Just about everyone has to work to some extent. Just about everyone has to leave the safety of their home at some point in order to earn a living that makes affording that home possible.
But leaving safety entails increasing the risk of harm. And while workplaces generally strive to keep high – or at least reasonable – safety standards, the odds of workplace accidents, sickness, and injury are never zero, no matter what industry you are in.
It’s a good thing, then, that every state has its own take on workers’ compensation. Especially for seriously injured employees, this government-mandated program provides considerable cash and healthcare benefits to help recover from injuries.
Unfortunately, despite the availability and mostly straightforward process surrounding workers’ compensation, not everyone is able to take advantage of it. Denials are fairly common, and when they happen, claimants end up shouldering their losses on their own.
The thing is, claimants don’t have to shoulder their losses alone, not with a workers’ compensation lawyer on their side.
Do I Need a Fulton County Workers’ Compensation Attorney?
While you are not legally required to hire a lawyer when you make your workers’ compensation claim, doing so does provide significant advantages compared to filing alone. Surveys show that people working with a lawyer secure claims 78.43% more often than those working without.
For context, that means 5 out of 10 claimants who work alone do not get any money, while 9 out of 10 claimants who hire a lawyer do. In addition, the value of claims made by people with lawyers is also up to four times higher on average, even after deducting lawyer fees.
How Do I Make a Workers’ Compensation Claim?
Every state has its own procedures for making a workers’ comp claim, though they are mostly similar to each other.
Generally, accident or work-related sickness is reported to the worker’s employer. Steps are then taken to prove the health concern qualifies the victim for workers’ comp, and finally, the claim itself is filed.
Determine Your Eligibility
Before you can make the claim itself, you first need to know if you are eligible to file one in the first place.
- Does Your Employer Have Workers’ Comp? Georgia requires employers to provide workers’ compensation coverage if they have three or more full or part-time workers. Employers with one or two workers do not need to provide workers’ comp but can still be at fault for workplace injuries, though in such a case, a different claim has to be made.
- How Long Do I Have to File for Workers’ Comp? Georgia law limits your ability to file workers’ compensation claims by requiring you to inform your employer of the injury you intend to make a claim for within 30 days of sustaining it. You must then file your claim within:
- One year from the date you sustained the injury.
- One year from the date of your last treatment for the injury.
- One year from the death of the worker (if you are making a claim on behalf of them).
- Two years after your last payment of weekly benefits.
If you fail to follow the timeline or otherwise violate a rule or regulation, you may be penalized between $100 and $1,000 for each violation.
- What Amount Am I Entitled To? The amount of money you can recover with a workers’ comp claim largely depends on two factors: the extent of your injuries and the legal limits applicable to your specific situation.
- Total disability: Max of $725 per week for 400 weeks from the date of injury, calculated as your average weekly wage OR ⅔ your average weekly wage if you make more than $50 per week.
- Temporary partial disability: Max of $483 per week for 350 weeks from the date of injury, calculated as ⅔ of your pre-injury weekly wage minus your current average weekly wage.
- Permanent partial disability: Max of $725 per week for up to 400 weeks from the date of injury, calculated as ⅔ your average weekly wage.
- Hearing impairment caused by noise: Max of $725 per week for up to 400 weeks from the date of injury, calculated as ⅔ your average weekly wage
- Death benefits: Max of $725 per week for 400 weeks from the date of death, calculated as the deceased’s average weekly wage OR ⅔ their average weekly wage if they made more than $50 per week, only to be provided to dependents.
- What Limits Are There to Workers’ Comp? Some categories of workers are exempt from worker’s compensation coverage, including government employees, railroad employees, farm laborers, independent contractors and contract carriers, and domestic servants. There are also other limits, such as:
- Workers’ compensation does not cover most psychological and cardiovascular diseases.
- Employers may limit medical service providers who will treat the employee to a list of physicians of their choosing.
- Workers’ compensation does not protect claimants’ positions in the company.
Report the Injury to Your Employer
Once you have determined whether or not you qualify for workers’ compensation, you have to inform your employer of your injury. You must do so within a period of 30 days from the date of injury or face a civil penalty issued by the Georgia State Board of Workers’ Compensation.
When you report your injury, your employer will be required to question you regarding how the injury came to be. They, in turn, will have to notify the Board of the injury.
Get a Medical Diagnosis
The Georgia State Board requires all employers to have a Panel of Physicians posted in at least one prominent location on work premises. This Panel is a list of medical practitioners from whom workers injured on the job may seek treatment.
Getting a medical diagnosis from a physician on the Panel fulfills the first of two prongs you need to prove in order to get a worker’s compensation claim: that you indeed suffered an injury in the first place.
Prove the Injury Is Work-Related
In order to prove the second prong of a worker’s compensation claim, you need to gather evidence that supports the idea that the injury occurred while you were doing your expected duties at work, on company time.
This sounds simple, but there are a few loopholes that could prevent you from making a claim.
For instance, scheduled breaks, such as recess and lunch, are not considered company time. As a result, if you are injured while on lunch break, even if you are on company premises, you would not be entitled to workers’ comp.
On the other hand, unscheduled breaks such as bathroom breaks would not disqualify you from workers’ compensation if you get injured on the way to the bathroom, for example. In a somewhat ironic way, sneaking a break is covered, while official breaks are not.
Things get even more complicated with company retreats or outreach programs, as presence at these events usually qualifies as company time. Further, not all breaks at these events can be scheduled, so lunch here may be treated differently from lunch at the office.
And then there is the matter of ingress/egress.
If you are driving to or from work and you get into an accident, you are not covered by workers’ compensation. There are, however, exceptions to this rule, such as if you were required to drive the company vehicle or if you are in transit from the office to a project site, or vice versa.
These rules change all the time as well, making it difficult to prepare evidence supporting whatever argument you decide to stick with. It is also at this point where you can benefit the most from a workers’ compensation attorney.
File Your Claim
When you are finally ready to file your claim, you will typically take it up with the HR department or whatever body is in charge of contacting the insurance company in your stead.
Thankfully, unlike many other injury claims, workers’ compensation is pretty cut-and-dry when it reaches this stage. This is because workers’ comp claims are owed to injured employees regardless of who is at fault for an injury.
As a result, there is no need to argue with an at-fault party to assign liability. The insurer will still conduct an investigation, but, for the most part, any hesitation on the part of the insurer to pay will usually just be to clarify details already provided in the evidence.
Of course, this could still pose problems for you if they do not get the answers they are looking for and decide that some of the damages you reported are not covered. At worst, they could be actively looking for reasons to deny your claim.
If they do deny your claim, your Fulton County injury lawyer can help address the reasons for the denial and give you a chance to appeal. They will work with you to smooth things out with the insurance provider to ensure you get a fair, full amount.
Get Relief From Your Injuries With the Help of a Fulton County Workers’ Compensation Law Firm
When you’ve been injured at work and need relief, the CEO Lawyer Personal Injury Law Firm stands ready to help. We provide Fulton County with professional legal services to help clients recover from tragedy.
Under the leadership of Attorney Ali Awad, we have become one of the country’s fastest-growing law firms. In our first year, we recovered more than a million dollars in damages for our clients, and we continue to push the bar today, seven years later.
Contact us today at (470) 323-8779 and schedule your free consultation. We serve our clients in both English and Spanish, and we do not charge until we have won your case or settled your claim.
