What should I know about workers' compensation in Georgia?

Contents

• What is workers' comp?
• Who is covered by workers' comp benefits in Georgia?
• What is considered a workplace injury?
• What are my rights to workers' compensation in Georgia?
• What are my responsibilities with workers' compensation in Georgia?

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What is workers’ comp?

If you are injured while working, you are entitled to workers’ compensation. Workers’ compensation benefits are there to help you recover and return to work. You may get:

• Medical benefits,

• Rehabilitation, and 

• Income replacement. 

 

If you die from a job-related injury, workers’ compensation also provides benefits to your dependants. 

 

Workers compensation is the only compensation you can get from your employer for an on-the-job accident. 

 

If your injury is serious or disputed, you might want to consult a workers’ comp attorney. Many attorneys who handle these cases will offer a free consultation.

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Who is covered by workers' comp benefits in Georgia?

Businesses with three or more employees must have workers’ compensation insurance. Employees are covered from the first day on the job. 

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What is considered a workplace injury?

Workers’ compensation covers any accident or illness that happens:

• During your assigned work hours, AND

• While performing your assigned job duties.

 

An injury might be:

• Caused by an accident at work,

• A repetitive motion injury. This is something that happens over time as a result of doing the same job over and over.

• A disease that you got because of something you were exposed to at work. This cannot be a disease that the general public is exposed to.

• A pre-existing condition that gets worse. You cannot get workers’ compensation for the underlying condition, but you can get benefits if the condition worsens.

 

Workers’ compensation generally does not cover an injury that happened:

• while you were commuting to work,

• while you were under the influence of drugs or alcohol,

• while you are fighting or playing around,

• while you were doing something you were not assigned to do,

• during lunch, on a break, or after work hours.

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What are my rights to workers compensation in Georgia?

As an employee, you have the rights. These include:

• If you are injured on the job, you have the right to benefits.

• Your employer must post the names of at least six doctors where you can get treatment. In an emergency, you can get care from any doctor.

• Your authorized bills from the injury must be paid by your employer. These might include:

  • Doctor bills, 

  • Hospital bills,

  • Rehabilitation,

  • Physical therapy,

  • Prescriptions, and 

  • Necessary travel expenses.

• If your accident is catastrophic, you are entitled to ⅔ of your average weekly salary up to the maximum allowed by law until you can return to work. Catastrophic injuries include:

  • Amputations,

  • Severe paralysis,

  • Severe head injuries,

  • Severe burns,

  • Blindness, or 

  • Another severe injury that prevents you from working any job. 

• If your accident is non-catastrophic, you are entitled to ⅔ your average weekly wage, up to the maximum allowed by law. You can get these benefits: 

  • up to 400 weeks as long as you are totally disabled, or

  • Up to 350 weeks if you are able to work with restrictions, but are not working.

• When you go back to work, if you can only get a lower paying job because of your injury, then:

  • You can get a weekly benefit for up to 350 weeks. 

• If you die because of an on-the-job accident, your dependents have a right to:

  • Burial expenses, and 

  • ⅔ of your average weekly wage up to the maximum allowed by law. 

• If your employer doesn’t pay your benefits, they must pay you an additional amount.

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What are my responsibilities?

You also have responsibilities when claiming workers compensation. Those include:

• Reporting the injury within 30 days. If you do not report, you might lose your benefits.

• Accepting reasonable medical treatment and rehab services that are offered. 

• Notifying your insurance or employer: 

  • if you move to a new location

  • when you are able to return to work, and

  • Your weekly earnings when you return to work.

• You must try to take a job that is approved by your treating physician. If you don’t take a job when it is offered, even at a lower pay, you may lose your benefits.

• If your claim is denied, you must file a claim within: 

  • One year of your last authorized medical treatment, or 

  • Two years of your last workers’ comp payment. 

• Dependants must claim benefits within one year of your death.

• Any reimbursement expenses related to medical care must be submitted within one year.

• You must submit to a reasonable request for a drug test after your injury, If you do not, you may lose your benefits. 

• If you lie about your injury to get benefits, you could be charged with a misdemeanor. 

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Contents

• How do I make a workers' compensation claim?
• How do I get medical treatment if I am injured on the job?
• How can I appeal a workers' compensation decision?

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How do I make a workers’ compensation claim?

If you are injured on the job you should: 

• Tell your employer right away. 

  • If your injury is so bad that you can’t make a report right away, you should be given medical help and your supervisor should make a report for you. 

• Ask for the workers’ compensation paperwork. 

• Fill out the paperwork with as much information about the injury as possible. 

• Send the paperwork to the insurance company.

• Tell your employer about any witnesses to the accident. 

 

After you make a report, your employer or the company hired to handle claims will investigate. 

 

If your injury is serious or disputed, you might want to consult a workers’ comp attorney. Many attorneys who handle these cases will offer a free consultation.

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How do I get medical treatment if I am injured on the job?

Unless it is an emergency, to get medical treatment, you must go to one of your employer’s list of doctors. The list will be posted at your employer’s office. It should have the name, specialty, address and phone number of each doctor. 

 

If you go to your personal physician or a doctor who is not on the approved list: 

• Your company will not pay your medical bills, and 

• Your health insurance will most likely not cover the costs. 

 

If you go to one of the approved doctors and are not happy with the treatment, you may switch doctors one time. If you wish to switch again, you must get approval from your company. 

 

If you have a medical emergency, you can go to any emergency room to get treatment. Ater the emergency is over, you must get any other treatment from an approved doctor.

 

You are not required to pay any portion of your medical care. If you are billed for any costs, contact your employer or workers’ comp provider. 

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How can I appeal a workers’ compensation decision?

If your workers’ compensation claim is denied, you can ask for a hearing with the State Board of Workers’ Compensation. There is a time limit to file your claim. You must file within:

• One year of the injury if your initial claim was denied, or

• One year of your last authorized medical treatment, or 

• Two years of your last workers’ compensation payment. 

 

To appeal, file form WC-14 with the State Board of Workers’ Compensation. Find the form on the State Board website. Mail the form to:

State Board of Workers’ Compensation

270 Peachtree Street N.W.

Atlanta, Georgia 30303-1299

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