Workers’ Compensation – Accepted Claims

An Accepted Claim means that the workers’ compensation insurance carrier has agreed that you sustained an injury in the course and scope of your employment (meaning; you can prove you were injured doing work for your employer) and has agreed to pay you appropriate medical and income benefits. This does not mean that your claim will always go smoothly as often times there are issues about choice of doctors and amount of weekly checks that you are owed.

Medical Benefits:If there was a list of doctors (6 or more doctors) posted in your place of employment and you are given a choice from that list, then generally speaking you are required to use a doctor from that list. However, you may need specialized treatment for an injury and no doctor on that list is qualified to give this treatment. In such cases, we will need to first try to come to an agreement with the insurance company on choice of doctors. If an agreement cannot be made, then it may be up to a judge to decide which doctor is appropriate.

Income Benefits: This is another term for weekly checks. The amount you receive under a claim depends on your average weekly wage (this is determined by the 13 week prior to your date of injury). You will receive 2/3 of your average weekly wage, not to exceed the maximum set by law. You may receive either full pay (temporary total disability benefits) if you are completely out of work or you may receive partial pay (temporary partial disability benefits) if you are working, but making less than your pre-injury wages.

Impairment Ratings: After you are finished with treatment for your injury, your doctor may say that you have forever lost a percentage of bodily function. It could be a lot or a little. For example, if you break your arm and it heals without much problem, the fact that your arm was broken generally means that it is not the same as it was before the injury. If your arm was 100% before the injury, it may only be 98% now. In that case you would have a 2% impairment (often called permanent partial disability). Or, for example, if you injure your back, need surgery and never fully recover, you may have a much higher impairment rating. An impairment rating entitles you to additional benefits. The amount of these benefits depends on the rating given by your doctor and the amount of your weekly checks (also called “comp rate”).

Steven Barnett has extensive experience representing clients in Workers’ Compensation matters. We can represent you at all locations of the State Board of Workers’ Compensation throughout Georgia. If you were hurt on the job, contact us today for a free consultation so you can receive answers to your questions and learn about your options.