Worker’s compensation insurance ensures that you are protected in case of an accident by providing medical and living expenses while you are hurt. In Atlanta (and Georgia as a whole), any employer that has three or more full-time, part-time or regular employees (regular employees means those that are scheduled regularly, such as every weekend or holiday) is required to have unemployment insurance. While this sounds like an excellent policy (and in many ways it is), like most things, there’s a catch.
Like it sounds, worker’s compensation is run by insurance companies, which means trouble for workers. And like all insurance companies, those providing worker’s compensation insurance are out to save money and deny claims. In fact, no matter what insurance they provide, many insurance companies employ people whose only job is to find ways to deny claims. And, no matter how nice your employer seems, don’t think that they will automatically support you; businesses with too many successful worker’s compensation claims risk rate increases or even being dropped by their current carrier.
Thus, if you need to file a worker’s compensation claim, it’s best to assume that your employer and their insurance company is out to get you. This means that you need to dot your i’s and cross your t’s when filing your claim. If you are injured at work, make sure to do the following to ensure that you’re covered.
Report the injury immediately
The number one most important thing to do if you are injured at work is to report it – even if you are unsure whether the injury will be severe enough to warrant time off. Be careful: injuries can be deceiving and once the adrenaline wears off (or your muscles begin to tighten up), the extent of your injury can become more apparent. In addition, sometimes (such as in the case of a head injury) the full symptoms become apparent well after the injury. Thus, if you don’t report your injury until later, your employer may question whether or not it happened at work. Even though in Georgia you have up to 30 days to report your injury, it’s best to report it right away to avoid future scrutiny.
Keep the paperwork
After you report your injury, your employer will probably make sure that you fill out paperwork to document it. This will include details of how the injury occurred and where you are hurt. Make sure to get a copy of this to ensure that your employer doesn’t change the information afterward. In addition, when you go to the doctor, make sure to get a copy of every piece of information the doctor writes, just to make sure that you have a record. Keep this record in an easy to access spot so that if you need it, you can access it easily.
Keep your story straight
This sounds more nefarious than it actually is. You don’t have to make up a story about how you were injured; just write down exactly what happened as you remember it. Make sure to detail the incident, where and how you were hurt, and what occurred after the injury. This ensures that you always tell everyone the same story, meaning that your employer or their insurance company can’t poke holes in your story in an attempt to discredit you – and get your claim declined.
Call a lawyer
Like we said earlier, it’s always best to assume that your employer and their insurance company is out to deny your claim – meaning that they will use every weapon in their arsenal. And, since worker’s compensation is based on laws and “lawyer speak,” the biggest weapons they have are attorneys. These attorneys will use laws and statutes that you had never heard of to deny your claim – and without a lawyer, you will be unable to combat this tactic. Make sure to contact a lawyer immediately after you are injured to make sure that you are adequately protected.
Bring your lawyer to mediation
If you and your employer can’t come to an agreement, a mediation session will be held. Mediation is designed to help you and your employer agree on terms without officially entering the legal system. The mediator is generally a judge or third party attorney who will informally guide the discussions. Even though the session is private and confidential, you can bring a lawyer with to ensure that your rights are protected, because you can bet that the insurance company will. Bringing your own lawyer will help you get the best deal possible. Make sure that your lawyer knows what you want, and make sure to be flexible in your description; mediation is the last non-legal option.
Don’t just accept light duty
Your doctor may approve you for light duty, which is often designed to be tedious and have long hours (so that you refuse to do it and are not entitled to benefits). This is a common misconception, however; just because your employer gives you light duty doesn’t mean you have to suffer through it. According to Georgia law, your employer must give you ten days’ notice before starting your light duty and you have fifteen days to try the job out before accepting it. While you can opt out of light duty, you need to try to work a full day (or at least 8 hours) before doing so.
In Georgia, you must provide valid reasons for why you can’t work light duty – it can’t just be that you don’t like the work. Examples of reasons why you can’t perform the light duty include that it places an undue burden on you or that it exacerbates your condition. You will need to get these reasons approved (anything relating to your injury must get a doctor’s approval). Your lawyer can help you determine what, if any, reason you have to get out of light duty.