What is Worker's Compensation
Workers' Compensation is a state-mandated insurance program that provides compensation to employees who are injured on the job, suffer a job-related illness, or suffer an injury from repetitive use on the job. In Georgia, employers are required to purchase insurance for their employees from a workers' compensation insurance company if they have 3 or more employees in the regular course of business. Larger companies may provide their own workers’ compensation insurance; when larger companies do this it is referred to as being self-insured. When a worker is injured his or her claim is filed with the insurance company or self-insuring employer, which pays medical and disability benefits according to Georgia law. Workers’ Comp is the exclusive remedy for a worker injured on the job. That means the injured worker cannot sue her employer or co-workers for pain and suffering damages. An injured worker may sue a third-party if the third-party contributed to her injuries. For example, if a worker is injured by a product or machine they use at work, the worker may seek other damages from the manufacturer of the product or machine.
History of Workers’ Compensation
The Workers' Compensation Act in Georgia can be found at Title 34, chapter 9, of the Official Code of Georgia. Georgia adopted the Workers’ Compensation Act as part of a national and international movement. Germany created the first workers’ compensation system in 1884, with England following in 1897. In Georgia, as elsewhere, the rapid rise of industrialization in the late nineteenth and early twentieth centuries resulted in a growing number of work-related injuries. The old common law of employer liability failed to meet the needs of injured workers and their employers. Under the earlier law, most employee claims failed because of legal hurdles. Workers were required to prove that their injuries resulted from the negligence of the employer. This excluded claims that resulted from natural conditions or from the strain of physical labor. Under the new system, workers are no longer required to prove fault, or negligence, of their employer; instead, they need only to show that their injuries arose out of and in the course their employment.
How Workers’ Compensation Works
The Workers’ Compensation system provides replacement income, medical expenses, and sometimes vocational rehabilitation benefits. If a worker becomes temporarily unable to work, she will usually receive two-thirds of her average weekly wage up to a fixed amount. To be eligible for the income benefits, a worker must have missed work for over seven calendar days due to their work-related injury. If a worker becomes permanently unable to do the work she was doing prior to her injury, or becomes unable to work at all, she may be eligible to receive long-term or lump-sum benefits. The amount of the payment will depend on the nature and extent of the worker’s injuries.
Types of Benefits Provided by Workers’ Compensation
- Medical Care The injured worker has the right to all reasonable necessary treatment to cure or relieve the effects of the injury. This includes compensation for medical bills, prescriptions, and roundtrip mileage expense for authorized medical services. If the injured worker never settles his case, then medical benefits may last indefinitely.
- Temporary Total Disability Benefits If the injured worker has been taken out of work because of medical reasons related to the injury, he or she may be entitled to temporary disability payments. These payments would provide the worker with partial compensation for lost wages and these payments generally equal two-thirds of the workers average weekly wage. Pursuant to O.C.G.A. 34-9-261, the weekly benefit that is equal to two-thirds of the employee's average weekly wage cannot exceed $500.00 and cannot be less than $50.00 per week. The weekly benefit that is payable under Temporary Total Disability shall be payable for a maximum period of 400 weeks if the Claimant is not catastrophic.
- Temporary Partial Disability Benefits Where the disability to work resulting from the injury is partial in character but temporary in quality, the employer shall pay a weekly benefit equal to two-thirds of the difference between the average weekly wage before the injury and the average weekly wage the employee is able to earn after the injury. The average weekly wage payable to the employee thereafter cannot exceed $334.00 per week for a period not exceeding 350 weeks from the date of injury.
- Permanent Partial Disability Benefits If the injured worker cannot completely recover from the effects of an injury, she could be entitled to a monetary award for her permanent disability. Permanent disability means that the injured worker has lost some ability to compete in the open job market. The amount and rate at which permanent disability is paid depends on how great a limitation the injury places on one's activities. O.C.G.A. 34-9-263 provides the formula utilized to determine payment amounts for Permanent Partial Disability Benefits. For example, if someone is 100% disabled to the body as a whole as established by their authorized treating physician, the Claimant would be entitled to 300 weeks. If the impairment is less than 100%, a simple formula is used to determine the benefit amount. For example, if one has a 10% impairment to the leg, 22.5 weeks of benefits are owed by multiplying 225 by .10 of their weekly (TTD) benefit amount. Each body part has an individual cap on the number of weeks one can receive PPD benefits. For example, for the arm only the weeks are capped at 225 weeks if the arm is determined to be 100% impaired.
- Vocational Rehabilitation If an injury prevents a worker from returning to his previous job, workers compensation benefits may include assistance in getting another job through vocational rehabilitation.
- Catastrophic Injuries In the event of a catastrophic injury, the employer shall furnish the employee entitled to benefits with reasonable and necessary rehabilitation services. The employer appoints a registered rehabilitation supplier who will have the expertise which is necessary to provide rehabilitation services. A catastrophic injury means any injury which is one of the following:
- Spinal cord injury involving severe paralysis of an arm, leg, or the trunk;
- Amputation of an arm, a hand, a foot, or a leg involving the effective loss of use of that appendage;
- Severe brain or closed head injury;
- Second or third degree burns over 25% of the body as a whole or third degree burns to 5% or more of the face or hands;
- Total or industrial blindness; or
- Any other injury of a nature and severity that prevents the employee from being able to perform his or her prior work and any work available in substantial numbers within the national economy for which such employee is otherwise qualified.
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