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Workers compensation is a kind of insurance that you might not even know you have. That is because your employer pays for it, but it doesn’t show up on your paycheck. Workers compensation is a no-fault system in Georgia. That means it doesn’t matter who is to blame for your injury. It is meant to compensate workers who get hurt one job. The decisions that you make about your worker’s compensation injury are critical. Before you sign anything from the insurance company, you need to make sure that you are being fairly compensated. After all, you only have one body for the rest of your life.

What Does a Workers Compensation Lawyer do?

Our primary job is to make sure our clients get all of the benefits that they are entitled to. The benefits you are entitled to under Georgia’s workers compensation system are:

  • A weekly check
  • 100 percent coverage for all of the medical care related to your injury with no co-pay and no deductible.
  • money for permanent impairment

Although this may sound very simple, there are complicated rules about how you are supposed to chose a doctor, when you are supposed to notify your employer of the injury, how long you are entitled to receive a check, etc. These rules can be found in the Georgia Workers Compensation Act and in administrative rules published by the Georgia State Board of Workers Compensation. The rules are so complicated that many lawyers do not understand them unless they have significant workers’ compensation experience.

There are many arbitrary deadlines and requirements in Workers Compensation that can harm your case. The Insurance Companies is aware of these rules and will use them against you. Often times, by the times you realize what happened, the value of your case may be irreparably harmed. As experienced workers compensation lawyers, our job is to make sure that you don’t fall into any of the common traps that insurance companies will use to deny you medical treatment of cut of your weekly check. And ultimately, our job is to make sure you get the largest possible settlement you can from the insurance company.

What exactly is Workers Compensation and how does it work?

Workers compensation is a type of insurance that employers are required to carry by the state of Georgia. You are limited to the types of compensation spelled out in Georgia law. Workers compensation gives you the right to get a weekly check and medical treatment related to your injury. This insurance covers you even if the accident was your fault.

Workers Compensation is an adversarial system. That means that the insurance adjuster is not looking out for your best interest. They want to stop paying you benefits as soon as possible. In Workers Compensation Claims, it is very common for even valid claims to be denied. The insurance company is always looking for a way to deny your claim and this is always their goal. When you are denied benefits, you can ask for a hearing before a workers’ compensation judge at the Georgia State Board of Workers Compensation. A hearing is scheduled when an employee files a Board form WC-14 with the State Board. In this form, you name the specific benefits that you are requesting the Insurer to pay for. For example, you can request the approval of a surgery that has been denied, payment of weekly checks that you are owed, payment for unpaid medical bills, etc.

Evidence will be collected and you will be entitled to a day in Court. The Judge can order the Insurer to pay for medical treatment, to pay you a weekly check (including back-due), or even to pay late penalties and attorneys fees. But, unlike in an auto accident or other type of personal injury claim, you are not entitled to recover money for for pain and suffering. Also, the Judge can not order the insurer to settle your case (cases can only settle with the voluntary agreement of both parties).

What Is My Workers Compensation Case Worth?

Every case is unique. In order to evaluate the value of your case, we look at the potential worst case scenario for the insurance company. We also evaluate the potential legal defenses and how likely we are to win those issues. If you try to negotiate a settlement by yourself, the insurance company will offer you peanuts compared to if you had a good lawyer that knows what your case is really worth. Robert Bourne has 30 years of experience negotiating workers compensation cases. Give us a a call today!

In virtually all cases, the workers compensation insurance company will want to negotiate a settlement with you. In exchange for a lump sum payment, the insurance company will want you to give up your right to a weekly check and other workers comp benefits. Workers compensation cases are different than other types of personal injury cases. There is no trial in a workers compensation case. The only way you get a lump sum payment is if both you and the insurance company can agree to settle. The value of your case depends on how much your benefits will cost the insurance company. If you have a high salary or expect to have large medical costs, then the insurance company will pay more money to make you go away. Simply put, if the insurance company has to pay a lot of money in benefits, then they will be willing to settle for more money. If you have a good idea of how expensive your workers comp benefits are, then you will have a good idea of the settlement value of your case.

What are your rights under Workers Compensation Law?

The Georgia State Board of Workers’ Compensation has issued a “Bill of Rights” for injured workers. The Bill of rights is a Summary of your rights and responsibilities under Georgia workers compensation. According to the state of Georgia, they are:

The Georgia State Board of Workers’ Compensation has issued a “Bill of Rights” for injured workers. The Bill of rights is a Summary of your rights and responsibilities under Georgia workers compensation. According to the state of Georgia, they are:

1. If you are injured on the job, you may receive medical, rehabilitation and income benefits. These benefits are provided to help you return to work. Your dependents may also receive benefits if you die as a result of a job-related injury.

2. Your employer is required to post a list of at least six doctors or the name of the certified WC/MCO which provides medical care. You may choose a doctor from the list and make one change to another doctor on the list without the permission of your employer. However, in an emergency, you may get temporary medical care from any doctor until the emergency is over; then you must get treatment from a doctor on the posted list.

3. Your authorized doctor bills, hospital bills, rehabilitation in some cases, physical therapy, prescriptions and necessary travel expenses will be paid if injury was caused by an accident on the job.

4. You are entitled to weekly income benefits if you have more than seven days of lost time due to an injury. Your first check should be mailed to you within 21 days after the first day you missed work. If you are out more than 21 consecutive days due to your injury, you will be paid for the first week.

5. Accidents are classified as being either catastrophic or non-catastrophic. Catastrophic injuries are those involving amputations, severe paralysis, severe head injuries, severe burns, blindness, or of a nature and severity that prevents the employee from being able to perform his or her prior work and any work available in substantial numbers within the national economy. In catastrophic cases, you are entitled to receive two-thirds of your average weekly wage up to the maximum allowed under the law for a job-related injury for as long as you are unable to return to work. You are also entitled to receive medical and vocational rehabilitation benefits to help in recovering from your injury. If you need help in this area, call the State Board of Workers’ Compensation at (404) 656-3875 or toll-free number (800) 533-0682. Your employer will advise you of the amount of your weekly benefit.

6. In all other cases (non-catastrophic), you are entitled to receive two-thirds of your average weekly wage but not more than the maximum allowed under the law for a job-related injury. You will receive these weekly benefits as long as you are totally disabled, but no longer than 400 weeks. If you are not working and it is determined that you have been capable of performing work with restrictions for 52 consecutive weeks or 78 aggregate weeks, your weekly income benefits will be reduced to two-thirds of your average weekly wage, but no more than the maximum allowed under the law, not to exceed 350 weeks.

7. When you are able to return to work but can only get a lower paying job as a result of your injury, you are entitled to a weekly benefit of not more than the maximum allowed under the law for no longer than 350 weeks.

8. Your dependent(s), in the event you die as a result of an on-the-job accident, will receive burial expenses up to the maximum allowed under the law and two-thirds of your average weekly wage, but not more than the maximum allowed under the law. A widowed spouse with no children will be paid a maximum allowed by law at the time of injury. Benefits continue until he/she remarries or openly cohabits with a person of the opposite sex.

9. If you do not receive benefits when due, the insurance carrier/employer must pay a penalty which will be added to your payments.

Unfortunetly, delay and denial is commonplace in Georgia's workers compensation system. If your rights are being violated or your benefits are being delayed and denied, you should speak to an experienced workers compensation attorney. An attorney has many different tools to protect your rights. For example, The State Board of Workers Compensation publishes a Form WC-PMT . This form requires the insurance company to authorize the treatment, or provide a valid legal reason for denying treatment. If they are unable to meet these requirements, they will have to answer to an administrative law judge in a telephone conference. The Judge may then order the insurance company to for your treatment.

Are You Running Out of Time to File Your Claim?

Workers compensation laws are intended to help injured workers, but if you don’t follow the rules your claim may be denied. An employee generally has 30 days from the date of injury to notify his supervisor that they have sustained a workers‘ compensation injury. If you report the injury, you are entitled to certain benefits:

Compensation for medical expenses, including travel expenses

A portion of your income if you are unable to work for 7 or more days

Compensation if you have a permanent disability because of your injury

If your employer denies you benefits then you may have to request a hearing with the State Board of Workers Compensation. You have only one year from the time of the accident or the last time your employer payed you benefits to file a claim. If you wait any longer then your claim will be denied because the statute of limitations has passed (O.C.G.A. 34-9-82). However, its best to make sure your claim is filled within one year of the accident date. Waiting too long can be a death sentence to your workers compensation case.

Sometimes an employer will pay you lost income benefits, otherwise known as TTD, but you will lose those benefits because your condition improved or you went back to work. If your condition changes for the worse, then you may restart your TTD benefits, but you only have two years from the last time you received a TTD check. In that situation, you will still be entitled to medical benefits, but you lose the right to get compensated for your time out of work.

You should not wait to contact a lawyer. These statute of limitations problems can be very technical and can kill your case. Its not uncommon for the insurance adjuster to string you along with the promise of a settlement, but really they are just waiting for the statute of limitations to run. You only have 400 weeks to receive compensation for your medical costs. If you wait until after the 400 weeks, the insurance company won’t have to pay for your treatment (unless your case qualifies as catastrophic).

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