SUMMARY OF BENEFITS: GEORGIA WORKERS’ COMPENSATION LAW
Disability benefits are 2/3’s of the average weekly wage, subject to a maximum limit of $575.00 per week for injuries occurring on or after July 1, 2016. For injuries occurring between July 1, 2013 and June 30, 2016, the maximum benefit is $525.00 per week. Before July 1, 2013, the maximum rate was $500.00 per week. The waiting period after an injury is 7 days; retroactive after 21 days of disability. Income benefits are due on the 21st day after the employer has knowledge of the injury. Temporary total disability (TTD) benefits continue as long as the employee remains disabled, up to 400 weeks from the date of injury. However, after release to light duty work, if employment is not provided by employer, the weekly disability check will be reduced to the temporary partial rate (TPD), not to exceed $383.00 for injuries occurring after July 1, 2016, ($350 per week (for injuries occurring between July 1 2013 and June 30, 2016), after 52 consecutive, or 78 aggregate, weeks on TTD. TPD benefits are limited to 350 weeks from the date of the accident. (No time limit in catastrophic injury cases) Benefits not paid on time must be increased by 15%, and benefits not paid on time after an award must be increased by 20%. Death benefits for dependents are limited to 400 weeks, generally, except that a surviving spouse can receive benefits until age 65, or for 400 weeks, whichever is greater (maximum of $230,000.00 for sole surviving spouse).
Generally, the Employer must furnish a panel of 6 physicians, one of whom must be an orthopedic surgeon, although other options for a conformed panel or managed care may be acceptable. 100% of necessary medical expenses incurred under the direction of an authorized treating physician are covered. Medical expenses include the employee’s travel to and from health care providers. The Board can order a change of physicians, or the employee can make one change to another physician on the panel, without authorization from the Board. The Employee is also entitled to one examination by a doctor of his or her choice, at the Employer’s expense, within 120 days of receipt of any income benefits. For injuries occurring on or after July 1, 2013, medical benefits are limited to 400 weeks from the date of injury, except in catastrophic injury cases. For injuries occurring before July 1, 2013, lifetime medical care for the injury is available.
In cases involving spinal cord injury; amputation of an arm, a hand, a foot, or a leg; severe brain or closed head injury; second or third degree burns over 25 percent of the body or third degree burns to 5 percent 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 (the same definition as for Social Security disability), the injury is considered to be catastrophic, and the employee is entitled to extended disability benefits, as well as lifetime medical care. Disability benefits are payable for life, but can be terminated after a hearing after the employee reaches the age of full retirement benefits for Social Security purposes (usually 67).
Mandatory only in catastrophic injury cases. Nurse Case Managers are not permitted to have direct contact with employee except in catastrophic injury cases, or by consent.
Compulsory as to all employers of 3 or more, including State and local governments. Coverage is elective as to partners, sole proprietors or farm employers.
The employer is entitled to notice of an injury on-the-job, and until such notice is given, the employer is not responsible for any benefits. Notice must be given within 30 days.
Grounds For Denial
Compensation is not allowed for willful misconduct or injury due to intoxication by alcohol or drugs. Compensation can be denied for an unjustified refusal to submit to a drug test.
Administration & Hearings
The system administered by the State Board of Workers’ Compensation. Cases are supposed to be scheduled within 90 days of a hearing request, and are tried by an administrative law judge. The ALJ conducts hearings on the record, under the rules of evidence. Medical reports and records are generally admissible in lieu of medical depositions. Appeals go to the Appellate Division of the Board (the 3 directors of the Board), then to superior court, and then to the Court of Appeals.