Frequently Asked Questions
Answers from Our Cobb County Workers' Compensation Attorney
At Herbert Chestnut & Associates, we have collected a list of common
questions that clients have for us. We have provided this list below to
help our clients better understand their rights and what they can expect
from their workers' compensation cases. If you have a question that
is not listed below, feel free to
contact our Cobb County workers' compensation lawyers.
- What Is Workers’ Compensation?
- Does my injury have to be my employer’s fault?
- If I accidentally hurt myself, is that covered?
- Is workers’ compensation the same in all states?
- Why do I only get $525.00 per week?
- If I am released to light duty work, is my employer required to hire me?
- Do I have to return to work with my employer?
- Do I have to go to the doctor my boss tells me to go see?
- Can I get a second opinion?
- If the employer / insurer sets up a second opinion, do I have to go?
- How is my income benefit calculated?
- Who should I choose to treat my injuries?
- What if there isn’t a Panel of Physicians?
- Is my employer required to explain the Panel of Physicians and other procedures to me?
- What should I do if a medical bill is sent to me?
- Is the employer or insurer required to pay my medical bills regardless
of how much they are?
- If the employer / insurer doesn’t pay all of my bills, am I responsible
for the remainder?
- Is the employer / insurer responsible for mileage?
- What Injuries are covered under workers’ compensation?
- Can I collect workers’ compensation and sue my employer?
- How long do I have to file a claim?
- Can I receive both workers’ compensation and Social Security benefits?
- How long do workers’ compensation benefits last?
1. What Is Workers’ Compensation?
Workers’ compensation is an insurance program financed by employers
that provides injured workers with income, medical, and rehabilitative
benefits in the event that they should be injured throughout the scope
of their occupation. Workers’ compensation also provides death benefits
to the dependents of deceased workers in the event that a worker should
pass away in a work-related accident. Under Georgia law, all employers
with three or more workers must have workers’ compensation insurance.
2. Does my injury have to be my employer's fault ?
No. Under Georgia law, you are entitled to benefits even if the injury
was not the fault of your employer. In fact, under most circumstances,
you are entitled to benefits even if you are injured as a result of your
3. If I accidentally hurt myself, is that covered?
Yes. However, there are exceptions in certain situations such as failure
to use safety appliances or devices when available or required or injuries
which result from the use of alcohol or illegal drugs.
4. Is workers' compensation the same in all states?
No. Each state has its own set of rules and regulations as to workers'
compensation. Most workers' compensation laws have many similarities
but each state has differences which materially affect your rights as
an injured worker. In addition, federal employees are covered under one
of two Federal Acts. Either the Federal Employees Compensation Act (FECA)
or the Longshore and Harborworkers' Compensation Act. There are other
Employees who are treated differently as well, such as railroad employees
and part-time workers.
5. Why do I only get $525.00 per week?
Under Georgia Law, the Employer must pay 2/3rds of your average weekly
wage with a maximum of $525.00 per week for dates of injury occurring
on July 1, 2013 forward. The maximum rate changes every year or two and
is set by your date of injury. Once your compensation rate is properly
set, it generally does not increase for cost of living or otherwise.
6. If I am released to light duty work, is my Employer required to hire me?
No. In certain situations, it is to the Employer's benefit to hire
you but nothing in the Workers' Compensation Act requires an Employer
to do so. There is also no direct recourse against an Employer who fires
an injured worker under the Workers' Compensation Act. However, there
may be a discrimination claim against an Employer under those circumstances
under either State or Federal Law.
7. Do I have to return to work with my Employer?
The decision on whether or not you return to work with your Employer is
yours alone. However, in certain situations, if light duty is offered
by the Employer and you fail or refuse to return to work, your workers'
compensation weekly checks may be jeopardized.
8. Do I have to go to the doctor my boss tells me to go to see?
It depends. Normally, when you are first injured, the Employer should allow
you to select from a "Panel of Physicians". The Panel of Physicians
should be posted in a conspicuous place on the job site and its function
should be explained to you at the time of your injury. You have the right
to choose any doctor from the Panel and treat with that doctor at the
Employer or its Insurer's expense. You may also make one change from
a Panel doctor to another Panel doctor without the approval of the insurance
company or the State Board of Workers' Compensation.
However, at any time during the pendency of the claim, the Employer or
Insurance Company has a right to send you for an independent medical exam
at a doctor of their choosing. They are allowed to do this with the only
exception that the request must be reasonable.
9. Can I get a second opinion?
Yes, within 120 days of having received income benefits, you are entitled
to a second opinion under Section 202(e) of the Act, with a doctor of
your choice. You may also request permission from the State Board of Workers'
Compensation to obtain a second opinion.
10. If the Employer/Insurer sets up a second opinion, do I have to go?
Generally, yes. As stated above, the Employer/Insurer may request a second
opinion or independent medical exam under the Workers' Compensation
Act. So long as the Employer/Insurer gives the proper notice under the
Act and fulfills other obligations, you have to attend. If you do not,
the Board can order your benefits suspended until you do attend.
11. How is my income benefit calculated?
Generally, your average weekly wage is determined by averaging the 13 weeks
prior to your injury. There are certain exceptions if you do not work
the entire 13 week period before your injury. After the average weekly
wage is established, your benefits are usually 2/3rds of that amount subject
to the maximum rates contained in the Act. The current maximum rate is
$525.00 per week.
12. Who should I choose to treat my injuries?
If time permits, contact an attorney to get some advice regarding the doctors
listed on the Panel of Physicians (read about the Panel of Physicians
in Workers' Compensation from A to Z). If you cannot obtain a recommendation
from an attorney, a specialist is generally preferred over a walk-in clinic.
Industrial Medical Clinics are generally not preferred.
13. What if there is not a Panel of Physicians?
By law, you have the right to treat with any doctor you choose at the Employer's
expense. You should take a photograph of the area in which legal notices
are posted at your job site to verify that no panel exists. Also, if a
panel exists but it does not comply with the law, for example, if it has
less than 6 doctors, it is treated as if there is no panel of physicians at all.
14. Is my Employer required to explain the Panel of Physicians and other
procedures to me?
Yes. In order for the Panel of Physicians' rule to apply, not only
does a Panel have to be posted but the Employer must take reasonable steps
to insure that the Employees know the function of the panel and how properly
to obtain medical care and treatment.
15. What should I do if a medical bill is sent to me?
If you are represented, send it to your attorney immediately. If not represented,
contact the medical provider and give them the workers' compensation
claim information. Finally, it is advisable to write the medical provider
and put them on formal notice that the bill is for a workers' compensation
injury. Give them the name and address of the insurance adjuster as well
as your claim number.
16. Is the Employer or Insurer required to pay my medical bills regardless
of how much they are?
No. There are numerous restrictions as to the Employer's/Insurer's
liability for medical expenses. First, in an accepted claim, the medical
bill must be from an authorized treating physician. Secondly, it must
be reasonably necessary to effect a cure, return the Employee to suitable
employment or relieve pain in order to be covered. Finally, if both of
the preceding requirements are met, the Insurer has the right to reduce
the amount of the bill by the Workers' Compensation Fee Schedule.
17. If the Employer/Insurer does not pay all of my bills, am I responsible
for the remainder?
No. Generally, if a medical provider accepts a workers' compensation
claim, it accepts the payment of the bills pursuant to the Fee Schedule
and you cannot be billed for what is written off.
18. Is the Employer/Insurer responsible for mileage?
Yes. You have the right to reimbursement for mileage to and from doctor's
offices, hospitals, physical therapy and other medical providers as well
as trips to the pharmacy to pick up medication related to your work related
injury. The current mileage rate is $.40 per mile.
19. What Injuries are Covered Under Workers’ Compensation?
Nearly any injury or illness that a worker should be afflicted with resulting
from their work is covered under worker’s compensation, as long
as the injury was not caused by a worker’s recklessness. Slip and
falls, stress-related injuries such as carpal tunnel, on-the-job car accidents,
and injuries from equipment malfunctions are just some of the many injuries
that are covered.
20. Can I Collect Workers’ Compensation and Sue My Employer?
No. In exchange for coverage under workers’ compensation, you waive
your right to sue your employer for damages in the event of your injury.
In the event that your injury should be caused by someone other than your
employer, however, you may be able to pursue financial recovery by filing
a claim against the responsible third parties.
21. How Long Do I Have to File a Claim?
You must inform your employer within 30 days of suffering a workplace injury.
Failing to do so may cause you to forfeit your right to receive compensation.
22. Can I Receive Both Workers’ Compensation and Social Security Benefits?
Yes, though your social security benefits may be reduced.
23. How Long Do Workers’ Compensation Benefits Last?
The length that workers’ compensation benefits will continue to be
paid depends on the extent of a person’s injuries and the time it
takes an employee to heal. Generally speaking, benefits will continue
to be paid as long as you adhere to all prescribed treatments as determined
by your physician. Disability payments will be payable for a maximum of
400 weeks from the date of injury, unless an employee’s injuries
are deemed catastrophic.
Call (770) 285-5542 if you have further questions. We offer