Jul 24, 2024
How Does Workers’ Compensation Work in Georgia?
Wesley McDaniel
Every year, approximately 78,000 work-related injury and illness cases are reported in the private sector in Georgia, out of which more than 41,000 are classified as “severe.” These injuries often require the employee to take days off, transfer to another department, or face restricted job duties. At Hansford McDaniel – Workers’ Compensation Attorneys, we fight to protect the rights of injured workers to maximum compensation in Georgia.
Workers’ Compensation Laws in Georgia
Worker compensation in Georgia comes under the “no-fault” system. This means you do not have to provide evidence that your employer was at fault or negligent in their duties. If an injury or illness is work-related, it’s automatically covered.
Workers’ Compensation Requirements for Employers
In Georgia, any business with three or more employees, including regular part-time workers, must have workers’ compensation insurance. Employers are also required to post a panel of at least six doctors employees can choose from in the event of an injury.
This is how the process works:
- Upon sustaining a workplace injury, the employee must notify their employer, who should then direct them to seek treatment from a medical provider listed on the company’s pre-approved panel of physicians.
- The employer must complete and file a “First Report of Injury or Illness” form (Form WC-1) with their workers’ compensation insurance company within seven days of learning about the injury.
- Employers must keep a log of all work-related injuries that outlines the date of injury, type of injury, how it occurred, and time lost from work. These records must be kept for at least five years.
- Once the injury is reported, the insurer will assess the claim and determine the workers’ compensation benefits due.
Workers’ Compensation Requirements for Employees
- Employees must report their injury to their employer as soon as possible—no later than 30 days after the accident to qualify for benefits.
- They can receive treatment from a doctor listed on the employer’s posted panel of physicians. That said, all employees in Georgia have the right to make one change to another physician on the panel without the employer’s permission. The medical expenses are fully covered, without deductibles or copayments from the employee.
- If the injured worker is unable to work for more than seven days, they are eligible for weekly income benefits amounting to two-thirds of their average weekly wage (up to a maximum; this is $800.00 per week for an accident that occurred on or after July 1, 2023). These may continue for up to 400 weeks or until they can return to work.
- If an injury results in permanent disability, you may be eligible for additional benefits based on the severity and nature of the impairment. For catastrophic injuries, such as a loss of limb or spinal cord injury resulting in paralysis, you may be entitled to lifetime medical benefits and vocational rehabilitation services.
- If your workers’ compensation claim is denied or a dispute is raised regarding the degree of disability, you have the right to request a hearing before the Workers’ Compensation Board.
How to File a Workers’ Compensation Claim in Georgia
Step 1: Report the Injury
As soon as the injury occurs, or as soon as you realize an illness is caused by your work, report it to your supervisor or employer. Ideally, this should be done both verbally and in writing to have a record. Georgia’s workers’ compensation law allows you up to 30 days to report the injury, but it’s best to do it immediately.
Speak to an experienced workers’ compensation lawyer first so they can make sure the wording used in your report does not inadvertently undermine the seriousness of your injury or the connection to your workplace.
Step 2: Visit an Approved Physician
Go to a doctor listed on your employer’s posted panel of physicians. In case of an emergency, when there is no time to consult the panel, you can receive treatment from any available doctor or emergency room. However, you should switch to an authorized physician for any follow-up care. Keep a record of all your visits, treatments, prescriptions, and any other medical costs.
Additionally, if your company does not have an officially displayed list of doctors or fails to inform you about your rights to choose one from this list, you may have the right to go to any provider (not listed).
Step 3: Employer Files the Claim
Under Georgia law, every eligible employer is required to provide workers’ compensation insurance, no matter whether you have a higher or lower-paying job. The employer should file a Form WC-1 with their workers’ comp insurance within 21 days of becoming aware of your injury. Confirm with them that this has been done. If they fail to file the claim, you or your workers’ compensation attorney in Georgia can contact the insurer directly or the State Board of Workers Compensation.
Step 4: Follow Up with the Insurance Company
The insurance adjuster may request additional medical reports from your doctor, proof of your earnings, and any witness statements about the accident to understand the severity of your injury and its impact on your ability to work. They might also require you to undergo an independent medical examination (IME) by a doctor of their choosing to validate your workers’ compensation claims.
Step 5: Receive Workers Compensation Benefits
If your claim is approved, you should start receiving benefits immediately.
- Medical Benefits: Doctor visits, hospital stays, physical therapy, medications, and necessary medical equipment (wheelchair, prosthetics, etc.)
- Temporary Total Disability Benefits (TTD): Equals two-thirds of your average weekly wage, subject to a state-set maximum, and paid if you are completely unable to work due to injury. Continues until you return to work or reach maximum medical improvement
- Temporary Partial Disability Benefits (TPD): Equals two-thirds of the difference between your previous and current wages (up to a limit), and paid if you return to work at a lower wage due to your injury
- Permanent Partial Disability Benefits (PPD): Calculated based on the severity of the impairment, these are awarded for permanent damage that does not fully disable you
- Permanent Total Disability Benefits (PTD): For severe injuries preventing any form of work, these are paid at a rate similar to TTD, but for a lifetime
- Death Benefits: If a work injury results in death, the employee’s dependents may receive burial/funeral expenses and a portion of the deceased’s wages
What to Do If Your Georgia Workers’ Compensation Claim is Denied?
The “no-fault” aspect means that you do not need to jump through legal hoops to receive compensation for your occupational injuries. However, this does not mean all workers’ compensation settlements are automatically approved.
Here are some common reasons why workers’ compensation claims get rejected:
- You did not report to your employer within 30 days from when the injury occurred or you first became aware of it.
- The paperwork you submitted was incomplete or inaccurate.
- Your medical records do not clearly link the injury to the workplace, or they do not support that the injury is severe enough to require treatment or missed work.
- There was a significant delay between the occurrence of the injury and your seeking medical help, suggesting that your injury might not be serious or related to work.
- The injury was reported after you were terminated, laid off, or quit your job.
- You did not follow the prescribed medical treatment or missed follow-up appointments with the authorized treating physician.
- A drug or alcohol test after the injury indicates that you were under the influence at the time of the accident.
In case of a claim denial, consult a workers’ comp lawyer in Georgia right away. They can carefully review why your claim was denied and contact the workers’ compensation insurance carrier for further clarity. If this does not work, your attorney can file a Request for Hearing with the Georgia Board of Workers’ Compensation. If necessary, they will prepare you for the mediation process where a neutral third party helps you reach a settlement with the insurance company.
You want an experienced workers’ compensation attorney in Georgia to argue your case before an administrative law judge. If the hearing does not go in your favor, they can appeal to the Appellate Division of the State Board of Workers’ Compensation and eventually to the state courts if necessary.
Maximize Your Worker Compensation in Georgia with Our Lawyers
If you think you’re being offered an unfairly low amount of compensation that falls short of covering your actual losses or your claim has been denied, get in touch with Hansford McDaniel – Workers’ Compensation Attorneys. With 60+ years of collective experience in representing mistreated, underpaid, and injured employees across Georgia, we know what it takes to get you the benefits you are legally entitled to. We can help make sure:
- Your on-the-job injury is correctly classified; for example, a partial disability is not mistakenly labeled as less severe.
- Your average weekly wage is calculated accurately, including overtime, bonuses, and other compensable earnings that might otherwise be overlooked.
- You receive a proper medical evaluation, and the documentation of your injuries and treatment rightfully supports your claim.
- Your claim is not diminished just because you have a pre-existing condition or your injury occurred over time (like a repetitive stress injury).
- Your case is swiftly resolved out of court (or we go to trial if necessary).
To schedule your free case evaluation, call us at 770-922-3660 or contact us online.