Know your workers’ compensation rights and responsibilities after a workplace injury or occupational illness
In the vast majority of cases, an employee who suffers a work-related injury, illness or disease in Georgia qualifies for workers’ compensation benefits through the Georgia workers’ compensation system.
This coverage typically includes medical treatment costs, rehabilitation assistance, and compensation for lost wages. In the event of a fatality, the dependents of the deceased employee may also be eligible for death benefits to help cover funeral expenses and lost income.
While fault is typically not a factor in receiving Georgia workers’ comp benefits, you must follow specific steps after an injury or illness is discovered to be eligible for benefits, which we’ll outline below.
If you were hurt on the job due to various factors, including lack of training, inadequate safety measures, or faulty equipment, and believe you’re entitled to workers’ compensation benefits, contact the knowledgeable Atlanta work injury attorneys at Gerber & Holder today for your free consultation.
Step 1. Report the injury
The first step you should take if you’re injured on the job is to report the injury to your employer as soon as possible, and preferably in writing.
Under Georgia law, you’re required to report any work-related injury to your employer within 30 days of the incident. Telling a coworker who isn’t a manager or supervisor isn’t sufficient.
This reporting can be given verbally to a supervisor or written down per company policy. The important aspect of this is that you affirmatively report your injury—presuming that your employer “knows” is never a good idea. If you fail to report the injury within 30 days, you may lose your right to workers’ compensation benefits.
When reporting the injury to your employer, make sure you provide details about how the injury occurred, the date and time of the incident, and the type of injury you sustained. Your employer should then provide you with a workers’ compensation claim form to complete, and they will need to complete one as well. If possible, get a copy of their report.
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Step 2. Obtain medical treatment
After reporting the injury to your employer, you should seek medical treatment as soon as possible.
If your injury is an emergency, seek medical attention immediately. Your employer and their workers’ comp insurance company must pay for emergency treatment regardless of whether or not there’s a list of doctors posted (more on this below).
If your injury is not an emergency, your employer may provide you with a list of approved medical providers to choose from.
Be sure to keep detailed records of all medical treatments you receive for your injury, including the names and contact information of all health care providers you see, the dates of your appointments, and the treatments and medications you receive.
Pay special attention to any paperwork provided by the medical provider, particularly documents that detail work limitations resulting from your injury, like light-duty restrictions. It’s important to provide a copy of these restrictions to your employer to ensure that your work duties are appropriately adjusted.
Additionally, keep copies for your personal records, as they are vital evidence in your workers’ compensation claim process.
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Step 3. Get a list of approved doctors
Your employer should give you a list of approved doctors (also known as the “panel of physicians” or the “authorized treating physicians”) that you are allowed to see. If you don’t receive this list, ask your supervisor or the HR department to provide one, or you can search the State Board of Workers’ Compensation Physician Database for an approved doctor.
If a list isn’t provided within a reasonable timeframe, you can go to the doctor of your choice. If there is a posted list and you don’t go to a doctor on that list, your employer and its insurance company can use this as a reason to deny you workers’ comp benefits.
Please also note that when you receive medical treatment, whether in an emergency or a scheduled appointment, it’s vital to inform the health care provider that your injury occurred at work.
Clearly stating that your injury is work-related ensures that the medical records accurately reflect the nature and cause of your injury. This documentation is crucial for your workers’ compensation claim, as it establishes the link between your injury and your workplace.
Additionally, be sure to follow your doctor’s instructions. It’s crucial that you attend all appointments and follow all work restrictions that you’re given or your workers’ compensation benefits could be denied.
Step 4. File a claim with the Georgia State Board of Workers’ Compensation
Once you’ve reported the injury to your employer and received medical treatment, you should file a workers’ compensation claim. In most cases, your employer should provide you with a “Notice of Claim” form to complete, which you must file with the Georgia State Board of Workers’ Compensation. If your employer doesn’t provide you with this form, you will need to obtain it yourself.
To protect your rights and file a claim, you’ll need to complete Form WC-14, “Notice of Claim,” file it with the State Board of Workers’ Compensation, and send a copy to your employer and their workers’ compensation insurance carrier. You can download and complete a free PDF of the form online or request a copy from the State Board by calling 404-656-3818 inside the metro Atlanta area or 1-800-533-0682 outside the metro Atlanta area.
When completing the WC-14 claim form, be sure to provide all the information that is requested. This includes the body part that was injured, the cause of the injury and what action you would like to take. Without an attorney, you may just want to toll the statute of limitations, and this option is available on the form.
After you file Form WC-14 with the State Board of Workers’ Compensation, make sure to retain a copy for your personal records. This form is a key piece of documentation in your claim process, as it officially starts the claim with the State Board.
Never just assume that because the insurance company has an open file, it means that reporting requirements have been met. It’s a common misconception held by many people that if they’re talking to an adjuster with the workers’ compensation insurance company and a file has been opened with that insurance company, they’ve met their reporting burden. This is definitely not true.
Sometimes, insurance companies stay in communication with an injured worker but do not provide medical treatment or indemnity benefits, telling them that their case is still under review. Other times, the adjusters change, and it becomes impossible to reach anyone who will talk to the injured worker.
Additionally, they may tell the injured worker that their case is “closed.” But be aware that just because the insurance company has deemed your case to be closed does not necessarily mean it is. A workers’ compensation case can only officially be closed through an order by the State Board of Workers’ Compensation.
If you run into any of these issues before or after filing a workers’ compensation claim, it’s essential to consult with a work injury attorney who can help protect your rights.
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Step 5. Request a copy of the report and/or notes
Once you’ve reported your injury to your employer, they are required to file Form WC-1, “Employers First Report of Injury,” with their workers’ compensation insurance company and the State Board of Workers’ Compensation.
It’s important to ask your employer for a copy of this report. Having this document can be invaluable, as it serves as an official record of the incident and the initial response by your employer.
In situations where your supervisor or employer refuses to make a written report, it’s critical to take the initiative to create one yourself.
Document all the details of the accident, including the date, time, how the injury occurred, any witnesses, and subsequent actions taken. This personal report can provide a backup record of the incident and can be particularly useful if there are discrepancies or disputes later in the claim process.
Step 6. Update your employer
If your doctor excuses you from work or gives you work restrictions, get this in writing and give it to your employer. Also, keep a copy for yourself. This documentation is a key component in communicating your work capabilities both to your employer and to the workers’ compensation insurer.
If you’re excused from work indefinitely, clarify with your employer how often they require you to check-in. This could be daily, weekly, or at another interval. Adhering to these check-in requirements is important to maintain a good line of communication and to comply with company policies.
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Step 7. Inform the insurer
Most employers have workers’ compensation insurance with another company that handles their claims. The insurer cannot help you unless it knows about your injury, so be sure to let them know directly of your inability to work or any work restrictions.
This information is crucial for processing your claim, ensuring that you receive the appropriate benefits and preventing delays or complications in your claim.
Verify with the insurer that your company’s personnel or HR department has sent the “Employers First Report of Injury” form to the insurer. Ask your employer for the name and telephone number of the insurer—and the name of the person who is handling your claim (the “adjuster”)—so you can speak directly with them throughout the claims process.
If you cannot get this information from your company, call the Georgia State Board of Workers’ Compensation Coverage Department at 404-656-3692 for the name of your company’s insurer, then notify the insurance company yourself.
Additionally, any changes in your medical condition, whether an improvement or otherwise, should be communicated to both your employer and the insurance company as soon as possible. These updates should be backed by medical documentation whenever applicable.
Step 8. Talk to an attorney
If you’ve been injured on the job in Georgia, it’s highly recommended that you seek the advice of a workers’ compensation attorney. An experienced attorney can help you navigate the complex workers’ compensation system and negotiate a settlement to ensure you receive the maximum benefits available to you.
An attorney knows the intricate rules of returning to work and should also be able to help you choose a doctor who will listen to you and help treat your injury. You’re entitled to a one-time change in authorized treating physicians, so even if you’re not happy with the doctor you’ve initially chosen, a remedy may be available to you.
Additionally, if your employer’s workers’ compensation insurer ultimately denies your claim, a workers’ compensation attorney can help you file an appeal with the State Board of Workers’ Compensation.
This can be a complicated process that involves a hearing in which medical records, witness statements, and other documentation will need to be presented to support your claim and counter the reasons for the denial. An attorney can be invaluable in effectively navigating these legal intricacies and ensuring you have the best possible chance of a successful outcome.
Remember, insurance companies have attorneys who advise them on every action they take—an injured worker should have the same protections.
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If you get hurt on the job in the state of Georgia, it’s important to take immediate action to ensure you receive the medical treatment and compensation you’re entitled to. By following the steps outlined in this guide, you can protect your rights and ensure that you receive the maximum benefits available to you under Georgia law.
If you’d like assistance filing a workers’ compensation claim, contact the experienced Atlanta work injury attorneys at Gerber & Holder Workers’ Compensation Attorneys. With over 75 years of combined experience, our firm has assisted thousands of injured workers in overcoming obstacles like denied claims and low settlement offers.
Under Georgia law, injured workers must file their claim within 1 year from the date of the injury. This timeframe is shorter than the typical 2-year period for most other personal injury claims. Failing to file within this 1-year period could prevent you from recovering any benefits. Delaying filing a claim even for a month can significantly affect the benefits you receive.
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