Employees who are covered by workers’ compensation benefits can receive payments for their medical expenses and lost wages if they sustain an injury or illness through the course of employment. Each type of injury carries its own set recovery value, depending on the severity of the injury or illness. An Augusta workers’ compensation attorney can answer any questions you may have about the specifics of your injury and the value of your claim.
Ted A. Greve is an experienced workers’ compensation lawyer in Augusta, Georgia with 20+ years of experience, and he is also a doctor. Call him today to get professional assistance with your claim.
What if I was at fault for my workplace injury?
In workers’ compensation claims, fault has no bearing on whether or not you can receive benefits. As long as the injury occurred in the course of employment, you can still receive benefits. Few exceptions exist, such as when the injury was intentional or if you were injured while intoxicated or breaking the law. A simple mistake, however, even if it’s your fault, will not keep you from receiving your workers’ compensation benefits and wage reimbursement.
Can I file a lawsuit against my at-fault employer?
If your employer intentionally caused your injury or showed egregious neglect, resulting in your injury, then you may be able to file a lawsuit against the employer. However, in most cases, you forfeit your right to sue by receiving workers’ compensation benefits.
What are my legal rights and responsibilities?
Georgia’s workers’ compensation laws include a list of rights that apply to all employees who seek workers’ compensation benefits. These include:
- The right to receive benefits for medical care, rehabilitation, income, and surviving family benefits (in the case of death).
- The right to receive payments for all necessary medical expenses, including doctor, hospital, physical therapy, and rehabilitation bills, as well as relevant prescription and travel expenses.
- The right to receive weekly income benefits.
- The right to receive unlimited benefit payments for catastrophic injuries at 2/3 of the average weekly rate, for as long as you are unable to work.
- The right to receive benefit payments for non-catastrophic injuries at 2/3 of the average weekly rate for up to 400 weeks.
Having said that, you will have to meet certain requirements as an employee to be able to receive workers’ compensation benefits in Augusta, GA. These requirements include:
- You must report your injury to your employer within 30 days.
- You must conduct yourself reasonably and safely on the job.
- You must accept medical treatment to mitigate the impact of injury.
Is my employer required to carry workers’ compensation insurance?
Georgia law requires all employers to proved coverage for workers’ compensation if three or more part-time or full-time workers are regularly employed. You are eligible for workers’ compensation coverage from the first day that you begin working all the way through to the last day of employment.
As long as your injury or illness result from the course of employment, you are covered by workers’ compensation. This does not include injuries that occur while on break or while commuting to or from work, but it does include any accidents that are related to your employment, including auto accidents that occur while completing workplace duties.
Workers’ compensation is a no-fault system, so that it doesn’t matter who is at fault for the injury. The exception to this is if you engaged in willful misconduct, like fighting, horseplay, or personal third party acts. Injuries related to abusing drugs or alcohol are also not covered.
If you are facing wrongful allegations of willful misconduct, an attorney experienced in workers’ compensation claims can help you to combat these accusations and receive the benefits that you deserve.
Can I choose my doctor?
Most people who are injured on the job would prefer to choose their own physicians, typically someone they know and trust, like a family doctor.
Unfortunately, workers’ compensation policies come with pre-approved lists of doctors and specialists, and you must see one of these to receive compensation for your medical care. If you wish to see a different doctor, you may request permission to do so, but must be approved.
Employers are legally required to post a list of at least six doctors for employees to turn to when injuries occur. On this list must be at least one orthopedic surgeon. If you go to a different doctor instead, your claim may be denied.
** In situations that necessitate emergency medical care, you can go to a local emergency room and the employer will cover this cost. **
What is my claim worth?
The value of your claim will be based on the type and severity of your injury. You will be reimbursed fully for your medical expenses and other injury-related out-of-pocket expenses, including travel in some situations. Then, if there is a significant amount of time off work with lost wages to recover, then this will further increase the value of your workers’ compensation claim.
If you miss more than seven days of work, you will receive weekly benefits that are 2/3 of your average weekly wages. If you miss more than 21 days, then the first seven days will also be reimbursed at the same rate. If you are absent from work for less than 21 days, then the first seven are not reimbursed. The benefits that you receive when you are unable to quickly return to work are called total disability benefits. If you can’t return to work at all, then you can receive permanent partial disability, with your benefits determined by your disability percentage rating (from a physician), and the injury’s statutory compensation rate (Georgia Code Section 34-9-263). You can also continue to receive benefits if you return to work at a lower paying position.
If you the surviving spouse or dependent of someone who lost his or her life to a workplace injury, then death benefits are available. These will be calculated at the same rate of 2/3 of the employee’s average weekly income.
What injuries are covered by workers’ compensation insurance?
Any injury that is sustained by a worker in the course of employment is covered by workers’ compensation. Workers’ compensation can also address illnesses and repetitive motion injuries that are caused by work related activities.
Illnesses like mesothelioma, which can be directly traced to workplace tasks and exposures, are covered by workers’ compensation. Repetitive motion injuries like carpal tunnel or back pain that occur through performing the same activities over a period of time are also covered.
What challenges will I face when filing a workers’ compensation claim?
There are some challenges that you may face, though workers’ compensation practitioners strive to ensure that the process is as simple and efficient as it can be. Some reasons that you may be denied include failing to report your injury within 30 days, having a discrepancy between reported injury and medical documents, having evidence of alcohol or drug use, filing the claim after being fired, being accused of willful misconduct, filing the claim late, or having a pre-existing injury. You may not be able to overcome all of these issues, but some are unfair and should not prevent you from receiving workers’ compensation.
The wisest course of action when your claim is denied is to contact an attorney in Augusta who specializes in workers’ compensation claims to discuss your options.
What are my options if my claim is denied?
You can appeal the decision if your empoyer denies your claim. You will need a detailed written explanation about why your claim was denied. Then, you can file an appeal with the Georgia State Board of Workers’ Compensation. You will need to do this within one year of the injury to avoid missing the statute of limitations. There will then be an administrative hearing to determine whether the claim denial was appropriate based on medical evidence and witness testimony.
** You do have the option of requesting mediation if you think the issue can be resolved without a lawsuit. **
If the denial is upheld, then you can seek another review from the State Board of Workers’ Compensation’s appellate team. Having a lawyer on your side at this stage is a good idea.
Ted A. Greve & Associates, P.A.
257 Bobby Jones Expressway
Augusta, GA 30907
Call Ted A. Greve for a FREE consultation
If you are facing a workers’ compensation claim or denial in Augusta, GA, you need a qualified and experienced attorney on your side.