Workers Compensation

Workers compensation is a kind of insurance that you might not even know you have. That is because your employer pays for it, but it doesn’t show up on your paycheck. Workers compensation is a no-fault system in Georgia. That means it doesn’t matter who is to blame for your injury. It is meant to compensate workers who get hurt one job. The decisions that you make about your worker’s compensation injury are critical. Before you sign anything from the insurance company, you need to make sure that you are being fairly compensated. After all, you only have one body for the rest of your life.

Is Your Injury Covered Under Workers Compensation Insurance?

All employers with three or more employees must have workers compensation insurance.  The employer has to pay all of your medical expenses that are related to your on-the-job injury.  Did you miss more than 7 days of work? Your employer has to compensate you for your lost time.  If your employer has denied you these benefits, we can file a claim with the State Board of Workers Compensation and force them to pay.

Are You Running Out of Time to File Your Claim?

Workers compensation laws are intended to help injured workers, but if you don’t follow the rules your claim may be denied.  An employee generally has 30 days from the date of injury to notify his supervisor that they have sustained a workers‘ compensation injury. If you report the injury, you are entitled to certain benefits:

  • Compensation for medical expenses, including travel expenses
  • A portion of your income if you are unable to work for 7 or more days
  • Compensation if you have a permanent disability because of your injury

If your employer denies you benefits then you may have to request a hearing with the State Board of Workers Compensation.  You have only one year from the time of the accident or the last time your employer payed you benefits to file a claim.  If you wait any longer then your claim will be denied because the statute of limitations has passed (O.C.G.A. 34-9-82).  However, its best to make sure your claim is filled within one year of the accident date.   Waiting too long can be a death sentence to your workers compensation case.

Sometimes an employer will pay you lost income benefits, otherwise known as TTD, but you will lose those benefits because your condition improved or you went back to work.  If your condition changes for the worse, then you may restart your TTD benefits, but you only have two years from the last time you received a TTD check.  In that situation, you will still be entitled to medical benefits, but you lose the right to get compensated for your time out of work.

You should not wait to contact a lawyer.  These statute of limitations problems can be very technical and can kill your case.  Its not uncommon for the insurance adjuster to string you along with the promise of a settlement, but really they are just waiting for the statute of limitations to run.  You only have 400 weeks to receive compensation for your medical costs.  If you wait until after the 400 weeks, the insurance company won’t have to pay for your treatment (unless your case qualifies as catastrophic).

Why Won’t the Insurance Company Pay for My Treatment?

The law requires the insurance company to pay for all medical expenses that are reasonably calculated to effect a cure or provide relief for your work related injury.  However, they often illegally delay medical treatment as a tactic.  They hope you will give up and settle your case for less than it is worth.

There are several ways to make the insurance company pay for valid medical expenses.  The State Board of Workers Compensation publishes a Form WC-205 .  This form allows a doctor to request pre-authorization for treatment. The insurance company to provide an answer within 5 business days or the procedure is automatically considered pre-approved.  If they flat out refuse to pay then you will have to request a hearing in front of an Administrative Law Judge and the Judge may order them to pay for the treatment you need.

What Is My Workers Compensation Case Worth?

In virtually all cases, the workers compensation insurance company will want to negotiate a settlement with you.  In exchange for a lump sum payment, the insurance company will want you to give up your right to a weekly check and other workers comp benefits.   Workers compensation cases are different than other types of personal injury cases.  There is no trial in a workers compensation case.  The only way you get a lump sum payment is if both you and the insurance company can agree to settle.  The value of your case depends on how much your benefits will cost the insurance company.  If you have a high salary or expect to have large medical costs, then the insurance company will pay more money to make you go away.  Simply put, if the insurance company has to pay a lot of money in benefits, then they will be willing to settle for more money.  If you have a good idea of how expensive your workers comp benefits are, then you will have a good idea of the settlement value of your case.

Every case is unique.  In order to evaluate the value of your case, we look at the potential worst case scenario for the insurance company.  We also evaluate the potential legal defenses and how likely we are to win those issues.  If you try to negotiate a settlement by yourself, the insurance company will offer you peanuts compared to if you had a good lawyer that knows what your case is really worth. Robert Bourne has 30 years of experience negotiating workers compensation cases. Give us a a call today!

Do You Need to Hire a Workers Compensation Lawyer?

Every case is different.  Every person that is injured on the job does not need  a lawyer. But, you will not know for sure until you talk to a lawyer.  The workers compensation system is extremely complicated, and there are many traps that insurance companies use to drain value out of your case.  We offer free consultations over the phone and in our office.  We know all of the insurance company’s dirty tricks and can offer you free advice.

Workers Compensation Client Testimonials

Contact us today for a free consultation.