Unfortunately, you do not get pain and suffering in a workers’ compensation case. As the injured worker, you are limited to three types of benefits: payment of indemnity benefits while you are out of work due to your work-related injury, medical treatment, and a permanent partial disability rating which you are assigned once you achieve maximum medical improvement by the authorized treating physician.
Workers’ compensation is a no-fault liability system which means that you are entitled to workers’ compensation benefits regardless of whether or not you or another party was at fault because of your on-the-job accident. There is no need to prove negligence in a workers’ compensation case, just that you were injured while you were working.
Yes, you can still file a workers’ compensation claim even if it was an unwitnessed accident. You must be sure to tell your employer within 30 days of your accident in order to fulfill the notice requirement for workers’ compensation.
However, it is also imperative that you tell your supervisor as soon as possible that you are injured. Be sure to memorialize, either through writing in your own journal or by filling out an accident report, as soon as possible in order to record the accident.
No, you do not have to allow a representative of the insurance company to accompany you in all the doctor visits. Make sure you tell the doctor that you do not want the representative of the insurance company to attend the appointments with you and/or have any conversation outside of your presence. It is imperative that you inform the doctor and his office of your wishes. Furthermore, at the Law Office of Benjamin Y. Gerber we can assist you in preventing the insurance company from accompanying you to doctor visits.
You are entitled to payment for your travel to and from the doctor along with any parking fees that you must pay while at that doctor. You must keep track of the mileage to and from your doctor and you are paid $0.41 per mile for all travel to and from a doctor.
If you forget to record your exact mileage, it is very easy to use MapQuest or a service like that to determine exactly how far you traveled on that day. You can also contact the doctor’s office to determine what days you went to and from the doctor.
The short answer is no. The workers’ compensation insurance carrier will not pay for medical treatment with your own personal doctor. However, you can receive medical treatment from whomever you want, but you may be stuck holding the bill at the end of the day.
If you do indeed go treat with your own personal doctor, then you must make sure that doctor is aware that you hurt yourself on the job.
If you are hurt at work in Atlanta, or anywhere else in Georgia, you will be paid two-thirds of your average weekly wage up to a maximum of $500 per week. Your average weekly wage is determined by looking back at the 13 weeks prior to your injury. The amount you earned during those thirteen weeks is added up and divided by thirteen. You are subsequently paid two-thirds of your average weekly wage before taxes.
Once you are out of work for seven consecutive days due to your on-the-job injury, the insurance company has until the 21st day to make payment to you. They have to go back and pay you from the first day you were out of work up to the 21st day and continuing so long as you are unable to return to work.
If you are injured at work but the employer is unable to meet your restrictions, you may be entitled to receive temporary total disability benefits.
It is the employer’s responsibility to provide you with light duty work within your restrictions. At the Law Office of Benjamin Y. Gerber we will ensure that your rights are protected and you receive the security the law provides.
If you are hurt on the job and treating with a doctor that the employer has sent you to, you are entitled to a switch in authorized treating physicians under the workers’ compensation laws in the State of Georgia.
Your employer is required to have a posted panel of physicians which consists of at least six doctors from which you can choose to treat from.
Many times an adjuster will ask an injured worker if they can take a recorded statement immediately following an accident. This generally occurs prior to the injured worker obtaining an attorney. I have heard from many clients that adjusters have told them that they need this statement to complete their investigation, as if the statement is required in order to process the case.
Let’s be clear, giving a recorded statement to an adjuster is not required by any statute. The recorded statement is an internal policy of the insurance company and not required by any law. I do not recommended giving adjuster’s recorded statements because they can be used against the injured worker. There are no rules or requirements of the recorded statement, in other words the questions are not governed by the rules of civil procedure or workers’ compensation. The injured worker has no recourse once they answer the question and the questions can be used for impeachment purposes later.
You should always contact a workers compensation attorney when the insurance company asks for an recorded statement.
In most workers’ compensation cases, the attorney for the employer and the insurance company will ask to take the deposition of the injured worker. This is a chance for the insurance company and their attorney to gather information regarding the injured worker’s accident, his/her medical treatment both before and after the on the job accident, and also other general information about the injured worker.
Despite the fact that the injured worker is answering all the questions, the most important thing to remember during the deposition is to listen carefully to all of the questions. You only have to answer what is asked during the deposition. This sounds easier than it actually is.
Everybody has a story they want to tell about their accident and how it happened to them. Many times, the injured worker gets very eager and just wants to blurt out exactly what happened, who was there, what was said, etc. Unfortunately, this does not always benefit the injured worker. If the defense attorney never asks the question, there is no reason to answer the unasked question. No matter how important the injured worker believes the information is, if nothing is asked about a certain issue, do not talk about it.
Anything that is vital to the case can be told to your attorney and they can decide how to disclose that information, and if it really is relevant to your case. When it comes to depositions, the old Air Force quote is very apropos : Keep It Short and Simple.
Many times in a workers’ compensation case, the authorized treating physician is not capable of treating the injury of the injured worker. This mainly occurs when an injured worker is treating with an emergency care facility such as Choice Care, Concentra, or Caduceus. After initial treatment, these clinics will often refer the injured worker to a specialist. The law in Georgia requires the employer and or the insurance company to authorize this referral.
This is very important for two reasons: 1) An injured worker is allowed only one switch in doctors if the employer maintained a valid posted panel of physicians. In other words, the injured worker can only change doctors one time and have the insurance company pay for it. Getting a referral from a treating doctor does not count against this one time change and will give the injured worker more options of doctors. 2) This can allow for better medical treatment for the injured worker.
As an attorney who practices in the field of workers’ compensation, I see many of the same doctors on panels of physicians. To put it mildly, many of these doctors have become jaded by the ‘system’ and in my opinion, do not provide the best treatment for the injured worker. In fact, their opinion is almost a forgone conclusion and I have many clients complain to me that their doctor “did not even listen to me.” Using this referral, the injured worker can attempt to steer their medical treatment to a more objective doctor who will both listen to them and give them appropriate treatment.
In conclusion, obtaining a referral from the current authorized treating physician does not mean that doctor has to be off the panel, and it may give the injured worker better medical treatment ot help them get better.
Many times in a workers’ compensation case, the employer/insurance company will request a mediation. By definition, a mediation is an attempt by two parties to reach and agreement or a reconciliation. In a workers’ compensation case, this means that the two parties, the injured worker and the employer/insurance company try to resolve the issues in dispute without having a judge make a ruling. The agreement can be over a single issue, such as who is the authorized treating physician, or it can be an attempt to resolve the entire claim via a cash settlement. Mediations are always voluntary and each party can walk away at any time. A mediation is like a fishing expedition and one of the goals is to find out what type of offer is being made. There is no requirement that the injured worker accept the offer, but they do have to listen. If you do not like the fish that you caught, you can always release it back into the water and move on.
I believe the key to any mediation is to be set realistic expectations and to listen to what the other side is saying. Many verbal and non-verbal signals are given by each party and the one who is most in tune with those signals, usually has a more positive result.