Do you really need to hire an attorney after a workplace injury in Georgia? Yes, and here’s why…
If you’ve been injured on the job in Georgia, you may be wondering if it’s okay to represent yourself. Your employer may even be pressuring you to work it out with their insurance company on your own.
The good news is that it’s your choice.
If you decide to work with an attorney, you may get more workers’ compensation benefits. In addition, you’ll have your own legal representative to help you file for additional medical expenses, financial compensation and approval for ongoing care. After all, your employer probably has their own legal team—or at least an insurance company with a legal team.
Are there any cut-and-dry workers’ compensation claims?
In some cases, employers work hard to take care of their employees. In other cases, they place profits above the welfare of their staff, or they may have a particularly aggressive insurance company that won’t recognize an injured worker’s full claim.
Most people aren’t quite clear about their rights after being hurt on the job. Often, they rely on their employer to tell them what they can and cannot do. However, this is never a wise practice. Let me explain why:
If you were in a car accident, would you rely on the person who hit you to take care of your injuries and look after your legal rights? Of course not, because they would obviously have their own agenda. So why would you trust your employer in the event of a workplace accident?
When things get complicated in a workers’ compensation case, you should hire a lawyer immediately. Just like there are rules and regulations regarding how much an attorney can charge (which we’ll discuss below), there are also rules and guidelines throughout the entire workers’ compensation process. Hiring a work injury attorney can help you navigate all of these complex rules.
For these reasons and more, it’s almost always a wise decision to hire (or at least consult) a workers’ compensation attorney if you’ve been seriously hurt on the job.
Why should I hire a workers’ comp lawyer?
One question we’re often asked by prospective clients is: Why should I hire a lawyer?
Simply put, these reasons are:
- There are many rules and regulations that have to be followed throughout the life of a workers’ compensation claim, and failure on your part to comply with any of these rules could lead to your forfeiture of benefits.
- Within the workers’ compensation system, there are certain avenues that can help you receive proper treatments and benefits that lawyers can assist you with. A lawyer can also assist you with enforcing your rights.
- The workers’ compensation carrier and their employer have lawyers working for them, advocating for them at every step—you should too.
How much is your injury worth?
Let’s explore each of these reasons more in-depth below.
Reason #1: We understand workers’ compensation laws, rules and regulations inside and out
Workers’ compensation in Georgia is governed by statute. Specifically, O.C.G.A. 34-9 contains the governing laws, rules and regulations that apply to those who are injured on the job, as well as their employers and their workers’ compensation insurance. Additionally, case law helps define what is and isn’t allowed under these statutes. It’s a very nuanced area of the law.
For example, if you return to work with light-duty restrictions for 15 days after receiving temporary total disability benefits and go out of work on the 15th day because you’re in too much pain, then temporary total disability benefits have to be recommenced by law. However, if you work 16 days under the same circumstances and then go out of work because of the pain, you’re not entitled to have your benefits started again.
There are numerous confusing situations just like this in the workers’ compensation system.
Because workers’ compensation is regulated by one specific statute, there are very strict guidelines that govern it. Hiring an attorney can ensure that you are meeting all of these requirements.
For instance, the statute of limitations for workers’ compensation claims isn’t as clear-cut as it is for personal injury claims. In a personal injury claim, you have 2 years to file suit. In a workers’ compensation case, you have as little as 30 days to provide notice to your employer and only 1 year from the date of the accident to file suit in certain situations.
Unless you’ve fully read and understand Georgia workers’ compensation statute and case laws, there’s no way to know what you don’t know. What you may not know could have real-world implications by significantly impacting your livelihood and your ability to receive proper medical attention and get back to work.
Workers’ compensation also has many rules that you have to comply with to receive benefits. If you’re receiving benefits, your employer (or their workers’ compensation carrier) can provide the authorized treating physician with a job description and offer you a job if that doctor agrees that you should be able to perform it. If you do that job for only half a day and have to leave work because of pain, your benefits may not be recommenced. However, if you attempt to work for a full day (8 hours), they have to be recommenced.
It’s little details like this that you may not know that are so important in a workers’ compensation case, which is why having an attorney is so crucial.
Reason #2: We can make sure you receive the best possible treatment
Attorneys can also help you stay on the offensive in your workers’ compensation case. Doctors are the gatekeepers of almost everything in workers’ compensation. They determine the work capabilities of the injured worker, determine what care is needed, and who should provide that care. Choosing the right doctor is imperative.
In a workers’ compensation claim, an injured worker is able to receive treatment from an authorized treating physician. An employer is required to have a posted panel of physicians who are authorized to treat an injured worker. Recently, we have seen the rise of industrial clinics in the workers’ compensation area. These clinics, such as Concentra, Urgent Care and others, are designed to quickly treat patients.
We have found that they rarely have the capability to adequately diagnose and treat those who have been seriously hurt on the job. Despite this fact, these clinics are often listed on workers’ compensation panels, and employers often instruct their injured workers to visit these facilities. We’ve had numerous clients tell us that the industrial clinic is more focused on performing drug tests as opposed to treating their injuries.
Hiring a workers’ compensation attorney can help you avoid these clinics and instead get treatment from a specialist, such as an orthopedic.
Reason #3: We will represent your best interests and skillfully negotiate with insurers
Finally, insurance companies have a plethora of lawyers working for them. Shouldn’t injured workers have the same resources available to them?
Even if the injured worker thinks that everything is going great and the insurance carrier is doing the right thing, events are proceeding based on the insurance carrier’s terms. They have protocols and teams of attorneys who have determined what the most efficient and cost-effective way to handle a claim is. This means that your injury claim may be handled in a way that is disadvantageous to you.
Just because your claim is proceeding smoothly doesn’t mean that you’re being made aware of all of your rights and entitlements.
An example of this is in the area of independent medical examinations (IMEs). If an injured worker has received indemnity benefits within the past 120 days, then they are entitled to an independent medical evaluation with a doctor of their choosing. Furthermore, the insurance carrier is required to pay for this evaluation and for any reasonable testing that this doctor requests. This information isn’t always given to the injured worker. Our attorneys can help you choose a doctor who is reputable and will give you a non-biased opinion.
Specific examples of when you can most benefit from professional legal counsel
If you’re facing any of the following scenarios, we strongly advise you to seek the help of an experienced work injury attorney before proceeding.
Your employer denies your claim or doesn’t pay upfront
Your employer has a duty to respond to your claim right away. Some employers don’t believe claims and simply deny them out of principle at first, hoping that they’ll go away. This is when you need to hire an attorney to file an appeal so you can get benefits through a settlement in a timely fashion.
Your employer’s settlement offer is too low
A lawyer can negotiate to bring up the amount of your settlement and work with a compensation judge to ensure that you get the right amount for your injury. While workers’ compensation settlements need to have judicial merit, judges typically sign off on any agreement as long as it’s grossly unfair.
An attorney can show that your injuries require more coverage due to wage loss, ongoing care problems or gross negligence that led to the worker’s death.
Medical issues prevent you from returning to work
These cases are difficult, and it’s often a tough fight to get benefits for ongoing wage loss and medical care. However, if your injuries led to a permanent handicap, and you are now disabled, then you may be entitled to weekly payments or one large lump sum settlement to make up for these lost wages.
In many of these cases, insurance companies don’t want to compensate the worker because of the cost. A knowledgeable workers’ injury lawyer can help you get organized and secure the benefits owed for your permanent injury.
You plan to apply for Social Security disability
If you don’t receive a settlement that is structured to cover you without affecting your Social Security benefits, you could actually reduce your Social Security disability payments. Experienced attorneys understand how to structure settlements so that your SSDI benefits are not affected.
Your employer retaliates after you file a claim
Did you return to work after filing a claim only to be fired or demoted?
You can seek compensation for a reduction in hours, slashed pay, demotions, termination, or any other action taken against you after returning to work. You should contact an attorney immediately if you experience any discrimination upon filing a workers’ compensation claim.
The injury occurred as a result of a third party’s actions or employer’s gross misconduct
The workers’ compensation system is designed to handle straightforward cases. If you fall because there was a leak in the roof, it can be documented and proven that there was a problem.
How do you prove that another employee purposefully sprayed water in an area that led to your slip and fall? Who is at fault?
You’re allowed to sue outside of workers’ compensation in certain cases where there was someone else or other actions that took place that contributed to you suffering an injury.
Your employer doesn’t have insurance
You’ll definitely want to contact a lawyer if your employer doesn’t have workers’ comp insurance as legally required, as this will lead to a lawsuit where you will need to file the right paperwork to sue your employer. In most cases, this ends with a settlement offer, but the employer may also face fines and other penalties.
Your employer wants you to return to work after your injury
There are certain requirements that an insurance company must meet before you have to return to work if you are presently receiving benefits. It’s important to understand that you don’t have to return to work if the authorized treating physician hasn’t released you to normal duty work.
Just because your employer asks you to come back, doesn’t mean you have to.
There is a very specific procedure that must be followed when it comes to bringing an injured employee back to work and strict consequences if these procedures aren’t followed. Furthermore, if you do return to work, your ability to receive benefits in the future may be compromised. It’s vital that you hire an attorney at this point in time—or at least consult one.
You’ve received medical treatment but remain in pain
Medical treatment plays a crucial role in workers’ compensation claims. Your authorized treating physician determines the course of treatment and your work status. Georgia law (O.C.G.A. 34-9-200) requires the insurance company to provide the injured worker with medical care for their work-related injury. The injured worker can select a doctor from a panel of physicians. Some of these doctors specialize in different areas, and some are better than others.
Many times, injured workers are steered to an industrial clinic by their employer. These industrial clinics rarely serve the injured workers’ needs. They are ill-equipped to handle serious injuries. Our clients’ complaints of pain are frequently ignored, and they are returned to work.
The good news is that injured workers are entitled to a one-time change in authorized treating physicians.
The doctor in a workers’ compensation case controls the work status of the injured worker. Therefore, they are essential to a claim, and choosing the right one is extremely important. A lawyer can help you choose a doctor who is going to actually listen to your complaints of pain and provide appropriate treatment.
A doctor has determined that you have reached maximum medical improvement (MMI)
There is a point when the insurance company thinks your case is coming to an end. Maximum medical improvement means that your injury has healed as much as it’s going to, according to the doctor. At that time, you will be assigned a permanent partial disability rating.
There are 2 important factors to consider here:
- First, your benefits will not be cut off just because you have reached MMI. Some states do this, but Georgia is not one of them.
- Second, just because a doctor states that you have reached maximum medical improvement doesn’t mean that you actually have.
An attorney can assist you if you are still in pain. Additionally, a lawyer can help you get a proper PPD rating from a doctor who may be more sympathetic to your permanent disabilities.
The insurance company makes an offer to settle your case
Remember, insurance companies are for-profit entities. It’s their job to make money for their shareholders and owners. They make money, in part, by collecting premiums and paying out as little as possible to injured workers.
If an insurance adjuster or other representative makes an unsolicited offer to you, be mindful that there’s likely a financial, business-motivated reason behind it. Don’t take the offer immediately. Instead, hire an attorney who can help you get the most money out of your claim and ensure you aren’t getting scammed or underbid by the insurance company.
You have a workers’ compensation hearing pending
The request for a hearing may have been made by the insurance company and their attorney. It greatly benefits claimants to have experienced representation at any such hearing.
There are rules of evidence to be followed and pre-hearing discovery that takes place. Navigating this complex process and avoiding a hearing is something our attorneys specialize in.
Gerber & Holder Law attorneys Ben Gerber and Thomas Holder discuss what’s involved in the settlement process as it relates to workers’ compensation.
Do I need a workers’ compensation lawyer or can I represent myself?
Immediately after you are injured at work, we recommend consulting with an attorney. Even if you don’t hire them at this time, it can be immensely valuable to get a lawyer’s perspective on what has happened and what is going to happen in the weeks and months ahead.
An experienced attorney will most likely have dealt with an injury similar to yours, and they can help you get treatment with an appropriate doctor. There are a number of important decisions that must be made at the outset of a claim. Lawyers can also work to ensure that indemnity checks are properly started and that there is no loss of income.
Hiring a lawyer at the beginning of a claim can make the entire case run smoother.
If you’ve already received an offer from the insurance company or your employer, consider whether the amount is enough to cover your full lost wages and pay your medical expenses. You may want to consult with a lawyer if you’re unsure of the laws or how much you could receive for your injury.
In many cases, you could be owed hundreds of thousands of dollars more than the insurance company initially offers. That’s why you should talk to a lawyer to evaluate the offer. Don’t miss out on the benefits and wages owed to you.
But what if I can’t afford to hire an attorney?
The first thing that every injured worker should know is that it doesn’t cost any upfront money to hire many reputable lawyers to handle a workers’ compensation claim. Lawyers in the workers’ compensation arena work almost exclusively on a contingency-fee basis.
This means that they don’t charge the injured worker any money up front and only get paid if they recover money for that individual.
Considering that fact, the next obvious question is:
What contingency fees do workers’ compensation attorneys charge?
Georgia law (O.C.G.A. 34-9-108) establishes how much attorneys can get paid in a Georgia workers’ compensation case. It states:
The fee of an attorney for service to a claimant in an amount of more than $100.00 shall be subject to the approval of the board, and no attorney shall be entitled to collect any fee or gratuity in excess of $100.00 without the approval of the board. The board shall approve no fee for an attorney’s services to a claimant in excess of 25% of the claimant’s award of weekly benefits or settlement.
This rule has 2 effects:
- First, it caps an attorney’s fees in a workers’ compensation case at 25% of the settlement or weekly benefits. This means that an attorney who is assisting an injured worker in a workers’ compensation case cannot charge more than 25% of the settlement. This is significantly lower than in a personal injury setting, where the percentage is usually 33 to 50%. For example, if your workers’ compensation case settles for $100,000, you would receive $75,000 and the attorney would be paid $25,000. If, however, the same individual was injured in a slip-and-fall accident outside of work and obtained the same $100,000 settlement through a personal injury attorney, they might only receive $50,000 after paying the lawyer.
- The second effect of Georgia law is that all fees over $100 must be approved by the State Board of Workers’ Compensation. There have to be official documents signed by all parties and submitted to the State Board.
To summarize, the fact that there are caps on fees and you won’t have to pay your attorney unless they successfully secure you a settlement means that you don’t have to worry about “affording one.” Additionally, the professional insight and guidance provided by an attorney often result in substantially higher settlements, offsetting the legal fees and more than justifying your investment in their expert legal representation.
Contact the experienced Atlanta work injury attorneys at Gerber & Holder for help with your claim
At Gerber & Holder Workers’ Compensation Attorneys, we have over 75 years of combined experience working in the workers’ compensation field. We are deeply familiar with many of the tactics that the workers’ compensation carrier will employ. We can assist you in both defeating the insurance company and avoiding potential pitfalls.
Contact Gerber & Holder today for your free consultation.