or conspicuous place upon the business premises. The law also requires that the employer take all reasonable measures to ensure that the employees are aware of the existence of the panel, and their right to select a treating physician from it. The law also requires that the employers give employees appropriate assistance in contacting panel physicians when necessary.

If an employer fails to post a panel list of physicians as required by law, then you may go to the physician of your choice. If you go to a physician who is not on the panel list or is otherwise authorized, then you will be responsible for payment of the bill. There is no dollar limit on the amount of medical bills that an employer/insurer is liable to pay and under certain conditions, the employer and its insurer remain liable for payment of medical bills related to your injury for the rest of your life.

In the case of a compensable work-related injury, the employer and its insurer are also liable for certain travel expenses. You should keep a list of your trips to the various medical providers, showing the date the trip was made, the name of the medical provider, and the total round trip mileage. You will be reimbursed at the applicable rate per mile.

(E) VOCATIONAL REHABILITATION:
The Workers' Compensation Act provides, in the event of a catastrophic injury,that the employer shall furnish an injured employee reasonable and necessary rehabilitation services.
The value of vocational rehabilitation services range widely. They may include:

1. Vocational evaluation and vocational counseling;
2. Psychological testing and evaluation;
3. Job analysis; job placement and job modification;
4. Additional training.

An injured employee should make certain that the rehabilitation counselor has his/her best interests at heart and can exercise his/her independent judgment. Vocational rehabilitation providers are paid by insurance companies.

YOUR DUTIES UNDER THE WORKERS' COMPENSATION ACT:

1. Report any on-the-job injury within 30 days of the date of the injury. Although the law provides that an employee should notify the employer within 30 days, any injury should be reported immediately. If you do not report your injury immediately, you may afford the employer and insurance company a defense that they would not otherwise have.
2. Determine on your own whether the employer has the required panel list of authorized physicians posted.
3. Seek medical treatment from authorized treating physicians only.

As with most other aspects of the law, there are many exceptions to the general rules of the Georgia Workers' Compensation Act. If you do not understand your rights or if you feel that you are being taken advantage of, it is best to consult your attorney for advice early on in the case.

If you or someone you know has been involved in a serious accident in Georgia, Finch McCranie, LLP may be able to help you. For your convenience Finch McCranie, LLP offers you a Free Case Review. For inmediate assistance, please contact us at Toll Free 1-800-228-9159 or fill out our Free Case Review Form. Remember that for over 30 years Finch McCranie, LLP has succesfully helped hundreds of people to solve their legal problems: "Our commitment is to the victims, their families and their future..."