A general timeline of work injury claims in Georgia
One of the most common questions we get asked when meeting a potential new client is:
How long will my case take?
This question is difficult to answer accurately; however, the injured worker typically wants—and deserves—an answer. In this article, we will address the how long a workers’ compensation case typically takes, and why it’s so hard to predict exactly how long you claim will actually take.
Before we answer this question, though, first we need to determine the root of the question the potential client is asking. Typically, they want to know one or more of these four questions:
- How long until I get my benefits?
- How long until I get better from the on-the-job injury?
- How long until I can go back to work?
- How long until I can settle my case?
Each question has a different timeline, and we will examine each below.
Timeline to receiving your workers’ compensation benefits
A workers’ compensation case in Georgia can exist in 3 forms, or “postures.” Each of these different postures can affect the timeline of your case. These postures are:
- An accepted compensable case
- A medical only claim, or
- A controverted case.
When an individual is injured on the job and the insurance company pays for both medical and indemnity benefits, it is deemed to be an accepted claim. When an insurance company only pays for medical treatment, but not indemnity benefits, it is said to be a medical only case. Finally, when the insurance company denies the claim, saying either that the individual is either all better from their on-the-job injury or that the injury never happened in the first place, then the claim is controverted.
When an individual is hurt on the job and the claim is denied, there is a formal process that is undertaken in order for them to receive benefits. The first order of business is to file a WC-14 requesting a hearing with the State Board of Workers’ Compensation. This is a form which lays out the reasons for the request of a hearing, and identifies all parties to the claim.
Georgia law (O.C.G.A. 34-9-102(a)) defines when the hearing is to take place. It states that a hearing shall be scheduled at least 30 days after filing of the WC-14, but no longer than 90 days. The law also states that the Georgia Civil Practice Act applies to all workers compensation cases. This means that both parties get to engage in discovery.
Discovery in a workers’ compensation case means that each side can serve requests for production of documents and interrogatories on the opposing party. Upon receipt of the discovery, the opposing party has 30 days to respond. Additionally, this allows for the deposition of fact witnesses to be taken by either party.
As you can see, this can make for a very condensed timeline.
Practically speaking, the first setting is rarely, if ever, set in stone. In most cases, the hearing is postponed at least once to accommodate for discovery. Additionally, there are times when medical treatment falls past the hearing date or an independent medical examination cannot take place prior to the hearing date due to the provider’s schedule. These are just a few examples of reasons why a hearing may not proceed on the scheduled date and has to be postponed. A hearing is ready to proceed in most instances by the second or third setting, depending on how quickly the resets are calendared.
From a timeline perspective, this process can take anywhere from 3 to 6 months. Once the hearing is held, the record is closed unless kept open by special request. The parties subsequently submit briefs at a time period established by the administrative law judge and the judge has 30 days to file a ruling. Either party can appeal the decision of the administrative law judge to the Appellate Division of the State Board of Workers’ Compensation within 20 days of the ruling.
In conclusion, taking a case to a hearing without an appeal from the time a WC-14 is filed until a decision is handed down can take anywhere from 6 months to 1 year, depending on the issues and the amount of discovery involved.
Timeline to recovering from an on-the-job injury
This question is a common one, and the answer is always the same. This question can be better answered by your doctor. Each person’s body reacts to an injury differently. Each injury is unique as well, from the cause and type of injury, to the severity. Therefore, this is an impossible question for an honest lawyer to answer.
There are medical guidelines that suggest how long the recovery from a certain injury should be. However, they are just that—guidelines. No injured worker would like to be treated by a robot who doesn’t take their feelings or complaints of pain into account, and therefore no guidelines can adequately capture what an injured worker is going through.
Not every doctor will listen to the injured worker or properly address their complaints of pain. It’s important to contact an attorney to ensure that you are seeing an appropriate doctor for your injury. There are many ways to change doctors and get a second opinion.
In short, the timeline for how soon an individual who is injured on the job will recover is case specific, and it’s impossible for a workers’ compensation lawyer to give a reliable answer to this medical question.
Timeline to going back to work
Understanding how long it takes for an individual to return to work is an interesting question. If the injured worker has been completely taken out of work by the authorized treating physician, then the answer is a medical one. If the injured worker is on restrictions as a result of their on-the-job injury, then the answer is up to the employer and the authorized treating physician.
It’s important to note that you should be very careful in returning to work after receiving indemnity benefits. There are a lot of rules and procedures that the insurance carrier has to follow when returning an injured individual to work. It’s best to contact an experienced attorney to discuss your legal options with them.
Timeline to settling your workers’ compensation case
There is nothing in Georgia’s workers’ compensation statute that requires either side to settle. The injured worker is under no obligation to accept money in lieu of indemnity benefits or a permanent partial disability rating, and the insurance carrier is under no obligation to pay a lump sum settlement either. It is merely a choice to resolve issues between two parties.
There are a number of instances where each party may want to resolve a claim. For example, if there is a dispute regarding medical care or indemnity benefits, the parties may agree to settle the entire claim or a portion of the claim. If the individual has reached maximum medical improvement, the parties may want to explore settlement. There is no set time when a case should settle.
The best method to determine the time period to settle your case is to keep your attorney aware of everything that is going on with your claim. That way, they can discuss the pros and cons of resolving a claim.
Consult an experienced Georgia workers’ compensation lawyer
While we cannot ethically tell you exactly how long your case will take to resolve, we hope this article gives you an idea of the factors involved. If you have any questions about how long your case will take, don’t hesitate to contact an experienced Athens workers’ compensation attorney at Gerber & Holder.