We are often asked by friends and family:
Why do people call an attorney when they have a workers’ compensation case? Isn’t it a statutory system and all anyone has to do is follow what is laid out in the law?
Oh, if it were only that simple.
For starters, an employer may refuse to report an injury to their workers’ compensation carrier. This has the effect of denying an injured worker many rights. It also may totally prevent an injured worker from being able to get medical treatment at all.
How long does an employee have to report an injury?
An injured worker has just 30 days to report their claim to the employer under Georgia’s workers’ compensation statute. This notice requirement doesn’t necessarily mean that the injured worker must file a written complaint to their employer. Rather, telling a co-worker or a supervisor may be enough notice. In fact, if a co-worker or supervisor is witness to the accident, that may also suffice.
If the employer does nothing after receiving notice—meaning the injured worker is not sent to a doctor nor receives any other type of treatment paid for by the employer or the insurance company—then the injured worker has 1 year to file notice with the State Board of Workers’ Compensation. This notice is to be filed via Form WC-14. This is a necessary requirement, otherwise the statute of limitations will toll.
If the employer does not report the accident, and the injured worker waits for over 1 year to get medical treatment, they could be prevented from getting compensation for the medical care they need and deserve. The reason for this is that their health insurance company could deny the claim, stating that all medical treatment should have been received through workers’ compensation; however, workers’ compensation will deny the claim because the statute of limitations has expired.
The question then becomes:
Why won’t my employer properly report my workers’ compensation case, even though I told them about my injury?
There are a number of reasons why this may be the case:
- The employer is uneducated and doesn’t know how to file a claim. (This is highly unlikely since they are required to learn about workers’ compensation when they purchase the policy.)
- The employer is being vindictive and attempting to prevent the injured worker from receiving medical benefits.
- The supervisor does not want to report the injury to the employer out of fear of reprisal from higher-ups.
- The employer is worried that their workers’ compensation premiums may increase.
Of course, it must be said that none of these reasons for failing to report a workers’ compensation claim are valid because they deprive the injured worker of their rights.
As a general rule of thumb, do not let your employer pay for medical treatment out of their own pocket. Instead, insist that the claim be submitted to workers’ compensation insurance so that you can be protected and have the full rights available to you under the law.
If you have any questions, don’t hesitate to contact the lawyers at Gerber & Holder.