Question 1

Who is eligible for workers' compensation in Georgia?

Accepted Answer

In Georgia, almost all employees are covered by workers' compensation from their first day on the job. State law requires any business with three or more workers (including regular part-time employees) to carry workers' comp insurance. This means if you are an employee (full-time or part-time) and your employer has 3+ employees, you should be covered. Even corporate officers or LLC members count as employees unless they opt out of coverage. Essentially, if you're on the payroll of a covered employer and get hurt at work, you are likely eligible for workers' comp benefits.

Question 2

What is workers' compensation and how does it work in Georgia?

Accepted Answer

Georgia's workers' compensation is a no-fault insurance program paid for by employers. It provides benefits if you are injured on the job, regardless of who caused the accident (you generally cannot sue your employer for negligence, but you get these guaranteed benefits instead). The system is designed to cover your medical treatment and part of your lost wages while you recover. It also can provide rehabilitation services to help you return to work, and even death benefits for your dependents if a work injury tragically results in death. In exchange for these benefits, you usually cannot sue your employer in civil court for a work injury – workers' comp is the exclusive remedy in most cases.

Question 3

What should I do if I get injured at work in Georgia?

Accepted Answer

Report the injury to your employer immediately. Tell your supervisor or boss as soon as the accident happens or as soon as you realize you were injured on the job. Georgia law says if you wait more than 30 days to report a work accident, you could lose your right to benefits. So even if the injury seems minor, report it right away (in writing if possible, and keep a copy). After reporting, your employer should guide you on getting medical care (usually by providing a list of approved doctors). Prompt reporting protects your rights and helps ensure you get medical treatment and benefits without delay.

Question 4

How do I file a workers' compensation claim in Georgia, and what are the deadlines?

Accepted Answer

To officially file a claim with the State Board of Workers' Compensation, you use a form called Form WC-14. The form asks for basic information about you, your employer, and the injury. In Georgia, you generally have one year from the date of your injury to file this claim form (filing sooner is better). If you don't receive benefits voluntarily from the insurer, filing a WC-14 protects your right to a hearing. After filing, if there's a dispute, you can request a hearing before an Administrative Law Judge who will decide your case. Note: If your employer/insurer is paying benefits, you might not need to file a WC-14 immediately – but to be safe, never let the one-year deadline pass without filing, especially if benefits have not been paid.

Question 5

Who pays for my medical bills after a work injury?

Accepted Answer

You should not have to pay for authorized medical treatment for a work injury out of your own pocket. In Georgia, your employer's workers' compensation insurance carrier pays for the doctor and hospital bills for your work injury, as long as the treatment is authorized and related to the on-the-job accident. This includes the cost of surgeries, medications, physical therapy, and any other necessary medical care. Make sure you go to an *approved* workers' comp doctor (see the next question) so that the bills are covered. As long as you follow the workers' comp rules for choosing a doctor, 100% of your authorized treatment should be paid by the employer/insurer, with no co-pays or deductibles for you.

Question 6

Can I choose my own doctor for a work-related injury in Georgia?

Accepted Answer

You do have some choice, but you must pick from your employer's approved list in order for it to be covered. Georgia law requires your employer to post a list of doctors (called a "Panel of Physicians") or provide access to a certified Workers' Compensation Managed Care Organization (WC/MCO). Typically, a Traditional Panel of Physicians has at least 6 doctors (including an orthopedic specialist) to choose from. You can choose one doctor from that panel to be your treating physician. If you're not satisfied, you're allowed one change to another doctor on the panel without your employer's permission. Some employers use a Managed Care Organization (MCO) network instead – in that case they must give you information on how to access an approved doctor, and you also have a right to change doctors once within the network. In any case, you cannot simply go to any doctor you want (unless it's emergency care); stick to the panel or MCO doctors so the bills will be covered.

Question 7

When do weekly wage benefits start, and how much will I receive?

Accepted Answer

If your doctor says you can't work (or your employer cannot accommodate any work for you) for more than 7 days due to your injury, you become eligible for weekly income benefits. The first check should be mailed by the insurance company within 21 days after your first missed work day. The amount is set by law: you will receive two-thirds of your average weekly wage (your pre-injury wage), up to a maximum set by the state. For injuries occurring on or after July 1, 2023, the maximum weekly benefit is $800. For example, if you earned $900 per week, two-thirds of that is $600, so you'd get $600 per week. *Note:* If you are out of work more than 21 consecutive days, workers' comp will retroactively pay for that first week of disability as well (the initial 7-day waiting period).

Question 8

How long can I receive weekly income benefits (wage loss payments)?

Accepted Answer

For non-catastrophic injuries, Georgia law allows up to 400 weeks of weekly benefits from the date of injury. This is roughly 7.7 years of potential benefits if you remain unable to work that long. However, if you recover enough to return to work (even at a lower-paying job), the benefits may be reduced or stopped (see FAQ #12). If you have a catastrophic injury (such as severe paralysis or amputation – see FAQ #11 for definition), you may be entitled to lifetime weekly benefits with no 400-week limit. Also, if you reach the 400-week cap and your injury isn't classified as catastrophic, wage benefits will end at that point. Keep in mind, these limits apply to Temporary Total Disability benefits; other types like Temporary Partial have different duration limits (as explained in the next FAQ).

Question 9

How long will my medical treatment be covered under workers' comp?

Accepted Answer

It depends on your date of injury and whether the injury is catastrophic. For injuries on or after July 1, 2013, medical benefits (doctor visits, treatment, rehab, etc.) are covered for up to *400 weeks from the date of accident. That's about 7.7 years of medical coverage for the injury, as long as treatment remains reasonably necessary. If your injury is deemed catastrophic, you are entitled to lifetime medical benefits for that injury. (Also, for older injuries that happened on or before June 30, 2013, the old law gives lifetime medical coverage.) Note that Georgia made a special exception for certain serious medical items like prosthetics: even in non-catastrophic cases, replacement of things like prosthetic limbs can be covered beyond 400 weeks by law. In summary, most injuries get 400 weeks of medical coverage, but the most severe injuries get medical care for life.

Question 10

What is a catastrophic injury under Georgia workers' comp?

Accepted Answer

A catastrophic injury in Georgia is a very severe injury that entitles the worker to additional benefits (like lifetime income and medical benefits). Georgia law defines "catastrophic injury" to include a few specific situations, such as (1) severe paralysis from a spinal cord injury, (2) amputation of an arm, hand, foot, or leg (or loss of use of that appendage), (3) a severe head or brain injury that causes serious neurological problems, (4) second or third-degree burns over 25% of the body (or third-degree burns over 5% or more of the face or hands), or (5) total blindness (industrial blindness) in both eyes. There's also a catch-all category (6) for any other injury so serious that it prevents the worker from doing any work available in the economy. Catastrophic designation is important because it means you can receive lifetime weekly benefits and medical care instead of being cut off at 400 weeks. These cases often involve additional vocational rehabilitation services as well. If you believe your injury is catastrophic and the insurer hasn't acknowledged it, you may need to request a catastrophic designation through the Board.

Question 11

What if I can return to work but only in a lower-paying or light-duty job?

Accepted Answer

If you can work again but earn less because of your injury (for example, you go from a heavy-duty job to a light-duty job at lower wages), you may receive Temporary Partial Disability (TPD) benefits. TPD pays you a portion of the wage difference. In Georgia, TPD benefits are calculated as two-thirds of the difference between your pre-injury wage and your new, lower wage, up to a statutory maximum per week. For injuries after July 1, 2023, the maximum TPD is $533 per week. You can receive TPD for up to 350 weeks from the date of injury (which is the cap for partial benefits). For example, if you used to earn $900/week and now earn $450/week in a lighter job, the $450 difference would entitle you to about $300/week in TPD. This helps make up some of the lost income. Keep in mind, if you fully recover or your earnings go back up, these partial benefits will end.

Question 12

What if I have a permanent disability or loss of use of a body part?

Accepted Answer

Georgia's workers' comp provides Permanent Partial Disability (PPD) benefits for lasting impairments. After your recovery has plateaued, the authorized treating physician will assign an impairment rating for any permanent loss of function (for example, limited motion in a knee, or loss of a finger). This rating (based on AMA guidelines) corresponds to a certain number of weeks of benefits. Additionally, the law has a schedule of benefits for specific body parts. For instance, the loss of an arm or a leg entitles you to 225 weeks of PPD benefits, loss of a hand is 160 weeks, a foot 135 weeks, an eye 150 weeks, etc. You would be paid your weekly benefit rate for that number of weeks. Even partial loss (e.g. 50% loss of use of an arm) would grant a proportional number of weeks. PPD benefits are paid after you've reached maximum medical improvement and is meant to compensate you for permanent damage. These benefits are in addition to any temporary wage benefits you received earlier.

Question 13

Are there benefits for the family if a worker dies from a work injury?

Accepted Answer

Yes. If a work-related injury or illness leads to an employee's death, Georgia workers' compensation provides benefits to the worker's dependents. The primary beneficiaries are the surviving spouse and children (or other dependents) of the deceased worker. The benefit is a weekly payment equal to two-thirds of the deceased worker's average weekly wage, up to the same maximum of $800 per week (for deaths on or after July 1, 2023). These benefits can continue for a long period: a spouse with no children can receive up to a total of $320,000 over time (which is 400 weeks at $800/week) unless they remarry or cohabitate in a marriage-like relationship. If there are minor children, benefits continue for their support (typically until age 18, or longer if a full-time student). Workers' comp also covers up to $10,000 in reasonable funeral expenses for the deceased worker. While no amount of money replaces a life, these benefits are there to assist the family financially after a tragic work-related loss.

Question 14

What if my work injury made a pre-existing health condition worse?

Accepted Answer

Georgia workers' comp will cover an aggravation of a pre-existing condition if the work accident made that condition worse. In other words, you don't have to be in perfect health before an injury – if your job duties worsened an existing issue, that aggravation is considered a new compensable injury. For example, say you had a prior back problem that wasn't causing you much trouble, but then you injure your back lifting something at work – if your work substantially aggravated the back condition, workers' comp should cover it. However, the rule in Georgia is that the aggravation is only compensable as long as it remains aggravated. Once the pre-existing condition returns to its baseline ("pre-aggravation") state, workers' comp coverage for that issue can end. Insurance companies often scrutinize these cases closely, sometimes arguing the problems are just from the old condition. It may help to have a doctor clearly document how the work injury exacerbated your condition. Bottom line: an on-the-job aggravation of a pre-existing injury is covered by workers' comp, but you'll need to show the work incident worsened the condition and the aggravation is ongoing.

Question 15

What should I do if my workers' comp claim is denied or my benefits stop?

Accepted Answer

If your claim is denied upfront, or if you stop receiving benefits that you believe you're owed, don't delay – you need to take action to protect your rights. In Georgia, you must file a claim (Form WC-14) with the State Board of Workers' Compensation within one year of the date of injury (or last authorized treatment) if benefits aren't being paid. Filing a claim will get your case on the Board's radar. If you're not receiving benefits or the insurance company denies the claim, you can request a hearing before the Board (this is like a trial in front of an Administrative Law Judge). At the hearing, you (often with the help of an attorney) can present evidence and make your case for benefits. The judge will then decide whether you are entitled to comp and can order the insurance company to pay if you win. Remember, the workers' comp insurer may deny claims for various reasons (disputing the injury is work-related, for example), but you have the right to appeal that denial through the Board. Because the process can be legalistic, many workers get an attorney at this point (attorney's fees are only paid if you recover benefits or a settlement ). Important: Always keep the one-year deadline in mind – if you let one year pass without any benefits or without filing a claim, you could lose your rights.

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