Table of Contents
- Do I Have a Workers’ Compensation Claim?
- Types of Accidents and Injuries That May Qualify for Workers’ Compensation
- Employer Violations
- Transportation/Roadway Incidents
- Workplace Violence
- Repetitive Motion Injuries
- Types of Duluth, GA Workers’ Compensation Benefits
- Complications in the Workers’ Compensation Process
- Mistakes in Filing a Claim
- FAQs for Workers’ Compensation in Duluth
Workers in Georgia who become injured on the job have a right to file workers’ compensation claims to get the medical care they need and cope with the financial impacts of workplace injuries. But many workers are reluctant to bring claims against their employers. They may like their employers or fear retaliation. However, the laws provide protections for injured employees, and also protect employers. So if you have any question as to whether to bring a claim, the best thing to do is talk to a workers’ compensation attorney. Contact our Duluth workers compensation lawyers at Brauns Law, PC to go over your case.
Workers’ compensation is an insurance program in which your employer participates as required by Georgia law. Workers’ compensation lets workers get the income benefits and medical care they need after a workplace injury and protects employers from lawsuits. In most cases, you will bring your claim against your employer’s insurance carrier, not the employer itself.
While you generally are not able to sue your employer under workers’ compensation laws, in certain cases you may file a lawsuit against your employer.
In other cases, a party other than you, your employer, or a co-worker is at fault for an injury at work. For example, if you are driving within the scope of your employment and another driver causes an accident, then that driver could be liable. You can file a third-party claim in addition to filing for workers’ compensation benefits.
David Brauns will help you handle these third-party claims in addition to your workers’ compensation claim, and explain how one affects the other.
Some common types of accidents in which people can be injured at work include:
- Collapse and crush incidents
- Negligent hiring of contractors or sub-contractors
These are just a few examples. Other types of accidents and injuries that warrant workers’ compensation benefits are discussed in greater detail below.
Georgia employers have a responsibility to their employees to provide safe workplaces. As such, they must follow the rules set forth by the Occupational Safety and Health Administration (OSHA). OSHA has a short summary of employer responsibilities which includes:
- Employers must provide safe tools and properly maintained equipment
- Employers must provide safety training and updated operational procedures relevant to employee roles
- Employers must develop written hazard communication programs and hazard training for employees exposed to hazardous chemicals.
- Employers must conform to OSHA standards to ensure safe workplaces, including safety equipment and environmental conditions.
The OSHA standards include regulations for nearly every major industry as well as general rules all employers must follow. When employers violate these rules, workplace accidents and injuries can result.
For example, employers commonly violate Standard 1910.9. This requires each employer to provide personal protective equipment (PPE) and training compliant with OSHA standards for each profession.
Workers’ compensation does not require proving fault to get benefits, so you may not need to establish the employer’s negligence or failure to abide by these standards. Still, being able to connect your injury to your workplace or job duties is critical to getting benefits.
You may qualify for workers’ compensation if you suffer an injury in an accident while traveling during the course of your job duties.
Even if you are not working as a professional driver, if you were traveling to perform a duty related to your job, workers’ compensation may cover your accident. If another driver caused the accident, you might have to file a claim against the negligent driver.
Note that workers’ compensation will not cover transportation accidents that occur while you are driving to and from your workplace. You must be traveling as a part of your job duties. An exception may be if you are driving to work in a company vehicle or if your employer has no fixed office and you must drive directly to visit clients.
Employers must promote a safe environment for employees by maintaining a workplace free from violence, discrimination, bullying, and harassment. Federal policies regarding workplace violence state:
“Injuries resulting from personal disputes are typically judged compensable, no matter how unusual. But an employee’s injury is covered under workers’ compensation only if the dispute leading to the injury is related to the employment. In other words, the employee must have been acting within the scope of his or her job when the injury occurred for the injury to be compensable.”
However, Georgia law states a workplace injury “shall not include injury caused by the willful act of a third person directed against an employee for reasons personal to such employee.”
If you are seeking workers’ compensation for an act of violence against you while working, you will need to prove your personal actions did not cause the assault.
Many jobs require repetitive motions such as reaching for objects, lifting items, and manipulating machinery. A repetitive motion injury (RMI) results from an action performed over and over again during the employee’s duties. These actions may not be strenuous in nature, but still may cause long-term damage.
An example of an RMI would be a worker who has to reach to pull a lever above her head every 90 seconds. This repetitive motion can cause damage over time. The employee may suffer injuries to her rotator cuff and become unable to lift or rotate the affected arm, for example.
Most REIs are avoidable with adjustments to workspace design, or ergonomic keyboards and chairs for computer workers. Another solution is to rotate job duties among employees, so one person is not always performing a repetitive motion task. Frequent breaks from the repetitive motion can also help alleviate long-term damage.
These cases can be tricky, because employers or insurers may argue that the RMI is not work-related. Work with Brauns Law, PC to prove otherwise through thorough evidence collection and careful case building.
Whatever the case, a work injury can lead to serious consequences for the worker and his or her family. An injured worker might face immediate medical expenses, lost wages due to time off work, extended therapies and treatment, and, in more serious cases, temporary or permanent disabilities.
Fortunately, Georgia’s workers’ compensation laws provide benefits to help workers get the medical care they need and replace a portion of their lost wages.
- Lifetime medical benefits – These pay medical care related to the work-related injury. Workers may even qualify for the costs of transportation to receive their treatment.
- Income benefits – Depending on the circumstances, disability, and how long the injured employee must miss work, workers may qualify for temporary total disability, temporary partial disability, permanent partial disability, or permanent total disability.
What If I Think I Have a Workers’ Compensation Claim?
Georgia Law requires that injured employees give notice of accidents to their employers. Further provisions require written notice within 30 days of an accident if notice was not otherwise given. If notice was not given within 30 days of the accident, with rare exceptions, you may not be able to receive workers’ compensation at all.
So time is of the essence. Notify your employer of your injury as soon as possible, and seek legal counsel with attorney David Brauns in Duluth.
Brauns Law, PC can help you understand all of the benefits to which you may be entitled and take action to recover them. Call us at (404) 348-8396 to set up your free consultation and get started with your case.
Because state law requires that companies provide benefits for the qualifying injuries of their workers, many people who are injured on the job believe that the process of receiving benefits will be easy. All too often, however, workers seeking benefits can experience delays, complications, and even denials of their rightful claims. This is all in addition to dealing with the actual injury that occurred and necessary medical treatment.
If your benefits were delayed, reduced, or completely denied, do not worry—this is not the end of your claim. Georgia’s workers’ compensation laws allow workers to appeal the decisions of their employers or insurance companies. This appeal process can be complex, however, and can have many specific requirements. It is always wise to have an experienced lawyer representing you throughout your appeal to ensure that you have the best chance of quickly getting the benefits you to which you are entitled.
Injured workers commonly encounter the following complications during the workers’ compensation claims process.
As mentioned above, there is a specific deadline for giving your employer notice that you were injured at work. In addition to the notice requirement, a successful claim includes several other requirements. You must provide all of the necessary information as well as necessary documents to support your diagnosis, the treatment you received, and the work you had to miss.
Any little error or omission on your claim can cause delays or can even result in a denial, which means you will not receive your benefits as soon as you deserve them. This can cause issues with your medical providers and can cause trouble paying your bills if you do not receive the necessary wage replacement. The best way to ensure that your claim is error-free and that it meets all the requirements is to seek help from an experienced workers’ compensation attorney as soon as you believe you have a claim. Brauns Law, PC can help file and review your claim to make sure it is as accurate as possible.
How Your Employer May Challenge Your Claim
Many people meet all the requirements and deadlines for filing a claim, then are shocked to receive notice that their claim has been denied. If you were injured at work, how can your employer challenge your claim for workers’ compensation benefits? There are many ways that both employers and insurance companies try to deny claims to limit liability.
Common reasons for denials include:
- Your injury was not work-related – Even though YOU know that your injury happened at work does not necessarily mean that your employer will simply believe it. This is especially true with back injuries or similar conditions that regularly happen at home or during recreational activities. Sometimes, your employer will allege that you are claiming the injury occurred on the job to get benefits when really you suffered the injury outside of the workplace.
- You did not need the treatment you received – Workers’ compensation should cover the costs of the treatment you receive for your injuries. However, treatments must be necessary or recommended by a medical professional to qualify for coverage. For example, if you sought an acupuncturist for your back injury, it would be considered an elective treatment and would not be covered. In too many cases, to avoid covering the costs, employers or insurers try to claim that recommended and appropriate treatments fall outside of what is “necessary” for the nature and severity of your injury.
- You did not need to miss work – Workers’ compensation will reimburse you for a percentage of wages you lost if you missed work due to your injury. As with medical coverage, however, the time missed must not only be related to your injury but must have been necessary due to medical treatments or because your injury limited your ability to work. Some insurance companies will try to limit benefits by claiming you were actually able to work but instead chose to stay home.
If you receive a denial for any of the above reasons, do not wait to discuss your situation with a skilled workers’ compensation lawyer. Our law firm can help you provide evidence—such as medical records or expert medical opinions—that demonstrates the true cause and severity of your injuries. Such evidence can prove your injury was work-related, that your treatments were necessary, and that your injuries truly did prevent you from working on the days you missed. Please contact us today so we can evaluate your appeal.
Were Your Benefits Reduced or Ended Prematurely?
Some people have their claims approved and begin receiving benefits—then, suddenly, the benefits on which they relied were suddenly reduced or eliminated. This can happen for many reasons, though it is often because your employer or its insurance company believes you have recovered enough to stop treatments and return to work. Our firm strongly believes that this determination should always come from a medical professional, however, and not your employer. No one should be forced to prematurely return to work and stop treatments because of benefits.
You’re a dedicated and loyal employee who shows up and works hard. Then, one day you suffer a job-related illness or injury. You rightfully anticipated that your employer and their workers’ comp insurance carrier would take care of you. Unfortunately, many injured workers meet adversity when trying to access the benefits they deserve to receive. Below, our Duluth workers’ compensation attorneys answer your common questions about these often confusing benefits.
What is workers’ compensation?
Workers’ compensation is insurance that gives financial benefits for medical costs, lost wages, and rehabilitation expenses to employees who are injured or become ill during their employment. If an employee dies from injuries they received on the job, it also pays death benefits to their family.
Legislatures across the U.S. and in Georgia created the workers’ comp system to give prompt payment of income benefits and medical bills without needing to prove fault on behalf of the employer, co-workers, or third parties. Typically, the employer purchases a workers’ compensation insurance policy to pay these benefits when necessary to all employees. Your employer pays for these benefits to help you return to work.
How Do I file a workers’ compensation claim?
You will need to complete Form WC-14 to file a claim. To obtain the form, you can contact the State Board of Workers’ Compensation. If you are in the metro Atlanta dialing area, call (404) 656-3818. If you are outside of the metro Atlanta area, call 1-800-533-0682.
You can write to request your form:
State Board of Workers’ Compensation
270 Peachtree Street, NW
Atlanta, GA 30303-1299
You may also print Form WC-14 from the State Board of Workers’ Compensation website www.sbwc.georgia.gov.
You will receive an email notification once the board has processed your form. Be sure that you list your email address on Board forms under the ‘Submitter’ sections if you want them to notify you.
This sounds easy, but for most people, it isn’t—the forms often confuse people who don’t understand workers’ compensation laws. Call us and ask us to fill out and file these forms for you. We can fill them out correctly and attach the necessary evidence to reduce the chance you need to file an appeal—and hopefully get your benefits to you more quickly.
Do I need a Duluth workers’ compensation lawyer?
Sometimes, it’s challenging to enforce your workers’ compensation rights. You’ll need to complete complicated forms and follow specific procedures. It’s usually best to have an experienced Duluth workers’ compensation attorney to represent you because of the many factors involved in winning your case. They know how to help secure the maximum amount of benefits for injured workers.
Do I have to stay in Georgia to receive workers’ compensation benefits?
No, you don’t have to remain in the state. You can continue to receive your regular weekly benefits no matter where you reside. Not only that, but the insurer must give you a physician convenient to your new location.
I haven’t returned to work, but my weekly Duluth workers’ compensation benefit was reduced. Can they do that?
It depends on the situation. If your physician releases you to light-duty work, and if the insurance company complies with the many procedural requirements of Georgia workers’ compensation law, they will reduce your benefits from temporary total to temporary partial, but only a year later. Your Duluth workers’ compensation lawyer would need to review all of your paperwork to give you a correct answer.
Am I eligible for a benefit increase if the maximum benefit limits increase under the law?
No, unfortunately. The maximum weekly benefit amount in effect on the date of your illness or injury is the most you can receive, even if the maximum changes while you receive your benefits. This is also true if you already receive the maximum amount of Georgia workers’ compensation benefits in your case. However, by meeting with a seasoned Duluth workers’ compensation attorney, you can ensure that you receive the maximum benefit amount you are entitled to receive.
How long can I receive workers’ compensation benefits for my Duluth work accident?
There are limits to how long you can receive benefits, but there is no one size fits all answer. Outside of the time limits, there are generally three situations that can stop your temporary total benefits without the insurance company getting permission from the State Board of Workers’ Compensation. These situations include:
- The authorized treating doctor returns you to work on regular duty without any restrictions
- You go back to work earning the same wages as you were earning when you were injured
- The insurer follows the procedure set forth under Georgia workers’ compensation laws and Board Rule 240 in regards to offering you light-duty work, and you don’t attempt to perform it
Keep in mind that there are many other circumstances under which the State Board can suspend benefits.
I am receiving Georgia workers’ compensation benefits. Can Social Security Disability benefits reduce them?
It depends. The total amount of your workers’ compensation checks and your Social Security Disability checks can’t exceed 80 percent of your average monthly or current earnings. Generally, when your workers’ compensation case settles, the settlement agreement can be drawn so that you can recover a large percentage of this lost offset.
Are Duluth workers’ compensation payments taxable?
Absolutely not. Neither workers’ compensation benefits nor workers’ compensation settlements are taxable. Your taxes are accounted for when your rates are determined.
An individual workers’ compensation rate is determined by taking the injured workers’ gross wages from the 13 weeks before the accident and dividing it by the number of weeks worked. Then, multiply that number by two-thirds. By taking only 66 percent of your wages, the workers’ compensation system accounts for your taxes. As such, you don’t need to pay taxes on any workers’ compensation benefits.
Even if you receive a lump-sum settlement for your injury instead of weekly payments, you are never responsible for paying taxes on it. However, this doesn’t mean that your workers’ compensation benefits are exempt from child support obligations or bankruptcy proceedings—it only means that you don’t owe taxes on any workers’ compensation benefits you receive.
Does workers’ compensation cover travel to work?
Workers’ compensation benefits cover injuries that were suffered by performing duties within the scope and course of an employee’s job. Georgia courts have held that employees who travel have a much broader work scope than a non-traveling employee. If an employee must travel for their job, the court might classify them as being under continuous employment. In this scenario, their employment includes not only time spent working but also any time away from home required by their employer for work.
For example, suppose you sustain an injury in a motor vehicle accident in a city you had to be in for work. In that case, you could be eligible for workers’ compensation benefits. This applies just as if you had been performing work. Contact an experienced Duluth workers’ compensation lawyer to discuss the details of your injury in greater detail.
Another common question we get is about suffering an injury while traveling to work. Workers’ compensation benefits may or may not apply under these circumstances. There are many different situations in which you can seek coverage for travel-related injuries from workers’ compensation insurance.
Here are several questions to examine to determine if your injury qualifies you for workers’ compensation:
- Did your employer require you to drive to a location that wasn’t their primary place of business? If yes, workers’ compensation might cover it.
- Did your employer ask you to pick up another employee on your way to work? If yes, it could be a work-related injury.
- Did your employer allow you to use a vehicle as part of your employment? If yes, it could be a work-related injury.
- Were you commuting between jobs for the same employer? If yes, it could be a work-related injury.
- Were you returning to your office from an errand they asked you to run? If yes, it could be a work-related injury.
- Did your employer require you to live in a hotel in another city when you were injured? If yes, it could be a work-related injury.
Call Brauns Law Accident Injury Firm so that we can review your situation and provide answers tailored to your situation.
Can I sue my employer after settling my Duluth workers’ compensation case?
Georgia state law makes workers’ compensation the only remedy for on the job injuries. If you want compensation after being injured on the job, you must use the workers’ compensation system. Even if an employer’s negligence caused your injuries, you probably can’t sue them apart from the workers’ compensation system.
It may not be the news you wanted to hear; however, it might still be of benefit to you and many others. The tradeoff is that no matter who is at fault for your injury, you can still receive compensation under Georgia’s workers’ compensation laws, even if it was you.
On the other hand, even if you can’t sue your employer, you may still need our Duluth workers’ compensation lawyers to ensure the insurance company treats you fairly and pays you the benefits you deserve—so call us today.
What if another party caused my Duluth workers’ compensation injuries?
Even though you sustained a work injury, there might be other liable parties besides your employer. Your employer covers their potential liability with workers’ compensation, which bars your right to sue. However, you should meet with a Duluth workers’ compensation lawyer to see if other parties might be liable as well. If someone else is at fault, you could have a third-party liability claim.
Third-party liability exists when someone not working for your employer causes your injuries. Perhaps you are a construction worker working on the same worksite as other contractors. An electrician is working and leaves a live wire exposed. You touch the live wire, not knowing it was there because the electrician didn’t post warning signs. The wire electrocutes you, causing severe burns, muscle damage, and heart problems.
Because the electrician isn’t an employee of your employer, this is a good example of third-party liability.
Some other examples of third-party liability are:
- Auto accidents occurring while you are in a company vehicle or while being paid to be on the road for work-related tasks. The liable third-party is the person who caused the accident.
- Suppose a particular tool or device you use at work is defective because of faulty manufacturing. In that case, the manufacturer is liable for the injuries.
- A delivery truck driver causes an accident while backing into the warehouse bay, resulting in injuries to warehouse workers. The liable third party is the delivery truck driver and their employer.
- A third-party company distributes a liquid that could be toxic but doesn’t contain the mandatory warnings. As such, workers suffer injuries or later develop occupational diseases.
- If a worker causes injuries deliberately or through gross negligence, they could be held liable for the damages they cause. A co-worker assault is a good example.
An employee can file a third-party liability lawsuit against a person or entity in many other scenarios. In these cases, you can file a workers’ comp claim and a personal injury lawsuit. A reputable Duluth workers’ compensation attorney will help you identify any parties that might have caused your injuries.
What if I decide to accept a Duluth workers’ compensation settlement?
When you settle your workers’ compensation claim, you must sign several settlement documents.
The workers’ compensation settlement agreement, called a “Stipulation & Agreement,” usually states that you and your employer are resolving your right to all past or future workers’ compensation benefits. Next, the State Board of Workers’ Compensation reviews and approves the Stipulation & Agreement documents. After the State Board approves it, neither party can appeal it.
Typically, the settlement package includes a mandatory “general release” agreement. With this, you must agree not to sue your employer for any other reason related to your employment. However, the general release has little to no impact on most workers’ compensation claimants because employees can’t “sue” their employer for their workers’ compensation injuries in many states, including Georgia, even outside of this agreement.
When should I contact a Duluth workers’ compensation lawyer?
You should contact a knowledgeable Duluth workers’ compensation attorney as soon as possible after your injury. We can review your case, help you file your claim, and determine if any other parties are liable for your damages. However, even if you have already filed your claim, you can still seek the advice of a qualified attorney. It’s never too late to see if legal counsel will benefit your Duluth workers’ compensation claim.
Contact a Duluth, GA Workers’ Compensation Law Firm Today for Help
At Brauns Law, PC, we have seen how a workplace injury can affect your life. Not only do you have to deal with the pain and suffering of the injury, the medical treatment, and the missed work, but then you may also have to deal with the often complex process of receiving the benefits that you deserve. David Brauns is an experienced workers’ compensation attorney who is dedicated to making this process as stress-free as possible for you and protecting your rights every step of the way.
If you’ve been injured on the job and would like to learn more about how our law firm can help, please contact us online or call our office at (404) 348-0889 to speak with someone for free today.
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