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Although workers’ compensation law varies from state to state, there is one general principle that remains fairly consistent: Exclusive remedy. This holds that if an employee is injured or killed while working and his employer carries workers’ compensation insurance, the only damages he may collect from his employer is workers’ compensation.
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There are, of course, options for third-party liability lawsuits and social service benefits for long-term disabilities. But in general, workers’ compensation will be the only money collected from an employer and/or an employer’s insurer in these instances.

However, an exception can be made when the company did not carry workers’ compensation insurance coverage, or when the individual making the claim was not an employee. Independent contractors have no right to collect workers’ compensation coverage, and therefore may pursue litigation. Sometimes, this issue is straightforward. Bear in mind, though, just because a company labels a worker an “employee” does not necessarily make it so. When there is a dispute, courts will weigh a host of factors, such as the degree of control a company had over the worker’s duties and method of payment.
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Injured workers in Georgia are often subjected to surveillance by a private investigator hoping to “catch” them with pictures or on video doing something that will help the insurer to cut off the employee’s benefits. These private investigators are working for the insurance company on a regular basis. Their goal is to be able to suspend or cut off your Workers’ Compensation benefits.

surveillance.jpgAnytime that an injured worker is outside of their home, there is a good chance that a private detective is watching. Simple things such as taking the trash out, bending to pick up something in the yard, carrying and putting a child into a car, or picking up a delivery package from the porch can be captured by the investigator.

When an injured worker leaves home there is also a great chance that there is a private investigator watching to see if the injured worker will do something to compromise their claim. Running errands, driving, visiting friends, eating out in restaurants and even going to church are all times when the investigator may be working to try and catch the injured worker doing physical activity that is prohibited by the doctor.

The insurance company often knows where the injured worker is going to be. After all, the insurance adjuster is the one who makes doctor appointments and schedules medical tests for the injured worker. The private investigator could be waiting in any parking lot, shopping in the same pharmacy, or even sitting in the same doctor’s office as the injured worker.

It is of extreme importance to stay within the restrictions that have been ordered by the authorized treating physician. Sometimes even an innocent movement can be distorted to make the injured worker look as if they are faking their injury. It is best to be cautious at all times. If the injured worker is photographed or caught on tape the claim for Workers’ Compensation benefits may be seriously compromised.

For more information on surveillance of injured workers and any other questions that you have about Atlanta work injury compensation, contact J. Franklin Burns, P.C., at 1-404-303-7770.

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Even though your benefits may have begun for your Workers’ Compensation claim, this does not mean that they are guaranteed to continue. There are many ways that an injured worker may lose his entitlement to benefits. As an injured worker, it is a good idea to educate yourself about how your benefits could be suspended, or cut off.

One way that an injured worker can lose his entitlement to benefits is by failing to report his or her Workers’ Compensation claim promptly and in a timely manner. Even if you are unsure, you should speak with your supervisor or employer about your injury. In Georgia, if the claim is not reported before the one year anniversary from the date of injury, the right to benefits is lost.

jeopardize-benefits.jpgIf you fail to cooperate with your employer or your authorized treating physician, your benefits may be compromised. What does failure to cooperate mean? It does not mean that you have to do anything and everything that your employer tells you to do. It does not even mean that you have to agree with all your authorized treating physician’s recommendations for medical treatment. For example, in Georgia you have the right to refuse recommended surgery. However, it does not mean that you can disobey the Workers’ Compensation laws at random. It is often very difficult to know whether your choices are going to jeopardize your benefits, even when the issue seems simple enough.
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In this global economy, it is not uncommon for workers to contract with businesses in one state and then conduct work in another.
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Almost all work-related injuries in Georgia are going to fall under the Georgia Workers’ Compensation Act. However, when a worker based in Georgia or working for a Georgia-based firm is injured in another state, that can complicate matters.

It’s known as an “extraterritorial workplace injury,” and the question of whether or not Georgia law will apply, as opposed to the workers’ compensation laws of the state where injury occurred, will depend on several factors. The issue can be an important one, as states can vary with regard to interpretations of key definitions like “work-related” and “independent contractor,” and may vary with regard to statutory limitations.
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In Georgia, the State Board of Workers’ Compensation is the governing body that makes the rules and regulations that are applied to Workers’ Compensation claims. One of these rules is Rule 205. This rule states that a doctor or medical provider does not have to get advanced permission to treat the injured worker before rendering services. The treatment does have to be injury related for the rule to apply.

wc205-1.jpgIn most cases, the doctor or medical facility will request authorization for treatment and testing. The Employer/Insurer has 5 days to respond to the request. Most medical providers send in a form to the insurance company asking for permission to give treatment. They do this so they can be sure to be paid. The rule states that the insurance company or the self-insured employer has to respond to the doctor or medical facility within 5 business days of receiving the form. If the insurance company or self-insured employer does not respond, the treatment by the doctor or medical facility is considered authorized and the doctor or medical facility must be paid by the Employer/Insurer.

Recently, the Georgia Supreme Court addressed Rule 205. One of the issues was the burden of proof. The burden of proof means which side has the obligation to prove a fact in court. The Court of Appeals held that the burden of proof was improperly shifted to the employer and insurer to prove that a claim was compensable or payable in situations regarding medical treatment and testing. In Georgia, proving whether or not a Workers’ Compensation claim is payable is always the burden of the employee. In other words, the worker must prove that his claim is payable in Georgia Workers’ Compensation claims.
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Naturally, being unable to work is going to place you in a financial bind while your injury is healing. Expenses can add up. In Georgia, some of these expenses may be covered by the Employer/Insurer. Others may not be covered, so it is good to know just what expenses might be reimbursed to you.

expenses.jpgIf you drive or ride in a personal vehicle to and from your doctor’s appointments, the mileage will be reimbursed to you at the rate of 56.5 cents per mile. If you take public transportation those expenses may be reimbursed. Expenses for taxis to and from medical appointments may also be reimbursed. In certain situations, meals and lodging may be reimbursed to you. For example, if your medical appointments take you away from home and require you to spend the night in a motel this may be an expense that will be reimbursed. These expenses are covered only if they are deemed necessary and appropriate in order for you to receive quality medical care.

In situations where expenses may be reimbursed, it is important for you to be a good record keeper. Save receipts and keep a log of your odometer readings with the dates that you traveled. Without receipts and good records, you most likely will not be reimbursed by the employer/insurer. It is very important that you submit documentation of your approved expenses within a year’s time of incurring the expenses. Otherwise, your right to reimbursement is lost.
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In Georgia, employees who are injured on the job are entitled to Workers’ Compensation medical benefits. These benefits include medical treatment that is necessary to cure you, provide pain relief, or restore your health so that you can return to suitable employment.

medical-treatment.jpgOne of the issues that every injured worker faces in their Georgia Workers’ Compensation claim revolves around medical treatment. After an authorized treating physician has been assigned to the claim, it is very import for the injured worker to be involved in their treatment and to follow the advice of their medical providers.

Georgia law requires that an injured worker cooperate with their doctors and therapists when at all possible. While recommended surgery may be rejected without fear of compromising the claim, failing to follow the doctor’s advice can have a negative effect on the claim. It is especially important to keep appointments and to follow up with medical providers on the schedule that they recommend. But, what happens when the injured worker is not satisfied with their medical treatment?
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Every state has varying rules when it comes to workers’ compensation law, but most provide that workers’ compensation is a no-fault system and employers generally cannot face negligence litigation. cautionwetfloor.jpg

That means workers don’t have to prove negligence in order to collect benefits, but neither can they sue the employer for negligent acts or omissions resulting in injury.

However, there are sometimes penalties for companies that fail to adhere to relevant state, federal and industry safety codes. These can come in the form of fines from the Occupational Safety & Health Administration. In New Mexico, it can result in a 10 percent higher amount of workers’ compensation benefits paid to injured workers.

That was the issue argued in Benavides v. Eastern N.M. Med. Ctr., where an injured nurse argued that lack of a “wet sign” floor in the slick hallway of a hospital where she work constituted lack of a safety device.
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In order for injuries to be compensable under worker’s compensation law, they either need to occur while working or “arise out of the scope and course of employment.”
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For most who work at stationary offices, the question of what is compensable and what isn’t is fairly straightforward, though there is always the potential for complexity in certain circumstances. However, the waters are often muddier for workers whose jobs are not stationary.

A good example of this was recently seen in the case of Trezza v. USA Trucking Inc., before the Arkansas Supreme Court. Although this is an out-of-state case, it’s relevant here in Georgia, as there are thousands of licensed commercial truckers in this state.
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Workers are constantly forced to multitask, particularly when it comes to juggling their personal and professional lives. Unfortunately, trying to be efficient cost one home health care nurse in Ohio the right to collect workers’ compensation benefits, following a decision by the Ohio Supreme Court in Friebel v. Visiting Nurse Ass’n of Mid-Ohio. carcrash2.jpg

The court ruled against the “dual intent” doctrine, which would have allowed a worker running a personal errand while on his or her way to the next assignment to collect benefits for a crash that occurred at that time.

Although the decision doesn’t directly affect workers in Georgia, we can rest-assured courts will review this case when similar questions arise.
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