What is a Workers' Compensation Claim?
When an employee is injured while working for an employer with three or more employees in its service, then in most cases the injured employee has a workers' compensation claim. The claim begins the very second the accident resulting in injury occurs, and although the injured employee must give notice to the employer that the accidental injury occurred, the employee is not required to "sue" his or her employer to start the claim or get benefits. Rather, any refusal on the part of the employer or its insurance company to provide the benefits required by law is addressed when the denied employee hires an attorney to request a hearing. Workers' compensation hearings are held before an administrative law judge before the Trial Division of the State Board of Workers' Compensation. A workers' compensation hearing can be requested to address limited issues (such as refusal to approve and provide certain medical care) or in the case of a denied claim a hearing is requested to ask the Judge to issue an Award for all available benefits. If an employee is injured at work, in most cases he or she must treat and seek benefits within the State's workers' compensation system, and cannot "sue" the employer. Rather, as it pertains to the employer and their insurance company a workers' compensation claim is the injured employee's "exclusive remedy" to obtain benefits. However, if a third party is also responsible in some way for the same injury, the injured employee may have a separate civil action against parties (other than the employer) outside of the workers' compensation claim.
What is Available in a Workers' Compensation Claim?
If a workers' compensation claim is "accepted" by the insurance company, either voluntarily or following a hearing, an injured worker can receive three forms of benefits: (1) income benefits, (2) payment for medical treatment with an authorized treating physician, and (3) permanent partial disability benefits. In the event that an injured worker is disabled from work by the authorized treating physician, or if the physician assigns work restrictions that the employer cannot accommodate, then the insurer or self-insured employer is usually required to commence weekly income benefits in the amount of two-thirds of the injured employee's "average weekly wage." Additionally, the injured employee is allowed to treat with the authorized physician at no cost to the injured employee, and in some cases with other authorized physicians to whom the injured employee is referred by the primary authorized physician. At the point when the injured employee is deemed to be at "maximum medical improvement" by the authorized physician, and no longer receiving any form of income benefits, in some cases the injured employee is also entitled to permanent partial disability benefits after receiving an "impairment rating" from the authorized physician.
What is Not Available?
The Georgia workers' compensation system does not allow for injured employees to recover punitive damages or many of the compensatory-type damages available in civil actions, such as pain and suffering, defamation, loss of consortium, etc. The closest thing to compensatory damages available in a workers' compensation claim is the payment of permanent partial disability benefits ("PPD"). Specifically, once the authorized physician in a claim has stated that the injured employee is at maximum medical improvement ("MMI"), the physician will issue an "impairment rating." Under the law, the impairment rating translates into a monetary payment to the injured employee based on certain factors. When the injured employee is no longer receiving any form of weekly income benefits the insurer is required to pay PPD benefits to the injured worker either weekly or in lump sum. This payment is designed to represent compensation for the permanent loss of use of the injured body part.
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Representation for Everyone
We handle workers' compensation claims for people from all walks of life, in every profession covered by the Georgia Workers' Compensation Act. Our clients work in construction, health services, transportation, manufacturing, airport services, education services, food services, law enforcement, engineering, warehousing, trucking, office administration, landscaping, and nearly every industry. Our clients are constructions workers, teachers, professional and commercial drivers, nurses, LPNs, wait staff, child-care workers, nursing home workers, plumbers, electricians, mechanics, retail workers, police officers, retail workers, and more. Workers' compensation injuries are not unique to heavy-labor professions; they effect people across many different professions. The Conklin Firm has the legal expertise and resources to handle even the most challenging workers' compensation claims.