Georgia Workers' Compensation Benefits - What Employees Are Entitled to Benefits?

This article is made available for educational purposes only, to give you general information and a general understanding of the law, not to provide specific legal advice. This should not be used as a substitute for competent legal advice from a licensed professional attorney in your state.

What is Workers' Compensation?

In Georgia, Workers' Compensation operates as a "no fault" system for compensating injured workers for time missed from work and for costs of necessary medical treatment. The system presents trade-offs for Georgia workers. While it bars claims against an employer for personal injury, it also bars some of the defenses an employer could use against a workers' claim such as "assumption of the risk" or that the injury was caused by a fellow employee.

This system means you cannot sue your employer in State/Superior court for your injuries, like you would in other instances. Instead, an injured employee is compensated according to a schedule set out by the Georgia State Board of Workers' Compensation. Sadly, this means you will not be able to sue your employer for such things as pain and suffering from your injuries.

Exactly who is allowed to make a Georgia Workers' Comp claim?

The foundation of workers' compensation law is in defining who is an employer and an employee for workers' compensation purposes. Unfortunately, it is not always as simple as "I work for Company X, therefore Company X is my employer and I am his employee."

The basic rule as to whether an employee/employer relationship exists involves two seemingly simple criteria; 1) a person in the service of another, who is 2) under contract of hire.

There is no requirement that a work contract be written. Actual pay may not be necessary (ex. Volunteer firefighters or police, elected officials). Minors can still benefit from workers' compensation even if they are working in violation of child labor laws. Also, unlike many states, migrant workers and temporary employees are covered.

However, many types of employment or employers are not subject to workers' compensation. Types of employment not covered by Georgia Workers' Compensation include Domestic servants, Farm laborers, Railroad common carriers, Sports officials (umpire, judge, linesman, scorekeeper, timekeeper, etc.), Licensed real estate salespersons with independent contractor agreements, Partners in a business, and Independent Contractors.

Georgia Workers Compensation does NOT apply to employers that do not have at least three employees operating in the same business within Georgia. These minimum three employees must be "regularly in service" within the state. The term "regularly" does not mean constantly or continuously, only that there is a routine practice by the employer to utilize three or more employees, even if that many employees are working on the date of an accident. In most situations your boss will count towards the three employee requirement.

Independent Contractors

Employers often do everything they can to classify their employees as independent contractors to protect themselves from having to pay workers' compensation to their injured employees. There may be a debate as to whether you are in fact an independent contractor, but if you one, you are not entitled to workers' compensation. While it can be complicated determining whether you are an employee or an independent contractor, below are some of the factors to look at in determining your status:

CONTRACT - Existence of an independent contractor agreement signed by the worker PAY - An hourly or salaried worker is likely an employee. When a worker is paid on a per-job basis he may be viewed as an independent contractor. TAXES - If an employer withholds taxes, the worker is more likely an employee. However, just because your wages are reported on 1099 tax form instead of a W-2, your employer has not automatically made you an independent contractor. TYPE OF WORK - If the workers' job is part of the regular business of the employer, rather than some additional service to the business, it would favor the employer/employee relationship. JOB "TOOLS" - Who supplies the tools, supplies, or materials of the job? If the worker supplies all their own tools and materials it likely indicates an independent contractor relationship. HOURS - If the employer controls a workers' hours, it likely indicates an employment relationship. OVERALL CONTROL - If the employer controls how a worker does their job, as opposed to simply requiring certain results, the worker is likely an employee. These "how" factors focus on the hours, manner, methods, and means of performing the work.

Injuries Under Georgia Workers' Compensation - What Injuries Are Covered?

You know you are injured, but is your injury covered by Workers' Compensation?

Georgia's workers' compensation laws require that for compensation to be due, an injury to an employee must 1) "arise out of" and 2) "in the course of" employment. These are deceptively complicated requirements here in Georgia. There is no clear cut test for either of these requirements. Below are some of the major considerations:

"Arising out of employment" Must be a causal connection between the condition of the work and the resulting injury Injury must relate to the employment and not be independent if it An accident arises out of employment when the accident arises because of the employment "In the course of employment": An accident must occur within the time period of employment At a place where the employee reasonably may be in the performance of their duties While the employee is fulfilling their duties Is my at-work injury covered by workers' compensation?

Aggravation of preexisting conditions

Your employer is required to pay for an at-work aggravation of your preexisting conditions. However, they are only required to compensate you to the point where you have returned to the pre-aggravation condition. For example, if you are over the age of 40, your back is likely not as healthy as it was when you were in your 20s. You might have what doctors call "degenerative discs" in your spine. These discs can be injured more easily than healthy discs, but your employer would still need to compensate you should you injure your back at work.

Occupational Diseases

Your employer may be required to pay for an "injury" due to a disease which is a specific risk of your job. In some rare circumstances this can include a psychological or nervous injury due to long-term stress or other job-related factors. There can be complicated limitations to coverage for occupational diseases. If you wish to proceed with a claim based on a disease believed to be developed out of the course of your employment, it is highly advisable that you contact an attorney.

Practical jokes/horseplay injuries

An employer is not required to pay for an injury to a party engaging in horseplay or practically joking during working hours. However, an injury suffered by an innocent employee due to the horseplay of a fellow employee is covered.

On the job fights/assault

Generally, injuries during fights at work are not compensable where the fight is not related to your employment. Additionally, an injury resulting from an assault by a third party (non-employee) at work is not covered where the assault by a third party is for reasons personal to the employee. For example, the assault of a store clerk during a robbery would be compensable, but an assault by a fellow employee or third party arising from a dispute over who has the fastest car would not be compensable.

Psychological or emotional illnesses

Generally, psychological or emotional injuries are only covered to the extent that the condition arises from a physical injury. In other words, if an employee develops a psychological condition, like depression, based on a purely emotional situation it likely would not be covered. However, if the same condition resulted from an underlying physical injury, it would be covered. Additionally, if an emotional injury, like stress, manifests itself in a physical way, those physical injuries (ex. headaches or blurred vision) may be covered by workers' compensation.

Is my off/after work injury covered by workers' compensation?

Off-work aggravation of work injuries

You employer is required to pay for many off-work aggravation of work injuries. However, an employer would not have to pay for an injury if it was found that the negligence of the injured employee in aggravating the condition had completely broken the connection to the previous injury.

After work activity injuries

If you are injured while not actually working, but participating in a work activity or recreation event (like a company picnic or softball game) the injury may be covered by workers' compensation. While no one fact controls, below are several factors that may be weighed to determine whether the injury is covered. Did the accident occur on the employer's premises? Was the event/team organized by the employer? Did the employer pay for the activity? Did the employer benefit from employee participation in the event?

Injuries going to and from work

For employees who work at a fixed location and do not travel as part of their job (unlike taxi cab drivers, truckers, pizza delivery persons), injuries sustained while going to or from work are not covered. However, there are some exceptions to this rule:

When an employer has furnished transportation to the employee When the employee runs a beneficial errand for the employer while going to or leaving work (ex. an accident while dropping off mail for your employer on the way home) When the employee is on call When the employee is reimbursed for transportation costs When the injury occurs in your employer's parking lot as you arrive or leave Rest Breaks/Lunch Breaks

Injuries during scheduled lunch or rest breaks are generally not covered by workers' compensation. However, injuries during unscheduled rest breaks may be covered in some instances, depending on the employer's rules regarding breaks as well as what you were doing during that break.

During both lunch and rest breaks, if you are doing something in furtherance of your employer's business or by your employer's instruction, an injury during that time is likely covered by workers' compensation. Examples include running an errand for your boss during lunch or carrying tool from one part of a shop to another during a rest break. These actions transform the non-work period into covered time.

Business Related Travel

When traveling on business for your employer, most injuries are going to be covered regardless of when it occurs. However, there are exceptions to this rule.

Notifying your employer of an injury

Notice of the injury must be given either orally or in writing within 30 days after the accident or within 30 days after a death from an accident. There are however, some exceptions to this rule. When the employee has been prevented from giving notice by physical or mental incapacity. When the employee is prevented from giving notice by the employer's fraud or deceit. When the employer (or a supervisor or foreman) has knowledge of the accident.

Your employer must be told not only of an accident, but that you were injured from the accident. However, this notice does not need to come directly from an injured employee. It could come, for example, from an employee's spouse, child, or a fellow employee. The notice must be made to someone in management (like a supervisor or foreman), not just a fellow employee.

If an injury is not known until more than 30 days after the accident, the 30 day period does not begin to run until you first had reason to realize the injury was from the accident. In the case of a gradual injury (like a slowly developing back problem) that causes you to stop working, you must still give notice to the employer that you are stopping work because of the work-related injury.

This article is made available for educational purposes only, to give you general information and a general understanding of the law, not to provide specific legal advice. This should not be used as a substitute for competent legal advice from a licensed professional attorney in your state.