Stephen Hasner | Georgia Law | July 3, 2020
An average of 2.8 million workplace injuries and illnesses are reported each year in the United States. Workers’ compensation insurance covers most workers in Georgia. Most employees hurt at work can receive benefits through Georgia’s workers’ compensation system.
What is Workers’ Compensation?
Workers’ compensation is not a state benefit, However, the state regulates workers’ compensation benefits. Employers required to provide workers’ compensation coverage typically purchase private insurance coverage to satisfy the coverage requirements.
Workers’ compensation is a no-fault benefits system. Workers do not need to prove that their employer was negligent or at fault for the injury. A worker injured on the job can be partially at fault for the injury and still receive workers’ comp benefits.
However, employees are not allowed to sue their employers for most injuries that occur on the job. That is the trade-off of the no-fault system. This fact can limit the amount and type of compensation a worker receives for a work-related injury or illness.
What Does Workers’ Compensation Cover?
Workers’ compensation insurance coverages most injuries that are related to the person’s work. It also covers illness caused by a person’s job and workplace fatalities.
The injury or illness must have occurred as the employee performed duties or tasks within the normal scope of employment. If an employee is injured while participating in horseplay, the injury may not be covered by workers’ compensation because the injury occurred outside of the worker’s scope of employment.
Likewise, a worker who leaves to run a personal errand is not covered by workers’ compensation if the person is injured during the errand. However, if the errand is business-related, such as taking mail to the post office, an injury would be covered by workers’ compensation even though the person is not on company property at the time of the injury.
Filing for Workers’ Compensation Benefits
If a worker is injured on the job, the worker files a workers’ compensation claim. In most cases, workers must report injuries within 30 days or risk losing benefits.
The workers’ insurance provider for the employer, not the state, pays the workers’ compensation benefits. Common worker’s compensation benefits that you may receive after being injured on the job include:
Reasonable and Necessary Medical Treatment
The workers’ compensation insurance company pays all costs related to necessary medical treatment. There are no co-pays or deductibles for a workers’ compensation claim.
Depending on the injury, a workers’ comp claim should cover expenses related to hospitalizations, physician’s bills, prescription medications, medical supplies or equipment, physical therapy, and other authorized medical expenses.
If you are out of work for more than seven days, you are entitled to weekly income benefits. Employees who are out of work for more than 21 consecutive days receive retroactive payment for the first week of missed work.
Income benefits do not compensate you fully for all loss of income. The amount of income benefits is based on two-thirds of your average weekly salary. The state has a cap on how much workers’ compensation pays for weekly income benefits.
Income benefits are also capped at a specific number of weeks. If you can perform some job duties, you may receive temporary partial benefits up to 350 weeks from the date of your injury. If you are unable to perform any job duties, you may receive temporary total benefits for up to 400 weeks from the date of the injury.
You may also receive compensation for permanent impairment. Examples of permanent injuries include loss of a limb, hearing loss, or vision loss. You may also have an impairment rating because of a broken bone or other injuries.
The amount of compensation depends on the type of permanent impairment. The workers’ compensation laws provide detailed calculations for determining how much a permanent impairment is worth.
Fighting for Workers’ Compensation Benefits
There may be other workers’ comp benefits that you might be entitled to receive depending on your case. Workers are not entitled to recover compensation for pain and suffering damages or full income loss, unless they have a claim against a third-party.
Unfortunately, receiving the workers’ compensation benefits you deserve is not always an easy process. Insurance companies or employers may deny valid claims or underpay benefits.
Fighting for workers’ compensation benefits can be challenging, but it helps to consult with an attorney who handles workers’ compensation claims. While you can file a claim or appeal a decision directly to the State Board of Workers’ Compensation, the process can be confusing and time-consuming without an attorney. A missed deadline or mistake could result in losing the benefits you should receive.