Learn the limits of workers’ compensation in Georgia
Workers’ compensation is a fairly comprehensive system that exists to aid workers in their right to be safe and healthy while at work. It exists to help compensate those who have been injured while on the job.
However, workers’ comp does not cover every injury—or every time when an injury may occur.
It’s vital to know what is specifically not covered by workers’ compensation in the state of Georgia just as much as what is covered by it. Here’s a list of scenarios that are usually excluded from workers’ compensation coverage in Georgia.
If you have questions, don’t hesitate to contact our Georgia work injury lawyers for answers.
Scars and disfigurement
Georgia generally does not offer compensation for work-related scars or disfigurement under the workers’ compensation system. It’s one of the few states that does not include this under the umbrella of workers’ compensation. Most people expect that all states would have this as part of their coverage plan, so it is important to understand that in this case it simply isn’t offered.
The initial injury that causes the scarring should be covered, but the actual scars themselves will not.
Workplace accidents while under the influence
Injuries that one sustains while under the influence of alcohol or drugs will not be covered by workers’ compensation in Georgia (or anywhere else, for that matter). There are a few exceptions to this rule, such as if a court can deem that the accident was otherwise unavoidable. That is rarely the case, but may be worth looking into.
Employers are allowed to require that you submit to a drug and/or alcohol screening after an accident has occurred. You must submit to the test or the presumption in court will be that you were intoxicated at the time of the accident. Your claim will likely be denied if that is the case.
A positive drug or alcohol screening is bad news, but there is still some potential that you could get your workers’ compensation benefits regardless. There is always a chance that some substance was taken days before and just now showed up on the test.
Accidents that happen during your lunch break
Hourly workers clock in and clock out when they are at work. They are typically required to clock out when they take a legally mandated lunch break. Their employer can’t tell them where to go during that time, and many employees take the opportunity to spend some time away from their workplace and go to get lunch. There is nothing wrong with that, but understand that injuries that occur while you are away from your place of employment or off-the-clock are generally not covered by workers’ compensation.
Georgia doesn’t require employers to cover any injury during a lunch break. The worker is off the clock and assumes all personal responsibility for the actions that they take at that time.
Some employers will use what is called an “affirmative defense,” such as the willful misconduct of an employee, to nullify any workers’ compensation claim that the employee may attempt to make.
Employees who blatantly disregard safety policies established by the company may find that their workers’ compensation claim is denied at first. They can no longer rely on a workers’ compensation claim because they have so clearly ignored the rules and taken their health and safety into their own hands.
Self-inflicted injuries are included as part of the “willful misconduct” defense. Someone can’t intentionally hurt themselves while at work and demand that their employer pay them out in workers’ compensation.
Heart attacks and strokes
Because certain medical conditions like heart attacks and strokes are so common both inside and outside the workplace, there are a variety of special circumstances that must occur for these types of health conditions to be covered by workers’ comp.
For starters, there must be medical evidence that the incident really was a heart attack or stroke, and it has to be proven that the episode took place at work and while the employee was on the clock. Another important factor to be considered is if the person who suffered the heart attack was at high risk or not. Someone at high risk with contributing health issues like obesity, hypertension or a smoking habit may have more difficulty winning this case.
PTSD and emotional trauma
In recent years, major efforts have been made across the country to include PTSD, psychological trauma and other “mental injuries” in workers’ compensation coverage. However, currently in Georgia, works must also have a compensable physical bodily injury in order to be compensated for a psychological injury. Georgia workers cannot file a workers’ compensation claim for PTSD alone.
Pain and suffering
When you hear that people received compensation for “pain and suffering,” it means they were compensated for the physical pain and discomfort that their injuries caused. This monetary compensation is meant to help make up for all of the negative emotions that a person experienced due to their injury, including anxiety, sadness, depression, anger, loss of quality of life, etc.
Pain and suffering is one of the damages you can receive in a personal injury lawsuit; however, this type of injury is not covered by workers’ compensation in Georgia.
Generally speaking, the only way an injured worker can receive pain and suffering compensation for a work-related accident is if they file a personal injury lawsuit against a responsible third-party (someone who is not your employer).
Get your questions answered by a knowledgeable Georgia work injury attorney
All Georgia residents should understand the unique situations that can arise that cause a workers’ compensation claim in the Peach State to be denied. It is clear that there are a lot of these potential circumstances, which is why it’s best to hire a law firm to sort through your options to keep yourself protected and covered. All employees deserve to empower themselves with this information.