Workers Compensation

What do I do if hurt on the job?*

If you get hurt at work, two things should be done right away: (1) you should seek immediate medical attention, and (2) you should notify your employer of the accident and the injury. All too often, workers’ compensation claims are denied because the injured worker thought he or she could “get over it” and never told his or her supervisor about the accident and put off going to the doctor. Understandably, workers’ compensation insurance adjusters “red flag” claims when the employer was told nothing, or the claimant did not go to the doctor until weeks after the accident date.

Where to seek medical attention?

In the case of serious injury, go to the nearest hospital emergency room by the fastest means available. The workers’ compensation insurance carrier will be responsible for paying for hospital care required on an emergency basis. Tell the hospital staff that the treatment is to be paid under workers’ compensation.

If the injury does not appear to require treatment at a hospital, you might go to a clinic (sometimes known as an “industrial clinic”) with facilities for providing prompt medical attention for an injury. Most employers include such clinics on their approved list of physicians, known as a “panel of physicians.” Going to a panel physician is necessary to assure that the employer will pay the bill, unless, as stated above, the injury requires emergency attention, or for some other reason it is not practical to go to a panel physician.

Once released from the hospital or emergency room, you will probably need follow up medical care. For this reason, you must obtain as soon as possible the list of treating physicians approved for workers’ compensation. Some larger employers use a managed care organization, a type of HMO, which includes a wide array of physicians. Most employers use the traditional panel of physicians, which must include at least six physicians, including at least one orthopedic surgeon. You can accept the services of a physician selected by the employer from the panel or you may select another physician from the panel.

When you see the physician selected to treat you, you should ask for a statement as to your work status. If the authorized physician excuses you from work for more than a week, you will be entitled to receive workers’ compensation disability benefits to make up for some of your lost income. To get these benefits, however, your medical excuse must some from a physician authorized by workers’ compensation, and the excuse must continue for more than seven days. (Initial excuses are often made for just seven days, but the doctor may extend that time after another examination, if appropriate.) The amount of benefits are calculated as two-thirds of your average weekly wage, up to a maximum set by law, currently $525 per week. If you are excused for only one week, you get no benefits; for two weeks, you get benefits for only the second week; if you are excused for a full three weeks, you get benefits for all three weeks. The first check for benefits is to be issued twenty one days after the disability began.

Here are a few other points to bear in mind:

  • You should inform your family doctor if you are injured; but, you should get treatment only from the authorized workers’ compensation doctor;
  • Your family doctor cannot give you a work excuse that would entitle you to weekly benefits, unless your family doctor also happens to be the authorized workers’ compensation doctor;
  • If there is no panel of physicians, you can choose any doctor you want to treat you under workers’ compensation; but, you may be required to prove there was no panel of physicians – that is, you  may need witnesses to testify that indeed there was no panel for that job;
  • Many large employers have all their new hires sign a bunch of papers (usually unread) when they start a new job; often, one of the papers that gets signed is a statement that the employee has been shown a panel of physicians and that the meaning of the panel was explained to him or her.
  • Do not put any information concerning your injury, your treatment, or any of your activities at the time of or after your injury, on Facebook or any other internet social media site! In the event that there is a dispute in the case, this information would be obtained by your employer or their attorneys and used against you.
  • If your workers’ compensation claim is disputed in any way, expect your employer to hire a detective to put you under surveillance and secretly film your activities. Therefore, if you are claiming benefits, you should not attempt any activities that are more strenuous than your doctor has advised. Sometimes, even relatively simple activities can be made to appear inconsistent with the claimant’s limitations. Suppose you have a back injury: tasks like carrying bags of groceries from a store, opening the trunk of an automobile and even pumping gas, can be used to contradict your doctor’s opinion that you are limited in your ability to lift or reach and can be used as evidence that the claim is fraudulent or at least exaggerated. If at all possible, avoid any activities that could appear even slightly inconsistent with your limitations.

The workers’ compensation system is designed to give injured workers fast access to medical care and at least partial replacement of lost income. In most cases, the system works well. But if problems develop, as happens all too often, it may be advisable to consult an attorney to make sure that your rights under the system are fully protected.

 

*This statement is given for information only, and does not constitute legal advice to any person. Also, this statement only relates to Georgia State Workers’ Compensation. Different rules may apply in other states, and also in Georgia there are different rules that apply to certain workers, such as employees of the federal government, longshoremen, and Railroad workers. Also, Georgia Workers’ Compensation does not apply to farm laborers or domestic servants. 

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