
Georgia is an industrious and hardworking state, but even the most efficient and careful workers can still get hurt on the job. When injuries or illnesses arise from the workplace, employees’ only option is to file for workers’ compensation benefits. Unfortunately, the Georgia workers’ compensation claims process is difficult to navigate and deceptively complex. Below is a breakdown of steps of how you can avoid common mistakes that may jeopardize your case. If you have any legal questions regarding the workers’ compensation process in Georgia, or you need representation in an ongoing case, contact Ramos & Law for a free consultation.
Notify Your Employer and Get Medical Attention as Soon as Possible
The first and most important steps in the workers’ compensation claims process are getting immediate medical attention and notifying your employer of your injury. The order in which you complete these steps depends on the severity of the injury. If your injury requires emergency intervention, dial 911 or go to the nearest hospital and explain to medical staff that you were injured at work. As soon as you are able to do so, notify your employer about your injuries.
If your injury cannot be reasonably considered an emergency, you will want to notify your employer first before seeking treatment. In Georgia, employers must maintain a list of at least six pre-approved doctors within their workers’ comp insurance network. This list should be prominently posted on the employer’s premises. You are free to choose any doctor listed. If your employer does not have a list of approved doctors, you may be able to choose one of your own.
Note that you only have 30 days to notify your employer of your workplace injury. You generally also have one year to file a Georgia workers’ compensation claim. In some cases, this statute of limitations may be extended. Failing to notify your employer in the necessary timeframe or failing to see a doctor within their network (except in the case of an emergency) can result in your claim being denied.
File a Workers’ Compensation Claim Form
Once you have notified your employer of your injury, the next step is to formally file a claim with the State Board of Workers’ Compensation. Before filling out the necessary forms, you should be prepared by having documents like earning statements and medical bills related to your injury on hand. At any point in the workers’ compensation claims process, you have the right to an experienced workers’ comp attorney. While some people may waive this right, it is generally considered a bad idea. Beyond the challenge of keeping track of various filing and reporting deadlines, many injured workers note that communication with both their employer and their insurance companies can be difficult, if not completely impossible.
A workers’ compensation attorney can not only help file the claim, but they can also represent you throughout the process. Depending on the seriousness of your injuries, this can be a true lifeline if you are dealing with intense pain and do not have the bandwidth to deal with a complicated and frustrating claims process. If a dispute arises, hiring a workers’ comp lawyer is well worth the investment, as getting a claim denied can result in the loss of thousands of dollars, not to mention detrimental effects on our health and sanity.
Be Consistent and Truthful
As with anything else in the legal realm, honesty and consistency is the best policy when it comes to workers’ comp claims. While you should never conceal information about your previous injuries or preexisting conditions, knowing how and when to disclose them is crucial. Additionally, whether you are speaking to a fellow employee, a doctor, or someone from the insurance company, you should ensure your account of the incident remains consistent, or it may jeopardize your claim.
It is important to be especially careful when speaking with an insurance company representative. They may use predatory tactics to get you to say something that will allow them to reduce your benefits or deny your claim. Hiring a lawyer is the best course of action, as he or she can handle communications with your employer and the insurance company for you.
Once you begin receiving treatment for your injury, you will also want to be consistent about adhering to any treatment that the doctor recommends. In addition, keep consistent records about your appointments and communication with medical staff, your employer, and the insurance company.
Maintain and Organize Relevant Documents
From the moment you are injured until your claim is closed, it is crucial to hold onto any documentation related to your case. Clerical errors are common in workers’ compensation cases, and if you ever need to respond to a dispute or file an appeal, you will need all the physical evidence you can muster. Examples of important workers’ comp documents include:
- Photos of the injury and accident scene;
- Medical records and bills;
- Medication receipts;
- Accident reports;
- Names of people you spoke to and what instructions they gave you
- Communications regarding your claim (whether from your employer, doctors, or the insurance company); and
- Pay stubs that document your earnings before your injury.
Be Careful When Dealing with the Insurance Company
As we have gone over earlier in this guide, it is important to work with your employer’s workers’ comp insurance company, but be careful not to forget that it is in their best interest to pay you as little as possible, or not at all. Some insurance companies may go so far as to hire someone to investigate the severity of your injuries. This could involve monitoring your social media accounts, following you in public, or talking to your friends and family to try and catch any inconsistencies in your claim. When communicating with insurance companies directly, never offer more information about your injuries—or anything else—than they ask for, and remember that you can always have a lawyer communicate with insurance companies or your employer on your behalf.
Expect an Independent Medical Examination
From your very first visit, your doctor will make a full examination of your injury and continue to monitor its progress. However, in some instances, the insurance company may decide that your doctor’s diagnosis is not satisfactory and order an independent medical examination (IME). The independent examiner will consider your doctor’s opinion but will ultimately form a diagnosis based on their own examination of your injuries. An IME’s observations may be beneficial to you, but they can also lead your benefits to be reduced or cut altogether. If this happens to you, you should get help from a workers’ compensation attorney as soon as possible.
Hire a Georgia Workers’ Compensation Lawyer
Unfortunately, many workers can follow every suggestion and step listed above and still get their claims denied. If you find that the adjuster is not responding to you or “giving you the run around” or if your claim has been denied, it is time to hire a workers’ comp lawyer to handle your claim. Many workers often choose to hire workers’ comp lawyers preemptively to speed up the process, which can take months to resolve otherwise.
If you are looking for an effective and experienced lawyer to represent you in a workers’ compensation claim in Georgia, Ramos & Law has you covered. Our firm has dedicated our entire practice to ensuring that workers maximize their occupational injury claims and can help you resolve any issues that may come up during the process. Contact our firm at (770) 637-0105 even if your claim has already been denied.