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A work injury can be a very disruptive event in a person's life. Those most affected are high wage earners who suffer a significant injury. The workers' compensation system is designed to compensate you for just a handful of things:
I will discuss each of these in more detail below. First, however, I would like to discuss the system, and particularly the fact that the workers comp system is a compromise. It is not designed for you to get ahead. It is not even designed for you to break even. It is designed for you to lose. Therefore, maximizing the compensation you are entitled to is paramount.
The Georgia Worker's Compensation Act, like most state worker's comp schemes, is a compromise. It is a no fault system. You do not have to prove your employer did anything wrong in order to receive compensation. All you have to show is that you were inured in an accident arising out of and in the course of your employment, and that no defenses apply. Defenses include intoxication, willful misconduct, and other defenses such as your employer was not subject to the Worker's Compensation Act or you were not an employee at the time. Defenses are beyond the scope of this article, but I do want to note that not every work injury is a valid worker's comp case.
In exchange for not having to prove liability on the part of your employer, you give up the right to sue the employer in court. The worker's comp system is your only remedy. You give up the right to recover for pain and suffering, or the full measure of your lost wages. You give up the right to treat with a doctor of your choosing except in certain limited circumstances. You give up the right to have your case heard by a jury. You cannot recover non-economic damages such as loss of enjoyment of life. The compromise works both ways. The employer has to pay you even if they did nothing wrong, and you have to accept the benefits the system allows with no ability to recover a full measure of your damages outside the worker's comp system.
Assuming you are an employee and your employer is subject to the Act, when you are injured in an accident arising out of and in the course of your employment, your employer is supposed to provide you with medical treatment immediately. This is usually done by having you choose a physician from the employer's "posted panel of physicians." The panel is required to be posted in prominent places, and in return you are required to choose a doctor from the panel for treatment. There are limited exceptions to this for emergency treatment or if the panel is invalid; however, in most cases you will be required to treat with one of several doctors the employer chooses. If you have questions about whether the employer's panel is valid, or which doctor you should choose for your injury, do not hesitate to call us. We will be happy to assist you in making a good choice.
If the doctor treating you, called the "Authorized Treating Physician" or "ATP," says you cannot work, or has you on light duty that the employer cannot accommodate, the employer and insurer are required to commence Temporary Total Disability ("TTD") benefits. This will be two-thirds of your average weekly wage (calculated as the average of the 13 weeks pre-injury, with certain exceptions), up to a maximum of $725.00 per week as of the date of this writing. Benefits must be started within 21 days of the injury, and you are not entitled to benefits for the first week of disability unless you remain out of work for more than 3 weeks, at which point the first week becomes due. If you are able to work light duty and your employer has light duty work, you will only receive benefits if you are earning less money than you were pre-injury. This is called Temporary Partial Disability ("TPD"). This is two-thirds of the difference between your pre-injury wage and your post-injury wage, up to a maximum of $483.00 per week as of the date of this writing. This is payable until such time as you earn more than your pre-injury wages, or alternatively are returned to work "full duty with no restrictions."
Your doctor may assign an "impairment rating." In Georgia this must be calculated according to the 5th Edition AMA Guides to the Evaluation of Permanent Impairment . This benefit is called Permanent Partial Disability ("PPD"), and will be a percent rating, paid at your TTD rate, against any of several scheduled body parts (fingers, hand, arm, leg, eye, etc.), or to the body as a whole. When there are multiple ratings to different body parts, you recover all of them. For example, if you have a 5% rating to the arm, the upper extremity is rated at 225 weeks. So you multiply 225 times 5 percent, and the result is you are entitled to 11.25 weeks of benefits at your TTD rate. If the rating is done multiple ways (to the finger, to the hand, to the arm and to the body as a whole), you generally get the calculation that pays you the most money. PPD is the only compensation you get for permanent injury. As noted above, there is no recovery for pain and suffering or loss of enjoyment of life.
In a catastrophic claim, the caps may be extended. Catastrophic claims are an article unto themselves, but briefly, there are several situations such as paralysis, loss of a certain percent of sight or hearing, certain amputations, that are automatically catastrophic. There is also a "catch all" provision that states if you are unable to do your past work or any work available in substantial numbers in the national economy, your case can be designated as catastrophic. Catastrophic claims are incredibly complex, and should not be undertaken without the assistance of an attorney.
As you can see, the workers' compensation system is very complex and in many cases very subjective. Your employer and insurer may believe they have defenses that do not apply, or may believe your benefits should be calculated one way when the law requires them to be calculated in a way that might net you more benefits. Having an experienced worker's comp attorney on your side can make the difference between recovering all the benefits to which the law entitles you, or recovering less. Since the system is already a compromise, this is unacceptable. If you have questions about your worker's comp case, call us today!
Garner Law Office P.C. Proudly Serves The Following Areas and All of Metro Atlanta and West Georgia
Contact Information
Fax: (770) 693-1751
Office Hours
Dallas Office:
215 Main St Dallas, Georgia 30132-4261
Hiram Office (by appointment only):
5888 Wendy Bagwell Pkwy, Suite C, Hiram GA 30141