Most people go to work in the morning and just look forward to getting back home. Sure, they’d rather stay home in the pajamas watching television, but in the real world, we’ve got to work. And most of us are okay with that. The last thing we expect is to need Lawrenceville workers’ compensation lawyers because we’ve been injured on the job.
Some jobs are, by their nature, dangerous. When you think of construction workers and oil drillers, you expect that they may get injured on the job. But it’s not just the dangerous jobs that result in work-related injuries. Even your typical office jobs can cause work-related injuries or illnesses.
When you do get hurt at work, you should be covered under workers’ compensation. This is insurance that is designed to offer coverage for employees who get hurt on the job. It’s intended to offer a short-term solution. It’s not meant to be permanent.
The purpose of workers’ comp is to provide you with two things: medical treatment and wages. Once you’re ready to go back to work, the benefits end you go back to normal. For people who’ve been hurt at work before, they can appreciate how important workers’ comp benefits are. Many people take them for granted.
But sometimes, workers’ comp claims are denied. When this happens, you need to turn to knowledgeable personal injury lawyers in Georgia at The Law Office of John B. Jackson.
Table of Contents
State of Georgia Oversees Workers’ Compensation
The State of Georgia sets the rules when it comes to workers’ comp. Employers can put policies into place when it comes to reporting workplace injuries. However, employers don’t have the right to decide who should be covered and who shouldn’t.
In Georgia, the following people are entitled to workers’ compensation benefits:
- People who are employees – independent contractors are not covered under workers’ comp
- You must be hurt while on the job – the injury must occur within the scope of your employment
- You must report the injury to your employer immediately
- Also, you must not refuse medical treatment
Employers can’t choose who is covered under workers’ comp. If someone gets hurt at work, they are entitled to workers’ comp. The employer must submit their workers’ comp claim to their insurance company.
The insurance company will review the claim to see if it’s valid. For the most part, your claim will be approved. If it’s denied, you’ll receive a denial letter. If this happens, you really need to contact a workers’ comp attorney in Lawrenceville.
How can I Be Injured at Work?
There are dozens of ways you can get hurt at work. It really depends on what kind of work you do. Some of the most common industries that experience work-related injuries are:
These workers are put in very dangerous situations. They have to climb scaffolding and work atop buildings. They’ve to carry and work with very heavy tools and materials. They also work in dangerous environments. Most worksites have things like rocks and half-demolished buildings. They work out in the elements and exposed to the hot and cold weather. There is a good chance that, at some point in their career, these employees are going to get hurt.
People who drive buses and cabs for a living are at special risk. Being on the road all day, they’re subject to get into car accidents. They also can end up with back and knee injuries from driving every day, all day. And, it’s even worse for delivery drivers. They have to jump in and out of their vehicles dozens of times every day. They are prone to all sorts of injuries.
People who work in factories tend to have to lift heavy items all day long. They are also subjected to a lot of repetitive motion. This can lead to all sorts of injuries. Factory workers’ are also exposed to a lot of noise. Loud noise over a long period of time can lead to hearing damage.
Plumbers, electricians and HVAC technicians
People who work in the trade industries all-risk special types of injuries. People who work as electricians, plumbers and HVAC technicians all risk things like electrocution. They also spend a lot of time on their knees. They have to crawl into small and dirty places. This can cause breathing problems. There’s no end to the kind of injuries that can happen to these employees.
Guys who are laborers work hard all day. Their work really takes a toll on their bodies. A lot of laborers suffer back, neck and knee injuries. They can also be hurt by some of the equipment and tools they’re required to use.
Utility work is inherently dangerous. This is even more true for utility line workers’. They are exposed to wiring all the time. They also have to climb high up on pools, something with no one there to support them.
Because these employees are doing physical work, they are more likely to get injured. You can imagine how hard it is to do these types of jobs. They’re exposed to so many more risks than people in an office or sedentary jobs.
Most workers’ compensation claims are filed by people who do physical or trade work. Of course, there are other types of employees who get hurt. Workers’ comp insurance is available to all employees, regardless of the type of work they do.
If you get hurt at work, make sure you report your injury to Human Resources right away. Then call and schedule a consultation with a workers’ comp lawyer in Lawrenceville.
How Do I File a Workers’ Compensation Claim in Georgia?
If you get hurt at work, there are a few things you need to do. If you don’t take these steps, you risk having your claim denied. You don’t want to jeopardize your workers’ comp benefits.
The first thing you need to do is report the injury to your employer. Even if you think the injury is minor, you need to document it. If it becomes something more serious later on, you need to have proof that you reported it.
You only have thirty (30) days to report your injury. This rule is really strict. If you don’t report it within this time frame, your entire claim may be dismissed. If this happens, you won’t be eligible for any benefits.
Your employer will complete something called an incident report. This report will describe what your injuries were and how you got them. It will usually include the names of anyone who witnessed your injury.
Your employer is going to arrange for you to see a doctor right away. You will have to see one of their approved doctors. You can’t just go to your primary physician. If you go to an unapproved doctor, your benefits may be denied.
After you seek treatment, you’ll find out whether you can return to work. You may need surgery or medical treatment. You may have to go to physical therapy. Depending on your injuries, you could be out of work for some time.
Make sure you comply with the doctor’s instructions. If you don’t, you risk having your claim denied.
Once you talk to your employer, you need to contact a Lawrenceville workers’ compensation attorney. Your attorney will communicate with your employer on your behalf. He will also deal with the insurance company.
What if I’m at Fault for my Injuries?
A lot of people wonder if they’re eligible for workers’ compensation benefits. They wonder if perhaps they’re at fault for their injuries. And, if they are at fault, they’re afraid they won’t be entitled to workers’ comp benefits.
Asking if you’re at “fault” is a difficult question. What does it mean to be at fault? If you’re referring to the fact that you made a mistake or did something by accident, then the answer is – you will still likely be covered.
If by fault you mean you were drunk or under the influence of drugs at the time of your injury then the answer is no – you probably won’t be covered under workers’ comp.
The point of workers’ comp is to help employees who get hurt while doing their job. The law doesn’t require that all employees do their job perfectly. You can still qualify for benefits if you had an accident at work. That is the point of the insurance after all.
Some of the behaviors that may prevent you from qualifying for workers’ comp benefits include:
- You were horse playing or playing with the equipment you’re not trained to use
- You were drunk or under the influence of drugs at the time of your injury
- Maybe you were intentionally trying to get hurt
- You were purposely ignoring your employer’s work instructions
- You were doing a job outside the scope of your employment
- Lastly, you wanted to get hurt so you could collect workers’ comp
In order to be disqualified from benefits, your employer would have to prove that you were acting unreasonably at the time of your injury. For the most part, the rules are pretty lenient. Unless you were acting recklessly or in gross disregard for your safety, your claim will probably be covered.
If your claim is denied, you should absolutely contact a workers’ comp lawyer in Lawrenceville, Georgia. They can help appeal your claim and get you the benefits you deserve.
Can You Be Fired for Filing a Workers’ Comp Claim in Lawrenceville?
Legally, an employer can’t fire you because you filed a workers’ comp claim. However, you have to remember that Georgia is an at-will state. This means that any employer can fire any employee for any reason. They can do this at any time.
You wouldn’t expect an employer to fire someone while they’re out on workers’ comp. That would be a bit too obvious. They usually wait until you return to work if their intention is to fire you. If you’re fired when you return from workers’ comp, you need to contact a workers’ comp attorney right away.
If you get to fire at the time of your accident, you may still receive your workers’ comp benefits. Also if this is the case, your attorney should be able to maintain your benefits until you’re ready to return to work.
Once you return to work, it’s important that you not give your employer a reason to fire you. Just show up on time and do your job. There really shouldn’t be any reason for them to want to terminate you. The only reasons they may want to terminate you are:
- You’re on light duty and they have to pay someone else to do your job anyway
- You were a problematic employee before the accident
- You have made comments that you got hurt on purpose and will do so again
- The company is afraid you’re at risk of getting hurt again
- Your claim was very contentious. If there was an ugly battle over your benefits, your employer may not want you around.
For the most part, employees don’t really face this issue when they return to work. However, strange things have happened. Make sure you discuss your case with a workers’ compensation lawyer in Lawrenceville immediately.
Can My Employer Deny My Claim?
Most workers’ comp claims are handled properly. Your employer files your claim and the insurance company pays it. They make sure you receive the medical care you need. They also pay you replacement wages while you’re waiting to return to work.
However, there are situations where an employer will deny your claim. This usually is because they doubt that your injuries are legitimate. They either think you are exaggerating your injuries or that you intentionally got hurt.
Some of the common reasons workers’ comp claims are denied in Georgia include:
You don’t report your injuries in time
Remember, you only have 30 days to report your injury. If you miss this window, your claim will be denied. Your lawyer can argue that you didn’t know you were hurt until the date you reported it. However, this excuse won’t work for the most part. Unless it was an illness or injury that built up over time, you are missing the deadline won’t be excused.
You don’t go to the doctor right away
You need to get medical treatment right away. There are a couple of reasons for this. First, the doctor is probably going to administer a drug test and take blood to measure your BAC. This is to determine if you were drunk or under the influence at the time of the accident. The other reason is, the doctor needs to ascertain your injuries immediately. This way, if you aggravate the injury some other way, there is a record of it.
There were no witnesses to the accident
If the employer thinks the employee is lying about how the injury took place, they may deny the claim. If there are no witnesses to the accident, the employer may be skeptical. This is especially true if you work in an environment with a lot of cameras. If your injury took place specifically not in sight of the cameras, it will raise suspicion.
You have a history of prior injuries
If you have a pre-existing condition or prior work injuries, your claim may be denied. The employer will argue two things: First, that you continue to get hurt so you can get benefits; and, Second, that you continue to aggravate your injuries and that your job didn’t cause them.
You specifically denied having a prior injury to your employer
If you’re asked about any specific prior injuries when hired and lie about it, you may be denied workers’ comp benefits later. For example, if you take a job as a card dealer, you may be asked if you’ve ever suffered from carpal tunnel. If you say you haven’t and it’s later discovered that you lied, you may be denied benefits.
You were drunk or using drugs at the time of the accident
If you fail a drug test following your accident, your claim will most certainly be denied. You would have to prove that the drugs were legally prescribed to you and that you were taking them as prescribed.
Your employer thinks the injuries happened somewhere other than work
This may be the most common reason for a claim to be denied. If an employer thinks you got hurt away from work, he will deny your claim. Sadly, some employees get hurt at home and then try to blame it on their job. They figure it’s a good way to get medical coverage and financial benefits. An employer may deny your claim for this reason. Be careful what you post on social media. It is being used more and more to prove that you weren’t injured at work.
Your Lawrenceville workers’ comp lawyer may be able to overcome some of these challenges. As soon as you learn your claim has been denied, you need to call and schedule a consultation.
What are the Workers’ Comp Benefits in Georgia?
Workers’ comp insurance in Georgia provides certain benefits to employees. The point of workers’ comp is to help you survive until you’re able to go back to work. If your injuries are minor, you’re still entitled to medical treatment under workers’ comp. However, you will only receive financial benefits if you’re unable to return to work for at least seven (7) days.
Under Georgia law, you’re entitled to temporary benefits. These benefits include:
- Compensation for medical treatment for a reasonable time after the accident
- 2/3 of your weekly wages during the period you are out of work
- The maximum weekly benefit is $575 per week
- Your benefits will continue until you have reached maximum improvement or for 400 weeks, whichever comes first
To qualify for workers’ comp benefits, you must be out of work for at least seven (7) days. Anything shorter than this, and you’ll be expected to rely on your sick time and vacation time.
If your claim is approved, you’ll receive your benefits shortly after filing your claim. If, however, your claim is denied, you won’t receive any benefits.
Depending on the reason for your denial, you may still receive medical benefits. You just won’t receive replacement wages. For example, if you were drunk at the time of your accident, you may be provided with medical care. You just won’t receive weekly benefits.
If your workers’ comp claim is denied for any reason, you need to call and speak with a Lawrenceville workers’ comp lawyer.
How Do I File a Third-Party Lawsuit?
An important thing you need to understand about workers’ comp is that it’s the only recourse you have against your employer. If you’re hurt at work, you can’t file a civil suit against your company. You need to file a workers’ compensation claim.
This does not mean, however, that you can’t file a civil suit against a third party. If someone other than your employer contributed to your accident, you can file a claim against them. An example of this could be the manufacturer of work equipment.
If you get hurt using equipment at work, you may have a third-party claim. If the machine was defective or was manufactured improperly, you may need to file a suit against the manufacturer.
Another situation where this could happen involves commercial drivers. If you drive a bus for a living and someone causes a car accident, you can file a claim against this person. It would be treated just like any other car accident claim.
You are not able to receive double payment for your injuries. So, if your employer covers your medical care, you can’t submit these same bills in your third-party lawsuit. Your workers’ comp lawyer can easily handle both claims. He’ll know exactly how to handle it.
How Is My Workers’ Comp Case Settled?
Most workers’ comp claims only last for a few weeks or months. There are a few that last for over a year. Unless your injuries are really serious, there’s no reason for it to take this long to get back to work.
There are cases, however, that lead to permanent disability. If you are permanently disabled as a result of your work injury, you won’t stay on workers’ comp forever. The longest you can receive workers’ comp benefits is 400 weeks. This is roughly 8 years. But very few cases drag on that long.
Most cases like this end up settling. Your lawyer will negotiate a settlement with the insurance company. The process is complicated. This is why we never recommend that an employee represent themselves in these cases.
Here is how workers’ comp settlements work:
Your lawyer will argue that you are permanently disabled by a certain percent. He will also limit your disability to certain body parts.
For example, let’s say you suffered a work injury. Your back may count for 35% of your total ability to work. If you are 100% disabled, then your lawyer will be negotiating 35% of your total wages until you retire.
The insurance company will argue that you are not 100% disabled. They may say you’re only 15% disabled.
The two sides will go back and forth until they can agree on a percentage. They will both rely on different medical experts. Usually, they’ll meet somewhere right in the middle.
Once they agree on the injured body parts and percentage of disability, they’ll have to come up with a dollar figure. This dollar figure will have to be fair to both sides or it won’t work in a settlement.
Without getting too detailed, there are charts that determine how much each body part is worth. These charts determine how much you would earn per week for that body part. The attorneys will use these numbers to determine what your permanent award should be. Once they agree on a number, it will be the basis for your settlement.
- Your lawyer will also have to negotiate a certain amount to cover future medical treatment. He’ll rely on medical experts to help him do this. This amount will be added to your base number.
- Your lawyer may also ask for other expenses to be covered in the settlement. The two attorneys will negotiate these amounts and come up with a final number.
- Once a settlement amount is reached, a check will be cut for this amount. It will also require that you sign a release stating that you won’t go after the insurance company for more money later on.
- Your settlement will be used to pay any outstanding medical bills. Your lawyer will also deduct any amounts spend on filing fees and expenses. He will then deduct his fee. Once these amounts come out, the remainder is yours.
It can take weeks or months for the attorneys to agree on a settlement. You will continue to receive benefits during this time. You may be asked to return to work on light duty pending a settlement.
Once you do settle your case, make sure you plan for your future. Depending on how serious your injuries, you may not be able to work again. It’s important that you keep this in mind. Once you settle, you won’t be able to return to your employer for more money later. This money has to last you.
Can I Be Forced to Return to Work Too Early?
One of the most important things your Lawrenceville workers’ comp lawyer will do is protect you. He will make sure you aren’t forced to return to work before you’re ready.
Keep in mind, being “ready” refers to your physical ability to return to work. Once you are medically cleared to return to work, you will be expected to do so. It’s not really a matter of when you’re comfortable returning to work. It is strictly based on your medical improvement.
Your employer will try to get you back to work as soon as possible. There are several reasons for this:
- While you’re out of work, your employer has to pay someone else to do your job.
- Your employer may have a light-duty reserved for you and wants you back to work.
- Your employer doesn’t want to give the impression that injured workers’ can sit home for months on end.
- The insurance company will pressure them. They don’t want to pay weekly benefits any longer than absolutely necessary.
If you’re truly not physically able to return to work, let your lawyer know. He can get a medical opinion and challenge the approved provider’s opinion. He will deal with your employer and your insurance company on your behalf.
How Can a Workers’ Compensation Lawyer in Georgia Help?
If you’ve been hurt at work, you need to contact a workers’ comp lawyer in Lawrenceville right away. You don’t want to attempt to handle this yourself. These cases can be very complicated. You want to have an experienced attorney by your side.
The insurance company will have attorneys working for them. When they see that you don’t have a lawyer, they may try to take advantage of you. They may force you to return to work before you’re really ready.
You are entitled to certain benefits under Georgia law. This included medical coverage and weekly benefits. As long as you have a legitimate and valid workers’ comp claim, you should be covered.
For more than a decade we’ve worked with those injured on the job. We know that every case is different and that in addition to being injured, you probably feel intimidated and concerned about your own well-being, as well as that of your loved ones. If you have been injured in the workplace and you would like to schedule a consultation to discuss your case, or you want to speak to a workers comp lawyer in Lawrenceville, GA, contact a workers comp lawyer at the Law Office of John B. Jackson at 770-988-6155.