Answers to Commonly Asked Questions About Workers’ Compensation
- Page 1
What's my workers' comp claim worth?
The injuries sustained in on-the-job accidents can be painful both physically and financially. Injured workers may face unexpected debt while they are unable to work as they wait for their injuries to heal.
Fortunately, in Georgia, injured employees are eligible for workers' compensation benefits, which includes temporary disability payments and payment of related medical expenses.
Workers' compensation settlements have to be agreed upon by the injured worker and the employer and their insurer. If all parties don't agree, then there is no settlement. The value of workers' compensation claims varies and depends on a number of factors, including:
- Severity of the injury
- Amount of the injured employee's weekly benefits
- How long the employee is expected to be disabled from working
- Past and estimated future medical costs
- Age of the injured worker
The more serious an injury, the more likely it is to require continuing medical treatment and significant future time off from work. The greater these anticipated costs, the more valuable the claim. As a result, workers with claims involving severe or catastrophic injuries tend to receive larger settlements than employees with relatively minor injuries.
Under Georgia's Workers' Compensation Law, injured employees are entitled to collect temporary total disability benefits equaling two-thirds of their average weekly pay (before taxes are deducted) each week for as long as their injuries prevent them from returning to work. The injured worker can receive these benefits for up to 400 weeks, or for the rest of their life if their claim has been deemed catastrophic. Again, the longer you and the insurer believe you will be entitled to continuing income benefits, the more the case will be worth in settlement.
An injured worker's average weekly wage is calculated based on the employee's pay for the previous 13 weeks. Individuals employed fewer than 13 weeks are compensated based on the average weekly wage of a similar employee who works in the same position for the employer as the injured worker. The maximum benefit rate is set by the Georgia legislature. Currently, the maximum benefit payable to injured workers in Georgia is $575 per week.
Consult an Experienced Workers' Compensation Lawyer
If you were injured on the job, you may have questions about the value of your case or the workers' compensation benefits to which you're entitled. The knowledgeable workers' compensation lawyers at Rechtman & Spevak have extensive experience helping injured workers. Our skilled legal team is happy to answer your questions and address your concerns to ensure you understand your rights, as well as all the options available to you.
Contact our Atlanta law office today to schedule an appointment for a free initial case consultation.
What Is The Process In Filing A Workers’ Compensation Claim?
In order to initiate a workers' compensation claim, your attorney will electronically file a Form WC-14 with the State Board of Workers’ Compensation. If a hearing is requested, which will be done if we feel that the employer and its insurer are not providing you with all of the benefits to which you are entitled, then the insurer will assign the file to an attorney to defend the claim within a few weeks of us filing the hearing request. The parties will then go through a discovery process in which each side will serve typewritten questions called interrogatories as well as requests for documents upon the opposing party. The defense attorney will also likely want to schedule your deposition, in which you will provide oral testimony about your claim. The deposition will typically take place at your attorney’s office, and there will be a court reporter present who will take down your testimony. If there is a dispute regarding medical treatment, the insurer may schedule you for an independent medical examination (IME) to get another opinion. Under certain circumstances, we also may send you for an IME to get an opinion to bolster your case. Ultimately, your case will proceed towards a hearing before an administrative law judge. However, most cases reach a settlement prior to you ever having to appear in court.
How can I maximize my workers’ compensation claim?
Workers’ compensation benefits provide a vital safety net for employees who’ve been injured on the job. However, it’s crucial that you actively advocate for your right to a fair settlement.
Report Your Accident Immediately
Even if you’re only mildly uncomfortable, report your accident as soon as it happens. It’s quite possible that your initial discomfort may turn into something more serious. If this happens and your employer has no record of your accident, they will likely argue that you were hurt outside of the workplace. When it comes to your workers’ compensation benefits, a “wait and see” approach should be avoided at all costs.
Many employers have internal deadlines regarding accident reporting, with some being as short as 24 hours. Georgia law requires that the report must be made within 30 days of the event. When you report your injury, provide as many details as you can regarding the circumstances of the accident. Ask any coworkers who saw the incident to verify that your account is accurate.
Create a Detailed Paper Trail
Once you’ve reported your injury, keep detailed records regarding the progress of your claim. Ask for copies of medical exams and test results as well as any other expenses you’ve incurred as the result of your injuries. Keep an appointment log noting the date, time, and name of every contact person you speak to regarding your case.
Lining up witnesses to testify on your behalf can also be useful in boosting your compensation. For example, you might ask friends or family members to provide statements regarding the effect your injuries have had on your daily activities.
Listen to Your Doctor
Refusing to follow your doctor’s recommendations regarding your medical care may result in your benefits being denied. You’re within your rights to ask for information regarding treatment side effects and any potential risk, but skipping appointments altogether will send the message that you’re not fully invested in your recovery.
Listening to your doctor also means following any recommendations regarding what activities you can and can’t do. If you’re not supposed to be lifting anything heavier than 25 pounds, don’t decide to use your time off work to landscape your front lawn. Many insurance companies will use private investigators to verify that you’re being truthful about your injuries, so being seen engaged in unauthorized physical activity will severely damage your case.
Remember That the Insurance Adjuster Isn’t Your Friend
An insurance adjuster's job is to make decisions that are best for the insurer's bottom line. He doesn’t care if you need a settlement to help pay your mortgage or student loans. The first offer you receive will likely be much less than what your claim is truly worth. Negotiating for the compensation you deserve is a must.
One common mistake that injured workers make is assuming that a denied claim is final. A large number of claims are initially denied, but an experienced workers' compensation attorney can turn that denial into a settlement on your behalf. Don't give up if your claim is denied. Instead, you should immediately contact an attorney for a consultation.
Seek Legal Assistance
It’s difficult to be objective about your claim when you’re focusing on recovering from your injuries and worried about how to pay your bills. Our skilled workers’ compensation attorneys can help prepare your case and advocate for the highest settlement available.
Your attorney will take into consideration factors such as:
- Your work restrictions.
- Your permanent partial disability rating.
- Your previous earnings.
- Past medical expenses.
- Future medical expenses.
Your attorney can also investigate the possibility of third-party claims. If another party’s negligence caused or contributed to your injury, this can substantially increase your compensation. For example, you may be eligible to pursue a personal injury claim against the manufacturer of faulty equipment or the driver of another vehicle that caused your work-related accident.
Rechtman & Spevak is dedicated to helping Georgia residents receive fair and timely workers’ compensation settlements. Please call 404-355-2688 or fill out our online contact form to get started with a free, no-obligation consultation.
How much is it going to cost me to hire an attorney on my workers’ compensation claim?
No matter what attorney you hire on your Georgia workers’ compensation claim, the fee is going to be the same. All lawyers who handle these types of claims will charge you 25% of the income benefits that they obtain on your behalf. This amount is regulated by state law. This fee only applies to money that your attorney gets for you. If you are already receiving benefits prior to hiring your attorney, or if the benefits are started voluntarily by the insurer, then your attorney doesn’t get any part of that. Attorneys usually earn their fee out of a settlement at the end of your case. However, you shouldn’t worry about having to pay a percentage of your settlement to your attorney. This is because experienced workers’ compensation attorneys will get you significantly more in settlement than the insurer would pay you if you were unrepresented.
How do employers choose their panel of workers' compensation doctors?
In Georgia, employees injured on the job may be entitled to medical, rehabilitation, and income benefits under the state's Workers' Compensation Law. Workers' compensation covers a wide range of authorized medical expenses, including doctor bills and hospital bills.
However, unless a worker's injuries are emergent in nature, their employer is unlikely to cover medical care provided by just any doctor.
Instead, in most cases, the injured employee is required to choose a physician from the employer's panel of workers' compensation doctors.
By law, this panel must:
- Be comprised of six unaffiliated doctors or clinics
- Include at least one orthopedic surgeon
- Have no more than two industrial clinics
- Include at least one minority doctor, based on ethnicity or gender
The doctors on this panel are chosen by the employer, often in consultation with its insurer. Additionally, employers can review the performance of the doctors on their panel and change them if they don't live up to their expectations.
The ability to choose and change the doctors on the panel is good for employers and insurers, as it gives them some measure of control over who's treating individuals who are injured on-the-job and, ultimately, how the claim is handled.
Unfortunately, this can be detrimental for injured workers. While some employers may choose well-qualified physicians who treat workers fairly, others may opt for doctors with reputations for keeping costs down by:
- Minimizing workers' injuries
- Failing to relate some or all of the injured worker's complaints to their on-the-job accident
- Recommending low-cost treatment options, even if higher-cost treatments are more effective
- Returning injured workers to work with restrictions too quickly
- Assigning a low permanent impairment rating
- Releasing injured workers from their care and sending them back to their regular job prematurely
Fortunately, knowledgeable attorneys with experience handling workers compensation cases can help injured workers choose a doctor from the panel who is more likely to listen to their concerns and treat them fairly. If you are dissatisfied with the treatment being provided by your treating physician, your attorney may be able to get your care transferred to a new doctor. Under Georgia law, you are entitled to a one-time change to another doctor on the employer's panel of physicians without obtaining prior approval.
Were You Injured on the Job?
Rechtman & Spevak is committed to helping injured Georgia workers receive the workers' compensation benefits they need and deserve. Contact us today to schedule an appointment for a free initial case consultation with one of our workers' compensation attorneys.
Are heart attacks and strokes covered by workers' compensation in Georgia?
There are approximately 1.5 million heart attacks and strokes each year in the United States. According to the American Heart Association and the American Stroke Association, the majority of heart attacks and strokes that happen outside of hospitals occur in public settings, including workplaces.
Heart attacks and strokes are not generally compensable as workers' compensation injuries. However, in Georgia, an injured worker may be able to collect workers' compensation benefits if he—and his attorney—can prove “by a preponderance of competent and credible evidence” that the worker's employment duties caused or contributed to the condition.
Well-Documented Medical Records Are Essential
Workers' compensation claims for heart attacks or strokes must include extensively documented medical evidence, which can be provided by the doctor who treated the injured worker, or a non-treating physician who's been asked to give an opinion after reviewing the individual's medical records. Other, non-medical evidence used to support these types of Georgia workers' compensation claims include testimony from witnesses, as well as testimony from the injured worker.
Common lifestyle and genetic risk factors for heart attack and stroke include:
- Unhealthy diet
- Family history of heart attack or stroke
- High cholesterol
- Coronary artery disease
However, even workers who have modest to moderate lifestyle and genetic risk factors may still be able to collect workers compensation benefits for an on-the-job heart attack or stroke if they can show their job duties are physically demanding and include a lot of heavy lifting, or expose them to excessive heat or cold, or induce mental and emotional stress.
Consult an Experienced Workers' Compensation Attorney
If you suffered a heart attack or stroke in the workplace and believe that your work duties caused or contributed to your injuries, you may be entitled to collect workers' compensation benefits for medical expenses, lost wages, and other damages.
Why do nurses, nursing assistants, and other hospital personnel experience so many work-related injuries?
Nurses, nursing assistants, orderlies, technicians and other healthcare personnel provide compassionate care to patients experiencing health problems and crises. Unfortunately, in doing so, they have an increased risk of sustaining or developing serious workplace injuries and illnesses. According to the Department of Labor's Bureau of Labor Statistics (BLS), more than 35,000 nursing employees sustain on-the-job injuries each year. Many have to miss work as a result.
Nursing may not seem like a particularly hazardous profession. However, the injury and illness incidence rate is six cases per 100 full-time workers. This means private industry hospital workers are more likely to suffer significant on-the-job injuries than employees in more traditionally dangerous industries, such as construction, manufacturing, commercial trucking, and warehousing.
What makes the healthcare field so perilous for nurses, nursing assistants, and other medical professionals? In addition to exposing employees to illness, jobs in this field are physically demanding, requiring workers to lift, move, or reposition numerous patients on a daily basis.
Common on-the-job injuries for nurses and nursing assistants include:
- Sprains, strains, and tears. These injuries are often serious—in 2015, most required an employee to miss more than 31 days of work.
- Cuts and punctures
- Herniated discs. Orderlies and nursing assistants suffer back injuries at a rate three times higher than construction workers.
The causes of such injuries vary, but often include:
- Overexertion and bodily reaction. Comprised of injuries sustained while lifting or moving patients, these incidents accounted for more than 24,000—or 45 percent—of private hospital injury cases in 2015.
- Falls, slips and trips. These injuries made up 25 percent—or more than 13,200—of private hospital cases in 2015, according to the BLS.
- Exposure. The Georgia Nurses Association estimates that health care workers sustain between 600,000 and 800,000 needlestick and sharps injuries each year. As a result, nurses and other healthcare aides are frequently exposed to airborne illnesses, bloodborne pathogens, chemicals, and other hazards.
- Workplace violence. Nurses and orderlies are often assaulted by upset or ill patients or their family members.
Consult an Experienced Workers' Comp Attorney
Workplace injuries often have significant financial consequences for healthcare workers. If you're a nurse, nursing assistant, or other health care worker who was injured while performing job-related duties at Emory Healthcare, Northside Hospital, Piedmont Healthcare, or in a private nursing facility, you may be entitled to workers' compensation benefits.
The knowledgeable workers' compensation attorneys with Rechtman & Spevak can help you protect your rights every step of the way. Contact us today to schedule an appointment for a free initial case consultation.
Does workers' comp provide benefits if an employee is injured by workplace violence?
Violence in the workplace is more common than people think. According to the Occupational Health and Safety Administration (OSHA), a federal agency tasked with regulating private industry workplace health and safety, as many as 2 million workers report having been the victims of on-the-job violence each year.
The Many Types of Workplace Violence
Workplace violence can come in many forms, including threats or acts of physical or sexual assault, intimidation, harassment, or other threatening or harmful behavior. Instances of violence in the workplace often involve other employees, but in some cases, they may involve clients, customers, and even visitors.
A victim of workplace violence may suffer serious physical, emotional, and psychological injuries that require extensive medical treatment. The cost of such treatment can take a toll on an injured worker’s finances—particularly if he’s unable to work while recovering from his injuries.
Fortunately, injured workers may not have to shoulder these financial burdens on their own. Workers who were assaulted while performing work-related duties may be eligible to collect workers' compensation benefits—as long as they weren't the initial physical aggressor.
Under Georgia's Workers' Compensation Law, workers who are injured on the job are entitled to compensation for related medical expenses, as well as temporary or permanent partial disability payments. An experienced workers' compensation attorney can help workplace violence victims ensure they receive all the benefits they're owed.
Our Attorneys Can Help Injured Workers Protect Their Rights
Georgia's Workers' Compensation Law can be confusing for those who have no previous experience with the system. However, if you sustained serious injuries in a violent attack that occurred in the workplace or while performing your work-related duties, you may be eligible for workers' compensation benefits. The skilled attorneys with Rechtman & Spevak can investigate your claim and help you explore your options for compensation. Contact us today to schedule an appointment for a free, no-obligation initial case consultation.
What is reasonable and necessary medical care in a worker's comp case?
Georgia law requires employers to provide medical benefits as part of workers' compensation for employees who've suffered on-the-job injuries. However, only reasonable and necessary medical expenses are covered.
Defining Reasonable and Necessary Medical Care
Under Georgia workers' compensation law, "reasonable and necessary" is thought to mean treatment in line with the standard of care for a specific condition.
For example, if you fell and broke your arm while delivering packages for FedEx or UPS, you'd expect to be provided with a diagnostic x-ray and a cast. If you sprained your ankle slipping on a wet floor while helping a customer at Lowe's or Home Depot, you'd expect to be provided with crutches and physical therapy exercises to help the injury fully heal.
Generally speaking, emergency room visits, basic diagnostic testing, limited physical therapy, and painkillers prescribed right after an injury are unlikely to be denied.
However, requests for coverage are often debated when medical expenses involve:
- Specialized equipment with deluxe features not found on standard models
- Modifications to the home to accommodate a disabling injury
- Care provided by attendants with little or no medical training
- Alternative treatments such as massage, yoga, acupuncture, chiropractic care, or water therapy
- Pain management
- Psychiatric care
- Extensive diagnostic testing
- New and experimental treatments with little research to support their effectiveness
- Duplicative treatments ordered by multiple doctors
- Specialized treatment ordered by a non-specialist health care provider
Some of the expenses a workers' comp insurance company may attempt to deny may very well be medically necessary. For example, modifications to the home would be an excessive expense for an employee with a minor back injury, but a perfectly reasonable request for someone suffering from permanent paralysis.
The Value of Legal Representation
If you're having trouble getting workers' compensation benefits to include medical expenses you believe are reasonable and necessary, it's a good idea to contact an experienced attorney who can advocate for your needs. Letting an attorney negotiate on your behalf maximizes potential compensation while giving you more time to focus on recovery from your injury.
Rechtman & Spevak's legal team is committed to helping injured Georgia residents resolve their workers' compensation claims fairly and promptly. Contact us today to schedule a free, no-obligation initial consultation.
How can I prove I am not an independent contractor to get the workers’ compensation benefits that I deserve?
In the modern economy, misclassification of workers is a significant and growing problem. While it was once rare for workers to be considered independent contractors, a large section of the workforce is now under this classification.
On the surface, the differences between an employee and an independent contractor may appear to be minimal. Some Georgia companies regularly hire employees and independent contractors to work side by side doing very similar tasks. However, if you’re hurt at work, being misclassified as an independent contractor will lead to a denial of workers' compensation benefits.
Proving the Nature of Your Relationship
In the simplest terms, an independent contractor is someone who does not have taxes taken out of his check and has no access to employer-provided benefits such as health insurance, a retirement plan, and paid vacation.
However, a business can’t simply decide on its own that you are an independent contractor. There is a specific legal definition for this term based on a number of different factors related to behavioral control, financial control, and the nature of your relationship with the business.
Classifications Based on Supervision of Work
- You are likely an employee if you have a supervisor who determines when, where, and how you must perform your work.
- You are likely an independent contractor if you work with minimal supervision and the business is only concerned with the end result of your work.
Classifications Based on Training
- You are likely an employee if the business provides you with specific training designed to help you perform your work in a certain way.
- You are likely an independent contractor if it is assumed that you either have the necessary training to do your job or will seek out training on your own time.
Classifications Based on Evaluation of Work
- You are likely an employee if your work is evaluated based on how it is performed.
- You are likely an independent contractor if your work is evaluated based on the quality of the final product or service.
Classifications Based on Nature of Services
- You are likely an employee if your work is a key part of the business. For example, if you are a server or cook in a restaurant, your employer is likely controlling your work to a significant degree.
- You are likely an independent contractor if your services do not relate to the business’s core mission. For example, consultants who provide accounting or marketing assistance to a manufacturing company are likely to be considered independent contractors.
Classifications Based on Investment in Materials and Supplies
- You are likely an employee if the business you work for provides you with the tools necessary to perform your work.
- You are likely an independent contractor if you are required to buy the materials needed to perform your work, such as a computer, specialized software, and general office supplies.
Classifications Based on Opportunity for Profit and Loss
- You are likely an employee if you’re paid a fixed hourly rate or a set salary.
- You are likely an independent contractor if you can either profit or lose money, based on the time and expenses necessary to complete your work.
Classifications Based on Permanency of Relationship
- You are likely an employee if you have a fixed, ongoing relationship with one business.
- You are likely an independent contractor if you are hired for a specific project or task and regularly work with more than one business at a time.
How Rechtman & Spevak Can Help
If you believe that your employer is trying to inaccurately classify you as an independent contractor in order to deny you access to workers’ compensation benefits, it’s vital that you seek the assistance of an experienced attorney as soon as possible. Do not take the risk of representing yourself, as mistakes can leave you responsible for your own medical expenses and lost wages.
Rechtman & Spevak’s attorneys are committed to helping Georgia employees receive the worker’s compensation benefits that they are entitled to. Call today to schedule a free, no-obligation initial case review.