Workers’ Compensation Frequently Asked Questions

Augusta, Georgia, Workers’ Compensation Attorneys

Here are some of the most common questions about workers’ compensation law. While these may provide a guide for you, there may be many complicating factors with your workers’ compensation case.

Do I have to remain in Georgia in order to get Workers' compensation benefits?

No. You can continue to receive your weekly benefits no matter where you are living. The insurer must provide you a doctor convenient to your new residence.

I am receiving the maximum amount of Georgia Workers' Compensation benefits. I understand that the maximum amount was increased on July 1, 2007. Am I eligible to have my benefits increased?

No. You are locked into the maximum amount of weekly benefits in effect on the date of your accident.

Can I be fired for making a Workers' Compensation claim?

Yes. Georgia is an employment at will state. In general, unless you have an employment contract or are the victim of discrimination, you can be fired for any reason. The Georgia legislature rejected a bill preventing such firing for making a claim many years ago. Your termination can be significant, however. If you are on regular duty work with no restrictions and you are fired, then you will not be entitled to further temporary total benefits unless a doctor later said that you had some restrictions when you are fired, you may be entitled to workers' compensation benefits. If you have been fired for reasons related to your workers' compensation claim, your temporary total benefits should start immediately and you need not seek employment. If it is not apparent that you were fired for making the claim, you will probably need to look for work and prove that the reason that you could not find work was on account of your workers' compensation claim and the lingering effects of your injury. If you can prove this then you would be entitled to temporary total benefits.

Am I personally responsible for my medical bills?

Not if you have an accepted claim and if you have seen the authorized treating physician. Georgia law prohibits the medical provider from billing you for such services.

When can the insurance company stop my benefits?

That is a very complicated question. There are limits on how long you can receive benefits. Without regard to these time limits, there are essentially 3 situations in which the insurer can stop your temporary total benefits without going to the State Board of Workers' Compensation for permission. (There are many other situations in which the State Board can suspend benefits.) First, if the authorized treating physician returns you to work on regular duty with no restrictions. Second, if you return to work making the same amount of money as you were making when you were hurt. Third, if the insurer follows the procedure set forth under O.C.G.A. § 34-9-240 and Board Rule 240 concerning offering you light duty work and you do not try to do it.

I am applying for Social Security Disability Benefits. If I get them, will they be reduced because I am receiving Georgia Workers' Compensation benefits?

Perhaps. The total of your workers' compensation benefits and your social security disability benefits cannot exceed 80% of your average monthly earnings. Usually, when your workers' compensation case is settled, the documentation of the settlement agreement can be drawn so as to recoup a large portion of this lost offset.

I think someone from the insurance company is watching me. Can they do this?

Yes. It is legal to perform surveillance. The insurance company is likely to be trying to see if your restrictions are less than you and your doctor say they are. Avoid doing any strenuous activity outside. The insurer will try to make it look like there is nothing wrong with you. While you may be able to bend over and pick something up once, this does not mean that you can do it all day. They may make a videotape that may be very misleading.

Workers’ Compensation Basics:

What is workers' compensation?

The workers' compensation system was developed to provide speedy payment of income benefits and medical bills without the necessity of proving fault on behalf of the employer, co-workers or third-parties. Usually the employer purchases a workers' compensation insurance policy which will pay these benefits.

Are you covered under workers' compensation laws?

In general, if your employer has 3 or more employees and you were injured performing a task that arose out of, and in the course of your employment, you will be covered under Georgia Workers' Compensation law.

Do I really need an attorney?

Workers' Compensation at times can be a challenging situation. Complicated forms and procedures must be followed, and if any discrepancies arise it is often beneficial for an attorney to represent you because of the skill needed to navigate these proceedings. Our experience has taught us to get the maximum amount of benefits for injured workers.

Catastrophic Injuries

While virtually every injury is catastrophic to the person who suffers it, the term "catastrophic injury" is an important concept in workers' compensation law in Georgia. The State Board of Workers' Compensation classifies work related accidents as catastrophic and non-catastrophic. When an injury is not considered catastrophic, limitations can be placed on the benefit amounts an Injured Worker is entitled to receive. We represent injured workers who are facing life-altering injuries whether catastrophic or non-catastrophic. We provide injured workers with strong legal advocacy and guidance to ensure the appropriate determinations are made about their medical conditions. Were you injured at work? Would you like to speak with an attorney about the nature of the injuries? Please contact Plunkett, Hamilton, Manton & Graves, LLP today to arrange a free consultation. We have been helping injured workers and their families in the CSRA for years. Put our experience to work for you by contacting us today to arrange a free consultation.

Catastrophic Income Benefits

Under a typical workers' compensation claim, you qualify for a limited amount of income benefits. State law limits income benefits to $450.00 per week for up to 400 weeks. If you suffer a catastrophic injury, you can earn income benefits for the remainder of your life.

Medical Benefits Following a Catastrophic Injury

The State Board of Workers' Compensation can extend your medical benefits indefinitely following a catastrophic injury. You may qualify to receive medical treatment, as well as reimbursement for medical care, prescriptions, surgery, rehabilitation, and mileage, after suffering a:

• Head injury/traumatic brain injury
• Back injury/neck injury/paralysis
• Blindness/cognitive impairment
• Amputation/disfigurement

If you are hurt on the job, it is important to give your employer notice of your claim within 30 days of the accident. Under Georgia law, employers with three or more employees must have workers’ compensation insurance to provide benefits to employees who suffer work related injuries.

Your employer has an obligation to provide you with a panel of physicians who will diagnose and treat your injury. If your employer posts a list of approved physicians, you must see one of them. When they fail to post a list of doctors, you can visit any doctor, at the insurance company’s expense.

It is important to maximize the income benefits you receive. Under workers’ compensation, you may receive two-thirds of your average weekly wage, up to $450.00 a week, for up to 400 weeks. We will make sure that the state calculates your average weekly wage by adding up all of your income, including overtime, any fringe benefits, and any employment perks.

Finally, we will seek to structure your workers’ compensation so that you continue to receive it until you are able to return to work. You can remain on workers’ compensation until a doctor says you can return to work. If your workers’ compensation benefits are cut off, we will file a Request for Hearing to get them started back.

Seek the workers’ compensation benefits you deserve. Contact Plunkett, Hamilton, Manton & Graves, LLP today for a free initial consultation.