Q: What benefits can I expect?
A: Wage Benefits are payable to you at the rate of two-thirds of your weekly wage. This is usually computed by averageing your wages for the 13 weeks before your accident. The maximum benefit is $375 per week. There are other ways to determine your average weekly wage (AWW), so please ask. There is no cost of living increase of weekly benefits after the amount is determined. Remember, weekly wage benefits are not payable to you until the authorized treating physician has placed you on a "no work" status. Wage benefits may also be started if the doctor puts you on limited or light duty and your employer declines to provide limited or light duty work for you.

2. Medical Benefits are payable by your employer and their insurance company. There is no deductable for you to pay. The doctor or hospital should not bill you directly. Medical benefits include mileage to and from the doctor and prescription payments. Please let us know if you are billed for medical expenses.

3. Permanent Partion Disability is payable when your doctor returns you to work and you are as well as you can get under modern medicine, your doctor should, but is not required, to give a PPD disability rating that will provide an end benefit to you.

 

Q: Which doctor can I see?

A: Your employer is required to keep a posted panel of doctors. This panel is usually located next to a time clock or in a break room. In order to get medical bills paid by your employer, you must go to one of their panel doctors. On only on occasion you can change from one panel doctor to another. If the employer has no panel, then you should be able to go to the doctor of your choice. It is extremely important for you to find the panel at the employer and get the names of the doctors and hospitals on it and supply them to us.

 

Q: What can I do to help my case?

A: In addition to being patient, there are three things you can do to help your case:

 

1) Stay in touch with us. Call every time you see your doctor and try to get a work status form during every doctor visit.

 

2) Be careful who you talk to about your case. If someone calls you, tell them to call your lawyer for more information.

 

3) Find out about the panel of doctors. Go to your employer and ask about the panel and see if you can find it. Please call us about your findings as soon as you can.

 

Q: Can I sue my employer for my injury?

A: No. Georgia Law makes it impossible to sue your employer for your injury. They only have to pay Workers' Compensation Benefits and there is no pain and suffering payable under workers' comp for your injury. If you are injured by a person other than your employer or a co-employee, you may be able to sue that person. The rules are technical, so please ask us if you have a question.

Q: When can I expect to receive benefits?

A: The insurance company has 21 days to investigate your case. In 75% of the cases they are on time, but they can be slow to investigate the matter and start your benefits. In the situation where the insurance company refuses to pay your claim, it could take us six months or longer to get your benefits started. The insurance company is not required to pay you for the first week out unless you have been out for the first 21 days straight. Remember, your authorized treating physician must have you on a "no work" status before you can receive a weekly disability check. The insurance company may start paying benefits if the authorized doctor places you on light or limited duty and your employer declines to offer such light or limited duty. The issues can be complicated, so please ask for further information.

 

Q: What if my employer refuses to pay my benefits?

A: If the employer and their insurance company refuse to pay you medical and wage benefits we can ask for a hearing before an Administrative Law Judge. The hearing process will be scheduled about two months from the date that we ask for a hearing and is very often rescheduled about two months from the date that we ask for a hearing, and is very often rescheduled a second or third time. It could take four to six months to get a hearing, so it is important for you to be patient.

 

Q: Do I get paid for prescriptions and mileage to the doctor?

A: You are entitled to 25 cents per mile going to and from the doctor and if you keep your parking receipts, we will get you reimbursed for those too. Many insureance companies will set up an account at a drug store for the prescriptions given by the authorized doctor. If you pay for a prescription, send a copy to us with the bill and we will send it to the insurance company.

 

Q: Is there a time limit for filing my claim?

A: Yes. You must report your injury to your employer within 30 days. In addition, if you haven't received a weekly disability check, then you must file with the State Board of Workers' Compensation within one year of the date of the accident, or if you have continuous medical treatment, the claim must be filed within a year of the date of last remedial (treatment of injury) medical treatment. If you have received a weekly check and the insurance company has stopped paying you because you returned to work, it will become difficult or impossible to obtain additional benefits for you after the expiration of two (2) years. The issue is complicated, for futher information, contact your lawyer.

 

Q: Can I get a jury trial to settle my case?

A: No. There are no jury trials under the Workers' Compensation procedure. hearings are held before an administrative law judge and they are held in various offices throughout the State. The issues are related to the three basic benefits to which you may be entitled and it usually takes 4 to 6 months to get a hearing. Be patient. An insurance company cannot be forced to settle your case. They only settle when it makes sense to them financially.