In Georgia, eligible employees are guaranteed certain rights under the state’s workers’ compensation program if they are injured while on the job. Unfortunately, many valid workers’ compensation claims are denied, leaving injured parties feeling helpless and unclear about their next steps. Having the guidance of a workers’ compensation lawyer can make all the difference in the outcome of an appeal, so if you were injured at work, it is critical to contact an experienced Macon workers’ compensation lawyer who can evaluate your case and walk you through the filing process.
According to Georgia’s workers’ compensation laws, injured employees have the right to receive:
- Benefits to help them return to work
- Compensation for medical bills, including rehabilitation expenses and travel costs
- Weekly income benefits for employees whose injuries require them to miss more than one week of work
- Two-thirds of their average weekly wage until they are able to return to work if they sustained a catastrophic injury, which includes blindness, severe head injuries, serious burns, and amputations
- Vocational rehabilitation benefits
- Two-thirds of their average weekly wage for injuries that are not catastrophic or totally disabling for up to 400 weeks
- Weekly benefits for 350 weeks if an injured employee is only able to fulfill the duties of a lower paying job as a result of an injury
- An additional penalty for overdue benefits
These rights also come with specific responsibilities with which employees must comply, including:
- Following written safety rules and procedures
- Reporting an accident within one month of the injury
- Accepting medical treatment as directed by the State Board of Workers’ Compensation
- Refraining from willful misconduct
- Notifying an employer when they can come back to work, even if only on a part-time basis
- Accepting a job that was approved by a medical professional even if it is compensated at a lower rate
- Submitting to a drug test after an accident
- Requesting reimbursement for mileage or medical-related expenses to an employer within one year
Employees are not the only ones with specific responsibilities, as spouses and dependents of a deceased employee must notify the company if they move or remarry. Dependents who have not received compensation for a parent’s death must also file a claim within one year, or they will forfeit their rights to compensation.
Only eligible employees can claim these rights. Fortunately, most employees satisfy the eligibility requirements. For instance, employers who employ at least three workers must have workers’ compensation insurance. While this covers the majority of employees in Georgia, there are some workers who do not qualify for workers’ compensation benefits, such as independent contractors. If it is unclear whether a person is an independent contractor or an employee, a court will analyze a series of factors, including:
- Whether the worker signed an agreement stating that he or she was an independent contractor
- Whether the worker is only paid when a job is completed or is instead compensated at an hourly rate or receives a salary
- Whether the employer withholds taxes from the worker’s paycheck
- Whether the service provided by the worker is part of the employer’s regular business
- Whether the employer supplies the worker with his or her materials and tools
- Whether the worker controls his or her own hours
- Whether the employer is given the discretion to decide how the work must be completed
Even employees who do not receive a regular wage can qualify as a covered employee. For example, temporary workers, migrant workers, volunteers, and elected officials are all covered by workers’ compensation.
There are also a number of professions, aside from independent contractors, that are not covered by the workers’ compensation program, including:
- Federal employees
- Railroad workers
- Farmers and farm laborers
- Business partners
- Domestic workers
- Sports officials, including referees, judges, umpires, and linesmen if they are not employees of an organization that specifically sponsors sports events
However, just because a person’s occupation is not covered under Georgia’s workers’ compensation program does not mean that an employee cannot recover for an injury. This is because many employers voluntarily provide workers’ compensation coverage for their employees. In other cases, specifically exempted occupations are covered by other compensation programs. For instance, federal employees can collect benefits and lost wages under the Federal Employees’ Compensation Act (FECA).
Finally, even employees who are not eligible for workers’ compensation and are not provided benefits by their employers may still be able to collect compensation for injuries sustained on the job. However, this will require an injured employee to file a claim in court, where he or she must establish that the employer was negligent, which can be a difficult undertaking.
Unfortunately, many valid workers’ compensation claims are denied on a regular basis. The following are some of the most common justifications for denials:
- The employee did not file a claim before the 30-day deadline
- The claimant failed to provide sufficient information about the accident and the injury
- The employee failed to turn in necessary documentation
- The claimant did not submit evidence demonstrating that the injury occurred while on the job
- The claimant’s employer disputes the claim
- The State Board of Workers’ Compensation concludes that an employee’s injury is not severe enough to qualify him or her for benefits
Filing an Appeal
Employees whose claims are denied should immediately begin the appeals process by requesting a hearing with the State Board of Workers’ Compensation (SBWC). This requires a claimant to file Form WC-14, a copy of which will automatically be sent to the worker’s employer. After the claim has been processed, the employee will receive a hearing date in front of an administrative law judge. In some cases, the parties are required to go through the mediation process before they can attend a formal hearing on the issue. Once at the hearing, a claimant must demonstrate that:
- He or she was injured during the performance of job-related duties that were within the scope of employment; and
- He or she filed a claim on time and submitted the appropriate paperwork.
After the presentation of evidence, the judge determines whether benefits are appropriate or if the initial denial was justified. In the event that a judge denies the appeal, a claimant can submit another appeal to the SBWC’s Appellate Division as long as he or she does so within 20 days.
Contact Us Today to Schedule a Consultation with an Experienced Macon Workers’ Compensation Lawyer
To learn more about your rights to compensation, please contact Hasner Law by calling 1-855-888-4878 (8478).