How Does Workers’ Compensation Work?

The Georgia Division of Workers’ Compensation is responsible for ensuring that any work injury claims are handled in accordance with state workers’ compensation laws. With nearly four million workers and a quarter of a million employers in the state, the importance of an effective system for handling workers’ compensation claims is clear.

While every state has its own rules regarding the process of handling workers’ compensation claims—as an employee of a Georgia employer, it is imperative that you learn about your legal rights in this state. If you suffer a work-related injury or illness, knowing your rights regarding workers’ compensation benefits ahead of time can ensure that you follow the proper procedures to receive all of the benefits to which you are entitled.

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If you have recently been injured in the workplace, the Gearhart Law Group can help. Attorney Beth Gearhart and her legal team have extensive experience successfully handling workers’ compensation claims.

Our law offices have convenient locations in the state of Georgia, allowing us to assist clients in multiple Georgia counties with their claims for workers’ compensation benefits. Contact us today to set up a free consultation to learn more about what we can do to help you pursue the workers’ compensation benefits that you deserve.

How Do I Know If My Injury or Illness is Considered Work-Related?

To be eligible for workers’ compensation benefits in Georgia, your injury or illness must be deemed work-related. If your injury or illness arose out of and occurred in the course of your employment, then it meets the basic requirements of a work-related claim and should be compensable.

But what does it mean for an injury or illness to arise out of and occur in the course of employment? This requirement essentially means that if an employee is performing assigned job duties during their designated work hours—and while doing so, is injured or becomes ill, the injury or illness should be compensable under workers’ compensation laws.

Put another way—a worker who is injured or becomes ill during a lunch break or while engaging in an action that does not involve an assigned work duty may not have a compensable workers’ compensation claim, but this very much depends on each case’s specific facts. Generally, injuries occurring during a worker’s everyday commute to and from the workplace are also non-compensable under the same reasoning.

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There are also some exceptions to the above that may apply in some circumstances. For this reason, it is beneficial to speak with a knowledgeable Georgia workers’ compensation attorney as early as possible in your case. Consulting with an attorney is particularly important if your workers’ compensation claim is denied (or controverted) because it might be possible for your attorney to resolve the reason for the denial—which could allow you to receive benefits right away, or later on if the matter must go before an administrative law judge.

How Do I Go About Getting Medical Treatment for My Work-Related Injury?

If you are severely injured in a work accident, you can (and should) get immediate medical treatment as soon as possible. In these situations, injured workers can get medical care at the nearest emergency room or medical facility can treat their injuries.

However, once the urgent nature of the emergency has resolved, injured workers who need further medical treatment must choose either a doctor from the employer-provided list of physicians or a physician from the Workers’ Compensation Managed Care Organization for care going forward.

What Happens If I Disagree with the Treating Physician That I Have Chosen?

If you have a negative experience with your chosen physician, Georgia workers’ compensation law allows you to switch to another doctor on the Panel of Physicians one time. Remember that any further changes typically require an agreement with your employer or the workers’ compensation claims administrator. Following the Georgia workers’ compensation laws regarding your choice of treating physician is vital because workers’ compensation carriers are not responsible for paying for unauthorized treatment.

Choosing a doctor who is not on an approved list can have serious consequences. Since most health insurance policies do not provide coverage for work-related injuries or illnesses, you could end up having to pay the full bill for any unauthorized medical treatment you receive.

For issues that arise in cases that require ongoing medical care—such as the potential need for expensive diagnostic tests or the possible need for surgery—your treating physician will make these arrangements, including any necessary referrals to other specialties. Your workers’ compensation attorney is also there to help you with any questions or concerns regarding any legal issues related to your treatment.

What Types of Income Benefits Are Available for Injured Workers in Georgia?

It is crucial for injured employees in Georgia to know their rights and responsibilities when it comes to workers’ compensation so that they do not miss out on benefits. There are many different forms of benefits available to Georgia workers who become ill or injured on the job. For example, one benefit is the payment of medical bills for necessary treatment needed to recover from the injury or illness.

In addition to reimbursement of or payment of medical bills for treatment related to the injury or illness, there are benefits available through the Georgia workers’ compensation system specific to income. The work injury and illness income benefits for workers’ compensation claims in this state fall into four main categories. These categories include temporary total disability benefits, temporary partial disability benefits, permanent partial disability benefits, and death benefits.

How Are Income Benefits Calculated in Georgia?

Workers’ compensation income benefits are calculated based on the income of the injured employee—by using their average weekly wage. While there are some exceptions that apply under certain circumstances, this amount is typically calculated by finding the average weekly wage of the worker based on the 52 weeks of work and earnings prior to the date of the injury or illness.

Additionally, Georgia sets a state maximum and minimum benefit rate, which is applied to workers’ compensation income benefits. Your workers’ compensation lawyer can help you learn more about how the maximum and minimum rates could impact your benefits if this issue is applicable to your case.

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