Georgia Workmen’s Compensation Eligibility Rules

One common question people ask our Atlanta workers compensation attorneys is who qualifies for benefits. You must meet certain certain requirements to be eligible for workers compensation in Georgia.

Navigating a workers compensation claim can be challenging, especially in Georgia. Whether you’re dealing with workers comp insurance or seeking to understand the intricacies of the workers compensation statute, it’s crucial for injured workers to be well-informed. In this guide, we’ll explore the essentials of filing a Georgia workers compensation claim, the process for injured employees to start receiving workers compensation benefits, and how to manage medical expenses following a workplace injury. Understanding these aspects can ensure you get the support you need during your recovery.

Here are the most important conditions you must meet in order to qualify for filing a workers comp claim and receiving benefits. If you aren’t sure whether you meet the requirements, contact us for a free consultation.

1.  Employment Status

The Georgia Workers Compensation Act states that all employers with at least three employees must carry workers comp insurance. Independent contractors are not covered by workers comp.

Under Georgia workers compensation law, an individual’s employment status plays a critical role in determining eligibility for benefits. Both full-time and part-time employees are covered, but independent contractors typically are not. Seasonal workers may be eligible under certain conditions. When an on-the-job injury occurs, the injured employee must report it to their employer, who then notifies the insurance company. The State Board of Workers’ Compensation oversees the process. Eligible employees can receive medical benefits, weekly income benefits, and wage replacement based on their average weekly wage. Unlike health insurance, workers comp insurance specifically covers work-related injuries and illnesses. Employees with the same employer can claim income benefits for lost wages due to their injury.

Thus, one of the first things a lawyer will check is your employment status. In some cases, even if your employer states that you are an independent contractor, an experienced attorney can prove that you are actually an employee.

So, do not give up as soon as your employer tells you that you do not qualify for workers comp. Talk to an experienced lawyer to understand your rights.

2. Eligibility According to the Workers Compensation Act

Eligibility for workers’ compensation in Georgia is determined by several factors under the Georgia Workers Compensation Act. A business must have three or more employees, including part-time and seasonal employees, to qualify. The injured employee must have been performing job duties when injured. The workers compensation insurance carrier calculates benefits based on the average weekly wage. Eligible employees can receive weekly benefits or a lump sum settlement. Georgia business owners must comply with these regulations to ensure injured employees receive benefits as mandated by the Workers Compensation Act.

Employers in Georgia are not required to provide coverage for some categories of workers. These are:

• Railway and maritime employees – who have their own specific coverage plans
• Farm laborers
• Domestic workers
• Volunteers.

You may not be eligible for workers compensation if you fall into one of these groups.

Some employers may choose to carry workers compensation insurance even when it’s not required. You can look up if an employer has workers compensation insurance using the workers compensation coverage verification tool.

3. The Accident Must Happen While You Are On the Clock

Workers compensation only covers injuries and illnesses that are related to your job. You can file a claim if you develop an occupational illness or suffer a workplace accident. For workers’ compensation to be applicable, the accident must occur while you are on the clock. This means the injury must happen during your work hours while performing job-related duties. For example, if a part-time employee slips and falls while stocking shelves, they can file a workers compensation claim to receive benefits. These benefits may cover medical bills, receive medical treatment, and future medical treatment. To ensure you receive workers compensation, it’s advisable to consult an experienced workers compensation lawyer. Workers comp insurance helps cover these expenses, ensuring employees get the necessary support.

If you are driving to or from work or are on your lunch break, you generally do not have a case. The experienced lawyers at our firm know that there are exceptions, such as:

• You got injured during a working lunch.
• You were driving to a business appointment as part of your job duties.
• Your employer specifically sent you to perform a task (such as buying office supplies).

4. You Must Have Performed Your Assigned Job Duties

To be eligible for a workers’ compensation claim, an employee must have been performing their assigned job duties when the injury occurred. This applies to all workers, including part-time employees and farm workers. For example, if a farm worker suffers a work injury while operating machinery as part of their job, they can file a workers compensation claim. Consulting a workers compensation attorney can help navigate the process, ensuring the injured employee receives medical care and other benefits. An experienced attorney can effectively handle workers comp cases to secure appropriate compensation.

Another important requirement for workers comp benefits is that you should have been acting within the scope of your employment when you suffered the accident. Let’s illustrate this with an example.

A bartender decides to help a delivery worker bring in heavy crates and suffers a back injury. However, bringing in merchandise is not listed as the bartender’s job duties. Thus, he or she does not have the right to file a claim.

It would be a different story if a supervisor instructed the bartender to help the delivery worker bring in the goods faster. In this case, the injured worker has a valid claim.

5. You Must Not Have Been Under the Influence of Alcohol or Drugs

Workers compensation does not pay benefits if employees are injured because they were under the influence of drugs or alcohol. If you refuse to take a drug test, your workers comp claim will be denied.

Ensuring an employee was not under the influence of drugs or alcohol is crucial when submitting a Georgia workers’ compensation claim for several reasons. Firstly, workers’ compensation cases require that the injury or illness occurred while performing job duties, and substance influence can cast doubt on the validity of the workplace injury. Secondly, sobriety ensures adherence to safety protocols, reducing the likelihood of work injuries. Additionally, workers compensation settlements, including weekly income benefits and medical benefits, are intended for those injured while responsibly performing their job. Substance influence disqualifies workers from receiving these benefits, as their condition could have contributed to the injury. Lastly, providing medical benefits and weekly income benefits to employees under the influence can lead to legal and ethical challenges for both the company and the workers’ compensation system. Maintaining sobriety is essential to uphold the integrity of the workers’ compensation system and ensure injured workers receive appropriate support.

Your employer’s insurance company will argue that you drank alcohol or used drugs before coming into work, and this is why you hurt yourself.

Talk With an Experienced Atlanta Workers Compensation Attorney!

Knowing all the ins and outs of Georgia workers comp law is difficult for the average employee. This is what lawyers are for. Our legal team has in-depth knowledge of the law and years of experience in a wide range of cases.

Navigating Georgia workers compensation law can be complex, but utilizing a workers compensation lawyer can significantly enhance the process. A lawyer can ensure your workers compensation claim is correctly filed, helping you receive workers compensation benefits for a job injury. They can also negotiate workers compensation settlements to maximize your compensation and secure appropriate income benefits. By leveraging their expertise, you can better understand your rights and improve your chances of a favorable outcome.

So, do not give up on your chances to get benefits without getting reliable legal advice. Call us today at 470-518-5026 to schedule a free case review with an experienced Atlanta workers compensation attorney!