Stephen Hasner | Workers' Compensation | October 13, 2020
Workers’ compensation pays for medical care after a work-related injury. It also provides income for injured workers. Workers’ compensation covers most employees in Georgia.
While the workers’ compensation system should be straightforward, workers might find that they have trouble receiving the compensation they deserve after a covered work accident. The workers’ compensation insurance company may deny a claim. In some cases, a worker might not receive fair compensation for permanent impairments.
It is important to understand that you have the right to hire a workers’ compensation lawyer. You do not have to fight the system alone for the benefits you deserve after being injured on the job.
Reasons for Hiring a Georgia Workers’ Compensation Lawyer
Do you need to hire a workers’ compensation attorney? It can be challenging to know when you need an attorney to assist you with a workers’ comp claim. Some reasons that you might want to consider when trying to decide whether to hire a workers’ compensation lawyer include:
Your Claim is Denied
If your employer or the workers’ compensation insurance company denies your claim, you may want an attorney to handle the appeal. Unfortunately, insurance companies often deny valid workers’ compensation claims. They rely on the fact that many workers do not understand the appeals process and will not contact a workers’ compensation attorney for help.
The insurance company might not explain why it denied your claim. It might hide behind long legal explanations and complicated statutes. Hiring a workers’ comp attorney might be the best way to find out why the insurance company denied your workers’ comp claim.
You Cannot Return to Your Job
In some cases, a workplace injury might prevent you from returning to your job. A permanent impairment or disability could result in work restrictions. In that case, you might need to seek vocational rehabilitation benefits.
Workers with catastrophic injuries are required to participate in vocational rehabilitation. The program provides skills tests, career counseling, and help finding a job. You must work with the workers’ compensation system to obtain these benefits.
If your injuries are non-catastrophic, you might voluntarily participate in vocational rehabilitation. However, employers are not required to provide this benefit if your injuries are non-catastrophic.
There could be a dispute as to whether your injuries are catastrophic injuries. If so, you might need an attorney to help you fight for vocational rehabilitation benefits after a work injury.
You Cannot Perform Any Type of Work
Some work accidents result in total permanent disability for a worker. If so, the worker is entitled to temporary total disability payments until the worker reaches maximum medical improvement for a maximum of 400 weeks. Maximum medical improvement occurs when the doctor states that further medical treatment will not result in improvements.
An insurance company might argue whether your condition meets the definition of total disability. If so, you may need an attorney to help you gather additional evidence from medical experts to prove that you cannot perform any type of work.
If you are totally disabled because of a work-related injury or illness, you may continue to receive disability benefits for the rest of your life.
Intentional Harm and Gross Negligence
Workers’ compensation is a no-fault system. Employees do not need to prove that their employer was negligent to receive benefits for a work injury. However, workers’ compensation laws prevent employees from suing their employers for an injury or illness covered by workers’ compensation.
There are some exceptions. If an employer intentionally causes harm to an employee, the employee might be able to sue the employer for additional damages. Also, if an employer’s actions or conduct rises to the level of gross negligence, the employee could have a claim for damages.
Suing an employer for a work-related injury or illness is not as common as suing a third party for an injury on the job.
Third-Party Claims and Workers’ Compensation
A worker might not be able to sue an employer for an injury occurring at work, but the employee might have a claim against a third party.
Third-party claims can include product liability claims, premises liability claims, negligence claims, and other personal injury lawsuits. For example, if a defective product causes your injury, you could sue the product’s manufacturer for damages.
Suppose you are driving from one job site to another job site. Another driver causes a car accident. You might be entitled to compensation by filing a car accident lawsuit against the other driver.
Another example might be an injury occurring on another party’s property. You stop to check on a project for a customer, and you are injured in a slip and fall accident. You could have a premises liability lawsuit against the property owner.
Workers’ compensation does not reimburse you for all damages caused by an injury or accident. For example, you only receive a portion of your lost wages. You are also not entitled to compensation for your pain and suffering under workers’ compensation laws.
However, you are entitled to full compensation for financial losses, pain, and suffering in a personal injury lawsuit. Therefore, a third-party claim can result in additional compensation for an injury that occurred on the job.
If a family member dies because of a work-related accident, the family could have a wrongful death action if a third party caused the death.
Workers’ Compensation Lump-Sum Settlements
The insurance company might offer you a lump sum settlement for your workers’ comp claim. However, before you agree to a settlement, it is wise to discuss your claim with a lawyer.
Lump-sum workers’ comp settlements are final. You cannot demand more money or additional benefits for your claim after you accept the settlement. Even if your conditions worsen or you discover additional injuries, you are barred from receiving additional benefits.
Your Family Member Dies
Families are entitled to death benefits when a worker dies because of a work-related accident or illness. Dependents who might receive death benefits include the surviving spouse, minor children, and other dependents.
Death benefits under workers’ compensation can be confusing. There are limits to death benefits. An attorney can help the family file for workers’ comp death benefits and ensure that the family receives all the benefits available to them by law.
Your Time to File Appeals and Lawsuits Is Limited
You have just one year from the date of your injury to request a hearing with the State Board of Workers’ Compensation. Hiring a worker’s compensation lawyer early in your case ensures that your claim is filed timely and correctly. Do not hesitate to contact a workers’ compensation lawyer if you have questions or concerns about an injury on the job.