What Happens When Workers Comp Is Approved?

Workers compensation is a critical safety net for employees who are injured on the job or suffer from work-related illnesses. In Georgia, the workers’ compensation system is designed to provide financial and medical benefits to help injured workers recover and return to work. However, navigating the workers’ comp claims process can be complex and daunting.

This comprehensive guide aims to shed light on what to expect when workers comp is approved and how you can effectively manage your claim with the help of an Atlanta workers’ compensation lawyer.

At Workers Compensation Lawyer Coalition, we are here to help you get the benefits you deserve. Contact us today for a free consultation.

How Does Workers Comp Work in Georgia?

In Georgia, employers with three or more employees are required to have workers’ compensation insurance. Workers compensation coverage provides benefits for employees who are injured on the job or develop work-related illnesses. Independent contractors are not covered by workers’ compensation.

Once a workers comp claim is approved, the injured worker can receive benefits to cover medical costs and a portion of lost wages. In cases of severe or permanent injuries, additional benefits may be available.

Workers Compensation Benefits

When your workers’ comp claim is approved in Georgia, you become eligible for several types of benefits designed to support your recovery and compensate for your losses. These benefits generally fall into three main categories.

Medical Benefits

Workers compensation covers all necessary and reasonable medical expenses related to your work injury. This includes doctor visits, hospital stays, surgeries, physical therapy, medications, and any required medical equipment. You are entitled to these benefits as long as you need medical treatment for your work-related injury.

The employer’s workers’ compensation insurance carrier is responsible for paying these medical expenses directly to the healthcare providers. For medical costs to be covered, you must choose a treating doctor from a panel of authorized physicians.

Income Benefits

If your injury prevents you from working for at least 7 days, you are eligible for disability benefits. These weekly benefits are typically two-thirds of your average weekly wage, up to a maximum amount set by Georgia workers’ compensation law.

You typically cannot receive benefits for more than 400 weeks. Most injured employees recover long before that time.

Rehabilitation Benefits

For injured workers unable to return to their previous jobs, vocational rehabilitation services may be provided to help them find new employment or retrain for a different occupation. This might involve job training, education, or assistance with finding a new job.

How Much Are Workers Comp Benefits in Georgia?

Understanding the payment structure for workers’ compensation benefits in Georgia is crucial for employees who are injured on the job. Here’s a breakdown of the benefits you can receive once workers comp is approved.

Temporary Total Disability (TTD)

Temporary total disability benefits are paid when you are completely unable to work due to your workplace injury. These workers comp benefits are two-thirds of the worker’s average weekly wage, up to a maximum set by state law. You can receive TTD benefits for up to 400 weeks

Temporary Partial Disability (TPD)

If an injured can return to light-duty work at reduced pay, they may receive temporary partial disability benefits to partially offset the wage difference. TPD benefits are calculated as two-thirds of the difference between your pre-injury average wages and your current earnings, with a maximum cap.

Permanent Partial Disability (PPD)

After you have recovered as much as possible, your workers’ comp doctor will evaluate if you have a lasting disability. Permanent partial disability benefits are based on an impairment rating assigned by your workers’ comp doctor.

PPD benefits pay two-thirds of your average weekly income. The duration of PPD benefits depends on the severity of your impairment and the specific body part affected.

Georgia law provides a schedule that assigns a specific number of weeks for different types of impairments. For example, the loss of a hand is compensated for 160 weeks, while the loss of a leg is compensated for 225 weeks.

Permanent Total Disability (PTD)

These workers comp benefits are paid in cases of severe, life-altering injuries that prevent injured workers from returning to any form of gainful employment. This applies to injuries that are deemed catastrophic, such as the loss of both hands, both feet, or total blindness.

Permanent total disability benefits can continue for a lifetime.

Workers Compensation Claim Process

Understanding the workers’ comp claims process is crucial to ensure you receive the benefits you deserve. Here is a step-by-step overview of the workers’ compensation claims process in Georgia.

Report the Injury

Notify your employer immediately after an on-the-job injury. In Georgia, you must report the injury within 30 days, or you risk losing your right to workers’ compensation benefits.

Seek Medical Treatment

Your employer should provide a list of approved doctors. It’s important to see one of these doctors to ensure your medical treatment is covered by workers’ compensation.

File a Workers Comp Claim

If the workers comp insurance company does not voluntarily pay your benefits, you can file a Form WC-14 with the State Board of Workers’ Compensation. This officially starts your claim.

Investigation and Approval

Once your workers’ comp claim is filed, it will be investigated by the insurance company. They may request medical records, witness statements, and other documentation. If workers comp is approved, you will begin receiving benefits.

Appeal if Necessary

If your workers’ compensation claim is denied, you have the right to appeal the decision. This often involves a hearing before an administrative law judge.

What Happens When Workers Comp Is Approved?

When your workers’ compensation claim is approved in Georgia, several key things happen.

Start of Benefits

You should receive workers comp benefits if you are unable to work to return to work for more than 7 days. These payments are typically made on a weekly basis. You should receive your first income benefit payment 21 days after you report your injury to your employer.

These weekly payments end when an injured worker reaches maximum medical improvement or returns to work at full capacity. Under Georgia law, weekly workers comp benefits can last a maximum of 400 weeks. There is an exception to the 400-week limit for catastrophic injuries.

Ongoing Medical Care

You will continue to receive necessary medical care until your doctor determines you have reached maximum medical improvement (MMI), which means your condition is stable and unlikely to improve further with treatment.

An injured worker must select an authorized treating physician from the employer’s panel of physicians or use the designated managed care organization. This doctor will:

• Oversee the worker’s medical treatment.
• Determine work restrictions and when the employee can return to work.
• Assess when maximum medical improvement is reached.

Monitoring by the Insurance Company

Throughout the process:

• The insurance carrier will monitor the claim and may periodically request medical updates.
• The injured employee must attend scheduled medical appointments and follow prescribed treatments.
• Any changes in work status or medical condition should be promptly reported to the employer and insurance carrier.

Return to Work

As the employee recovers, the authorized treating physician may:

• Clear the worker to return to regular duties
• Recommend light-duty work with restrictions
• Determine if the worker has any permanent impairment.

If an employee returns to work in a light-duty position, they may receive TPD benefits to supplement the reduced income.

Navigating Workers Compensation Settlements

In some cases, it may be beneficial to negotiate a settlement agreement with the insurance company.

A workers’ compensation settlement can be paid as a lump sum or overtime. In most cases, the settlement is a lump sum payment. However, structured settlements, which provide periodic payments, may be used for severe, disabling injuries.

Timing of Workers Comp Settlements

Workers comp settlements typically occur after injured employees have reached MMI and future medical needs are more predictable. However, they can be negotiated at any point in the claims process.

Valuing Your Claim

Determining the value of your claim involves calculating your future medical expenses, lost wages, and any permanent disability. This requires a thorough understanding of your medical condition and its long-term impact on your ability to work.

Negotiating With the Insurance Company

A settlement must be negotiated with the insurance company. It’s important to have an experienced workers’ compensation lawyer to ensure you receive a fair settlement that adequately compensates you for your losses.

Approval by the Board

All workers’ comp settlements must be approved by the Georgia State Board of Workers’ Compensation. This involves a hearing where the terms of the settlement are reviewed.

How Our Lawyers Can Help Your Workers Comp Claim

Navigating the workers’ compensation system can be complex and challenging, especially when you are dealing with an injury. Here’s how an experienced Atlanta workers’ compensation lawyer can help you.

• Expert Guidance: A lawyer can provide expert guidance throughout the claims process, ensuring you understand your rights and options at each stage.
• Filing Your Workers Comp Claim: Your lawyer will help you properly file your workers’ compensation claim and gather the necessary documentation to support it. This increases the likelihood of your claim being approved.
• Handling Disputes: If your workers’ comp claim is denied or disputed, a lawyer can represent you in appeals and hearings, advocating for your rights and helping you obtain the benefits you deserve.
• Negotiating Settlements: A skilled lawyer can negotiate with the insurance company to secure a fair settlement.
• Maximizing Your Benefits: Your lawyer will work to maximize your benefits, whether through ongoing income benefits or a lump sum settlement.

Call Our Atlanta Workers Compensation Lawyers Today

Having your workers’ comp claim approved in Georgia can provide crucial financial and medical support as you recover from a work-related injury. However, navigating the system and ensuring you receive the full benefits you are entitled to can be challenging.

Our experienced Atlanta workers’ compensation lawyers can effectively manage your claim and maximize your workers’ comp benefits. You pay no legal fees unless we secure compensation for you.

If you have been injured at work, contact us today for a free consultation to discuss your workers’ comp case and learn how we can help.