Georgia's system of workers' compensation is compulsory, meaning that employers are required to provide workers' compensation insurance to their employees. Workers' compensation insurance may be provided through private insurance carriers or self-insurance. Waivers may be permitted to exclude certain employees from coverage, including corporate officers. Sole proprietors may elect to be covered.
Exemptions from coverage may apply to certain employees, including employees of very small businesses, domestic workers, casual workers and professional athletes.
Medical Benefits are provided to employees entitled to workers' compensation benefits, with reasonable and necessary care provided for up to four hundred weeks from the date of injury. Additional care may be available for workers who have suffered a catastrophic injury.
The employee makes an initial choice of treating physician from a panel of six doctors provided by the employer, or by choosing a doctor within the employer's managed care plan. The employee can make one change of doctors to a different panel physician. An employer may seek second opinions without limit. An employee may request one IME at the employer or insurance company's expense, subject to time limits.
Indemnity benefits are payable to injured workers to help make up for lost income. There is a waiting period of 7 days before a worker is eligible for indemnity benefits, but if the worker's disability lasts more than 21 days indemnity benefits become retroactive to the date of the injury.
Benefits available to injured workers include the following:
Temporary Total Disability (TTD)
Temporary total disability (TTD) benefits are paid to workers who are unable to work due to injury, but who are expected to make full or partial recovery such that they may return to work. Benefits are based upon 2/3 of the worker's pre-injury average weekly wage, subject to a cap, and continue for up to 400 weeks. Extended benefits may be available in the event of catastrophic injury. Offsets may apply for unemployment insurance, and for employer-funded disability insurance benefits.
Permanent Total Disability (PTD)
When a worker is not expected to recover from a total disability caused by a work-related injury, and as a result suffers a total loss of earning capacity, the worker becomes eligible for permanent total disability (PTD) benefits. In Georgia PTD benefits are calculated based upon 2/3 of the injured worker's average weekly wage, subject to a cap, and may continue indefinitely. For workers who suffer catastrophic injury, rehabilitation benefits may be available.
Permanent Partial Disability (PPD)
Once an injured worker has recovered to the maximum possible extent, the worker may be able to return to employment but nonetheless remain partially disabled, and may potentially qualify for permanent partial disability (PPD) benefits. In Georgia PPD benefits are determined based on a statutory schedule, and are paid at the TTD rate. Benefits for unscheduled injuries are payable for a maximum of 300 weeks.
Temporary Partial Disability (TPD)
When a worker suffers an injury that limits his ability to return to work, resulting in a reduction of income as a result of reduced hours or wages, the injured worker may be eligible to receive a benefit based on the difference between the worker's pre-injury earnings and their reduced, post-injury earnings. In Georgia, TPD benefits are paid based upon 2/3 of the difference between the injured worker's pre-injury and post-injury wage, subject to a cap. TPD benefits are payable for up to 350 weeks.
For some, more serious injuries, workers' compensation indemnity benefits may be paid according to a statutory schedule, instead of following the standard model of the weekly benefit based on the duration of the disability. Scheduled injuries include such injuries as the amputation of an arm, the loss of a dominant hand, the loss of a leg, the loss of a foot, the loss of an eye, or loss of hearing in an ear.
Coverage may be available for cumulative trauma, and for occupational hearing loss.
When a worker dies as the result of a work-related injury, workers' compensation pays additional benefits, including a burial allowance, and benefits for a surviving spouse and dependents. Survivor benefits are calculated based on the applicable total temporary disability (TTD) rate, subject to a cap in amount. Benefits may continue for minors until the age of 18, the age of 22 if the dependent is a student, or indefinitely in the event of disability, subject to the cap. Spousal benefits end upon remarriage.
Attorney fees are limited to no more than 25% of income benefits, and any fee in excess of $100 must be approved by the workers' compensation board.
This article provides a quick overview of the benefits available to injured workers, but the full formulas used for assessment of benefits, coordination of different types of benefits, and assessment of injuries and disability ratings can quickly complicate the determination of benefits. Also, states frequently revise their workers' compensation laws. Most workers who suffer a significant injury or wage loss as the result of a workplace injury will benefit from consulting a workers' compensation lawyer.
The state agency responsible for workers' compensation is:
Georgia State Board of Workers' Compensation
270 Peachtree Street, NW
Atlanta, GA 30303-1299
(404) 656-3818 or 1-800-533-0682