Posted by Louis B. Lusk
What is workers’ compensation? Seems like an innocuous question, but how many working individuals have read their employer’s workers’ comp policy? What is covered? What is not covered? What is the process?
The Georgia State Board of Workers Compensation (SBWC) describes workers’ comp as “a benefits program created by state law that provides medical, rehabilitation, income, death and other benefits to employees and dependents due to injury, illness and death resulting from a compensable work-related claim covered by the law.”
No. If an injury happens during travel to and from work, that is not covered. If an employee is injured while engaging in “fighting, horseplay, [by] willful act of third party for personal reasons, [or suffers] injuries related to alcohol or drug abuse,” those injuries are not covered. The Georgia SBWC also notes that “injuries sustained while engaging in unassigned duties, during lunch and breaks are not covered.”
When a worker is injured in the workplace while executing assigned duties, the first step to take is to inform the employer. There are specific forms to be filled out and the Georgia SBWC advices claimants to “be as specific as possible when reporting your injury. If anyone witnessed your accident, inform your employer of such a witness.” If an employee needs medical assistance, then of course make sure they get medical assistance first.
After an injured individual informs the employer of an injury and receives treatment, then it becomes necessary to file a claim for workers’ compensation benefits to cover the cost of treatment. An individual has “one year from the date of the injury to file a claim. If an individual received remedial treatment from their employer for the injury, then the individual has one year from the date of treatment to file a claim for workers’ compensation benefits.”
If an individual is injured on the job, that individual must choose a doctor from an approved list of physicians. If an individual goes to their personal doctor who is not on the list, then any treatment “is considered unauthorized treatment, and your employer will not be responsible for the cost associated with this medical care. In addition, most health insurance policies will not pay for medical treatment associated with an on-the-job injury.”
If the injury requires immediate medical attention, and even surgery, then medical treatment and even surgery is allowed. However, “once the emergency is over, you must continue your care by selecting a doctor from the list of physicians provided by your employer.”
In addition to payment for medical services and physical therapy, workers’ compensation provides income benefits as well. “The maximum amount of weekly workers’ compensation benefits an employee can receive from an on-the-job injury, illness or death depends on the workers’ compensation rate at the time of the injury and the employee’s average weekly wage.”
While many sources say it is unnecessary to hire a lawyer to deal with workers’ compensation claims, there are quite a few details to keep track of. An attorney can assist with making sure you receive the benefits you are entitled to. Contact our knowledgeable attorneys about assistance with your workers’ compensation claim.