Workers Compensation Claims Process
Injured at work? If you have suffered an injury at your workplace, you may be entitled to workers’ compensation depending on the facts of the case and the laws in your state. You may be entitled to benefits under Georgia Workers Compensation Act. However, some employees assume that the workers compensation claims process Atlanta is straightforward just because it’s stipulated by state and federal laws. It is a big mistake to make such an assumption!
When seeking compensation for a work-related injury, you should be careful with what you do and say so that you don’t jeopardize your claim. Insurance companies are in business and they want to grow their profits. Therefore, they will do everything they can to protect their interests to reject claims or pay as little compensation as possible.
Insurance companies will fight hard to pay out the smallest amount possible – or nothing at all – in claims. Their insurance adjuster and attorneys will be out to look for any mistakes and try their best to poke holes in your workers’ comp case so that your claim is denied or you’re paid a low settlement.
It just goes to show that insurance companies and their adjusters and attorneys won’t act in your best interest. You will need a workers’ comp attorney to represent you and look out for your best interest.
Filing A Workers Compensation Claim in Georgia
Filing a workers’ compensation claim in Georgia is relatively easy. However, what can be challenging is understanding the entire workers’ compensation system process, getting the initial form processed, and not letting any details slip through the cracks.
Without a lawyer by your side, it can also be difficult to maximize your workers’ compensation claim or even get a fair settlement for that matter.
The parties involved in the workers compensation claim process Atlanta, include the injured employee, the employer, and the insurance company, and they all have different roles to play in the process.
But, ideally, the process starts with the injured employee who reports his/her injury to their supervisor immediately after the accident before seeking medical treatment from one of the six employer-provided doctors.
Under the Georgia workers’ compensation law, an injured employee must report his/her injury to the employer within 30 days of the date of the accident. Also, the one-year statute of limitations gives employees one year from the date of the injury to file a claim provided they met the 30-day stipulation of informing the employer about their injury.
Even if you feel that you haven’t suffered a serious injury, remember timing is of the essence when it comes to the 30-day limit for reporting injuries in workplaces. On some occasions, you might suffer what seems like a muscle pull or minor cut, and not feel it is worth the effort to report it to your supervisor and seek immediate treatment.
But over time, that seemingly minor cut could get infected or the muscle pull might become more severe. Perhaps several weeks after the incident, you might need serious treatment.
Therefore, it is important to report your injury to a supervisor right away. Get it on record that could need medical attention. That simple act could save you lots of frustration and aggravation.
Employer’s Responsibility in Workers’ Compensation Claims
The Georgia employer and/or company responsible for handling workers’ compensation claims will investigate on-the-job accidents and injuries. The investigations are necessary to determine where, how, and why the injury occurred, then to possibly implement policies and procedures, and safety measures that will make for a safer working environment.
Workers’ compensation will not provide benefits for an injury or accident resulting from an employee’s willful misconduct (defined as fighting, horseplay, willful act of the third party for personal reasons, or injuries related to alcohol or drug abuse).
An injury that occurs due to haste or inattentiveness will generally be covered. However, the employee might be subject to company discipline if they were not following company policies or safety rules and protocols.
Immediately upon knowledge of a workplace injury, the employer must file a report with its insurance carrier or self-insurer’s claims office. If the injured employee misses work more than seven days due to the injury, the employer must inform the State Board of Workers’ Compensation within 21 days of that disability.
Georgia employers are required to have workers’ compensation insurance coverage. Employees can report a suspicion of fraud and non-compliance to the Board’s Enforcement Division at (404) 657-7285.
So far you can see that the workers compensation claims process Atlanta involves a lot of crucial steps and details that must be handled carefully and diligently. It underscores the need to have an experienced workers’ comp attorney help and guide you every step of the way.
Insurance Carrier’s Responsibility
The insurance carrier, which will conduct its own investigation, will file a First Report of Injury with the State Board of Workers’ Compensation. Copies of the report will be mailed to the employee and employer.
The insurance carrier is also obligated to mail a brochure to the injured employee that explains the rights, benefits, and procedures for obtaining benefits.
The insurance carrier will require all written statements and accident reports, along with the names of all witnesses and the employee’s payroll records for 13 weeks before the injury.
Deadlines for Georgia Workers Comp Claims
Here is a review of the deadlines you must meet to avoid any snags:
- Deadlines for Notifying Employers – Immediately is best. But under Georgia law, you have 30 days to report the injury after you have been hurt on the job. In some cases, just telling your supervisor or having a supervisor witness the accident without verbal confirmation could be deemed enough. Sometimes the timing might seem hard to define because some work-related injuries are not due to a specific accident but occur from overuse or repetitive activities. But to be safe, it is best to inform a supervisor immediately after you are injured. It is also best to do it in writing.
- Deadlines for Filing Claim – In Georgia, if the employer has taken no action to provide the injured worker with either medical treatment or benefits, the worker has up to one year to file a notice with the State Board of Workers’ Compensation (SBWC) about their claim. It requires a specific WC-14 form. That same form can be filed within one year from the last medical treatment paid for by the workers’ compensation insurance carrier (and not your health insurance). The WC-14 is accepted within two years of the injury if you have received some lost wages, but are still seeking money because you cannot work, have work restrictions, or are earning less due to the injury.
- Deadlines for Occupational Diseases – You generally have one year after the date that you knew (or should have reasonably known) of the disease and how it was caused by your job. With few exceptions (notably asbestosis or mesothelioma), you cannot file a claim more than seven years after your last exposure to the work hazard.
Eligibility for Workers’ Comp in Georgia
Nearly every employer in the state of Georgia is required to provide employees with workers’ compensation insurance. Under Georgia law, any business with three or more workers (including regular part-time workers) must have the insurance, and coverage begins on the employee’s first day of work.
There are some exceptions to coverage requirements, including U.S. Government agencies, railroad carriers, farm laborers, and domestic servants.
Want to check on your workplace? Coverage can be verified by going to www.sbwc.georgia.gov and clicking on “Verify Workers’ Compensation Coverage”.
Injured At Work? Contact Us Today
If you have been injured at work and want to file a workers’ compensation claim, our experienced, reliable, and dedicated workers’ compensation attorneys at Bobe & Snell Law Office LLC can help you.
Workers Compensation Claims Process
Our attorney will help you navigate the Atlanta workers compensation claims process, guiding and helping every step of the way to ensure you get everything right, thus increasing your chances of getting the compensation that you deserve.
Call us today at (470) 268-5802 or contact us online to schedule a free, no-obligation consultation and case review.
Workers Compensation Claims Process