If you’ve been injured at work, Georgia employees are entitled to certain benefits by law. However, there are instances where your employer or its insurance company might deny your claim, delay payment, or otherwise drag their feet. When this occurs, working with a skilled Atlanta workers’ comp lawyer can get you the answers you need, as well as make sure payments are on the way.
By law, the State Board of Workers Compensation has certain deadlines set by which they must respond to your claim. If you are concerned about missing deadlines, delayed responses, or any element of your claim being challenged, Ramos & Law can help. We are a Georgia Workers’ Compensation law firm focusing only on helping injured Georgia workers get the support and compensation they need. One of our attorneys is available to take your call. We begin each of our cases with a complimentary consultation about the facts of your claim. Contact us today for yours.
Understanding Workers’ Compensation Disability
Factors that contribute to your workers’ compensation timeline include the types of benefits for which you are eligible, the kind of injury you have sustained, and the medical recommendations you receive from your doctor. It also depends on the Employer and Insurer communication. Not every injury follows the same timelines for the start of income benefits, rendering of medical care, or medical mileage reimbursement. Depending on the severity of your occupational injury, you may find yourself sidelined for a longer period of time than expected. Moreover, you might be eligible for temporary or permanent disability payments in addition to remedial medical care. The following are different kinds of Georgia workers’ compensation income benefits:
Temporary Total Disability (TTD)
If you are injured and cannot return to work in any capacity because of the work-related injury for over 7 consequent days as permitted by an authorized treating physician, you may be eligible for temporary total disability payments. If the authorized treating doctor places you on light duty or restrictive duty status and your employer cannot accommodate your medical limitations stemming from the work-related accident, then you may also qualify for these payments. For example, the nature of some jobs may be so physically demanding that would be no alternative “light duty” available. This is common in professions such as landscaping, trucking, factory work, merchandise stocking, bartending, and waitressing. Also, not every job involves lifting over 30 to 50 pounds, however. If your occupational injury results in carpal tunnel syndrome diagnosis that prohibits you from using your hands normally and you work as a court stenographer or typist, you may also qualify for temporary total disability during the time that you need to recover.
Remarkably, the Georgia law allows the insurance company a 21 day “waiting period” before it has to issue your temporary total disability payments. There is also no requirement that payment must be made electronically. The maximum number of weeks an injured worker may receive benefits is 400 weeks from the date of accident. This is rarely reached as many workers recover, return to work, or the authorized treating physicians medically release them. If you were occupationally injured in Georgia after July 1, 2023, the maximum weekly workers’ compensation payment you can receive is $800.
Temporary Partial Disability (TPD)
Temporary partial disability payments often apply in cases where you can return to work in an altered or “diminished earning” capacity. If you are earning less than you were before because of your work injury, even if you are able to return to work during your recovery period, you may be able to collect temporary partial disability payments. These payments are dependent on your pre-injury wages, your work duties, and your post-injury wages. As you can imagine, this analysis is very fact sensitive.
Like temporary total disability checks, there is a cap on how much you can collect. A Georgia worker who has been injured and returns to light duty work cannot collect more than $533 per week if the Georgia injury occurred after July 1, 2023. These temporary partial disability benefits may be available 350 weeks from the date of the work accident.
Permanent Partial Disability (PPD)
Permanent partial disability claims are common when a worker has been certified that he or she has reached maximum medical improvement by the authorized treating physician and has permanent residual limitations or impairments because of the work accident. Typically, this “impairment rating” measures the percentage of functional loss the occupational injury has caused. This PPD rating is determined by the Georgia authorized treating physician pursuant to the American Medical Association’s Guide to Impairment, 5th Edition.
Catastrophic Designation
If your occupational injury is such a nature and severity where you can never return to work for your employer or any other employer, then you might be eligible for lifetime income and medical benefits, as well as vocational rehabilitation. This designation is usually hotly contested by the insurance company. However, there are some injuries that are automatically “catastrophically designated” under the law. These injuries typically involve the loss (or loss of use) an arm or leg, severe brain injuries, blindness, or severe spinal cord injuries.
When Can I Expect a Workers’ Compensation Check After an Atlanta Workplace Accident?
Do not let your employer get away with delayed payments or missing checks. In the state of Georgia, there are specific timelines that employers and their insurance company must follow for making workers’ compensation payments to you once you have been injured on the job. If they fail to do so, they can be held accountable fines and penalties.
It is important to understand that you may not receive payments immediately after being injured on the job. You must first notify your employer within 30 days of the accident, injury, or on the job illness.
You must be seen and treated by the authorized physician, who will certify that your condition is eligible for workers compensation payments. You must then wait 7 consecutive days of missing work due to a qualifying occupational injury or illness. You can then expect to receive a check during the first 21 days after you missed work due to your illness or injury. If you are out of work for over 21 days, you will be compensated for the first 7 day waiting period as well.
If they fail to pay you timely, the Employer and Insurance Company may be hit with a 15% penalty fee applied for each late payment that your employer sends you. Under O.C.G.A. 34-9-221, a workers comp check is considered late when it is postmarked outside of the week for which benefits are due. If your company’s insurer is based outside of the state of Georgia, then your disability check must be mailed 3 days prior to the due date.
Why Haven’t I Received My Georgia Workers’ Comp Benefits Yet?
Common issues that delay Georgia workers’ compensation payments include:
- Your address or personal information is incorrect.
- Your employer has not reported in injury to its insurance company.
- Your US Postal Service mail delivery service is delayed.
- Your check has been lost by the US Postal Service.
- Your doctor has not yet certified your work status.
- Your employer’s insurance provider is dragging its feet.
A delayed workers’ comp payment can be a brutal blow when you need it the most. When you’re sick or injured and have medical bills piling up, the entire situation can be extremely overwhelming. It is not smart to go head-to-head and toe-to-toe with the insurance company and its attorneys by yourself. Remember: under Georgia law you are entitled to timely payments of your workers’ comp benefits. Call Ramos & Law and we advocate on your behalf and ensure you get the compensation you deserve.
How can I track my Workers’ Comp checks?
The dates for your workers’ comp benefits should be listed on either your pay stub or on the check itself. Additionally, please keep track of the post-mark on the envelops of these payments. If the payments are incorrect or made untimely, you may be able to collect late fees and penalties from your employer. However, the burden will be on you to prove the insurance company’s mistake. Hence, keep these records in case you need to share them with your attorney.
What If My Claim Is Denied?
If you are not receiving workers’ compensation payments of any kind (medical or income), you generally have within one year from the date of your accident to file Form WC-14 Notice of Claim / Request for Hearing with the State Board of Workers’ Compensation. Under Georgia state law (O.C.G.A. 34-9-102(a)), a hearing with the State Board of Workers’ Compensation shall be scheduled at least 30 days after filing of your initial WC-14, but no longer than 90 days. A judge will be involved in examining the facts and evidence in your case. You may be asked to testify, or to submit to an independent medical examination. If your case is challenged at all, both sides will have up to 30 days to respond to the other side’s discovery process under the Georgia Civil Practice Act.
Once a settlement has been reached, your employer or its insurance carrier has 20 calendar days to pay you the settlement. These are not business days, but calendar days. If your employer or insurance carrier fails to pay your workers’ comp settlement in this period, they can be held liable for a 20% workers’ comp late payment penalty on top of what they already owe.
How Can a Georgia Workers’ Comp Lawyer Help?
Working with a workers’ comp attorney can level the playing field against the corporate insurance carriers. Their mission is to deprive you from any and all benefits you may be entitled to receive. The adjusters have been known to provide injured workers false or misleading information and have generally “gotten away with it.”
At Ramos & Law, we will compile and keep a record that documents your injury, your costs, and all your paperwork and WC filings. We will zealously go after all of the compensation you are legally entitled to receive. As a former insurance defense lawyer, Mr. Bryan Ramos, is able see through workers’ comp delay tactics and hold them accountable. We will not let late fees and additional penalties slip through the cracks. If your claim is challenged or denied, we will provide thorough and expert legal representation in Georgia. Georgia workers’ compensation law is all we do.
As every workers’ compensation case is different, there is no set timeline that can be universally applied to every case. Ramos & Law has had cases settle within one week while we have had severe cases go on for many years. On average, we try to resolve most cases within 4 to 6 months but it really depends on the facts of each case including the adjuster’s position; the workers’ situation; the authorized treating physician opinion; and a host of other things. Regardless of the case facts, Ramos & Law strives to reach a resolution as fast as possible as we understand that your life and well-being are better served outside of the workers’ compensation system.
If you want a workers’ compensation expert advocating for your well-being, retaining Ramos & Law will ensure you are protected and you case will have appropriate value in the eyes of the insurance company. Let our firm handle the details of your claim so that you can get back to what matters most after your injury or workplace accident. Contact Ramos & Law today to see how we can help.