How do I Know If I’m Eligible for Workers’ Compensation?

If you become injured or sick at work, you are probably eligible for workers’ compensation benefits. These benefits help cover the costs of your injuries, missed work time, and more. 

John Foy & Associates can help you with your workers’ compensation claim and ensure you seek the full benefits you deserve. To discuss your case with an experienced and compassionate workers’ compensation lawyer, call us today or reach out online.

What Is Workers’ Compensation?

Workers’ compensation is insurance most employers must purchase to cover the costs of workplace injuries. Workers’ compensation claims differ from personal injury claims because:

• Fault doesn’t matter. If the injury happened at work, it should be covered.
• Since fault does not matter, you cannot sue your employer, except in some extraordinary situations.
• Your employer also cannot blame you for the accident to reduce their liability.

Workers’ comp provides medical benefits and wage replacement during your recovery. In addition, this system exists to protect both workers and employers from lengthy legal battles. 

What You Need to Be Eligible for Workers’ Compensation

Here are the requirements you typically need to meet to qualify for workers’ compensation benefits:

• You must be employed by an employer who carries workers’ compensation insurance (more on that below).
• Your injury must have happened at work or while performing work-related duties.
• You must be away from work for more than seven days because of your injury to receive weekly wage benefits.
• You must meet Georgia’s deadlines for reporting your accident and filing a claim.

It’s best that you follow these requirements exactly if you want to receive any sort of benefits from workers’ compensation. You may also be required to see a doctor chosen by your employer to gain benefits. You can ask for this visit to be covered, and you can go to your own doctor for a second opinion at your own expense.

Most Georgia Employers Must Carry Workers’ Compensation Insurance

According to the State Board of Workers’ Compensation (SBWC), any business with three or more workers must carry workers’ compensation insurance. This includes employees who are part-time or seasonal as long as they are regular employees. 

This also includes corporate officers or members of a limited liability corporation, even if those individuals opt-out of coverage under the Official Code of Georgia Annotated (OCGA) § 34-9-2.1. 

There are a few exceptions to the workers’ compensation laws in Georgia. The following workers are exempt from coverage requirements:

• Farm laborers
• Most railroad employees
• Domestic servants
• Government employees
• Independent contractors

If you don’t work in any of these industries, the odds are high that your employer has workers’ compensation. You can confirm this by looking in your employee handbook or talking with HR. The labor poster at your workplace may also have this information.

How to Know If Your Injury Qualifies for Coverage

Your injury does not have to be related to your job for you to be eligible for workers’ compensation. As long as you are injured while you are on the clock, you should be covered. You may also be covered if you were not at your typical worksite or on regular work hours but still performing duties for your job, such as:

• Traveling for a work meeting
• Running errands for your boss
• Driving a work vehicle while on the clock
• During an office holiday party

If you’re unsure whether your injury is covered, call a workers’ compensation lawyer to discuss the details. A lawyer will examine Georgia law in relation to your situation and know what your options are.

There are some regular situations where workers’ comp does not apply. For instance, if you are injured during your commute, you’re probably not covered. You might also lose eligibility if your injury occurred while misbehaving or breaking the rules at work, especially if it involves violence. Again, it’s best to consult with a lawyer about your specific circumstances.

What If I’m Told I don’t Have Workers’ Compensation?

Contact a workers’ compensation lawyer right away if your employer says there is no workers’ compensation coverage after a work injury. Employers can face serious penalties if they are not carrying legally required coverage.

Some employers and their insurance companies will look for ways to reduce what they pay on your claim. Don’t miss out on the benefits you are entitled to receive as a worker. If you believe you’ve been denied benefits that should be yours as a Georgia employee, an experienced lawyer can help.

You Must File Within a Certain Amount of Time to Be Eligible for Benefits

Even if you fully meet the qualifications for workers’ compensation through your employer, you must meet certain responsibilities to claim those benefits.

Reporting the Accident

As soon as possible after the accident happens, report it to your supervisor. If you wait over a month to report the work injury, you might lose any chance of receiving workers’ compensation benefits.

Filing the Claim

To file a workers’ compensation claim in Georgia, you must fill out a WC-14 form and file it with the SBWC. You should also send a copy to your employer and the insurance company that provides their workers’ compensation.

In Georgia, you have one year from the date of your work accident to file a claim. If you can keep working after your injury or your employer is providing medical treatment for your injury, the deadline may get extended. However, it’s best to take action right away and file as soon as you can. If you’re unsure about whether you can make a strong claim, a lawyer can help you fill out the form.

What Happens If My Claim Is Denied?

Even if you file a claim on time and you’re eligible for workers’ compensation, your claim could be denied by your employer or the insurance company. This is the point where you need to have a workers’ compensation lawyer to help you.

For minor claims, you do not need to have a lawyer help you. But as soon as you get denials or pushback, you need one. We can help you argue for your claim in front of investigators. Or should you need to appeal, we can bring it in front of the SBWC’s Appellate Division.

A denial doesn’t mean you have to stop your claim. It means it’s time to argue the matter. We can help you make a strong case and fight for your right to workers’ compensation.

I’m an Independent Contractor. Am I Covered By Workers’ Compensation in Georgia?

Unfortunately not, and this is a hole in the system considering so many people are independent contractors these days. Under Georgia law, you have to be an employee or a statutory employee to be covered.

Independent contractors should file a claim with their own health insurance to cover the costs of a workplace injury. You may wish to consider getting a higher level of insurance to ensure you can get enough coverage. You may also be able to sue your clients in certain circumstances. Speak with our lawyers to see if you may have a claim.

Does Workers’ Compensation Cover All My Damages? 

Workers’ compensation only covers medical costs related to your injury and lost pay. It won’t cover other damages, such as: 

• Pain and suffering 
• Mental anguish and emotional trauma
• Loss of consortium
• Loss of enjoyment of life 

If you wish to receive compensation for these damages, you would need to file a third-party claim and establish that your injuries were due to the negligence of an at-fault party. There are many legal options available to you. You just need to discuss them first with a lawyer to help you understand what the best course of action is. 

If your injury prevents you from working for over seven days, you’re eligible for weekly earnings at two-thirds of your average regular weekly wage or up to $575 per week. The amount of time you receive this depends on the severity of your injury. Depending on the circumstances, you may qualify for up to 400 weeks of weekly benefits.

What Are the Benefits of Hiring a Lawyer? 

Even though you don’t need a lawyer to file a workers’ compensation claim, it’s still in your best interest to do so, especially if the insurance company or your employer isn’t cooperating. Don’t ever find yourself in a position where you have to settle for much less than what you deserve. 

Employers and insurance companies don’t have any incentive to assist you during this difficult time. Instead of bending to their preferences, you can fight to ensure that your financial compensation accurately reflects the damages you’ve suffered. Allow our experienced workers’ compensation lawyers to assist you today. 

Talk to Our Workers’ Compensation Lawyer for Free

It can be difficult to determine whether or not you’re eligible for workers’ compensation. However, most employers in Georgia must carry a workers’ compensation policy, so chances are good you have access to benefits after a work injury.

John Foy & Associates can help you know for sure if you are eligible to receive workers’ compensation. So, give us a call today for a free consultation where we’ll discuss the details. Call or contact us online to get started.