Georgia workers compensation law requires the insurance company to pay weekly checks to compensate you for certain types of losses. Three of the common situations where an insurance company should pay checks are:
- When your injury keeps you from working;
- When your injury causes you to make less money per week; and
- When your injury causes you some form of permanent impairment.
But, insurance companies often fail to file these forms. Even when they do file the forms, the forms can be confusing and are sometimes not filled out correctly. So, it can be difficult to determine what the insurance company is paying you for and how they calculated your weekly check amount.
What weekly amount is the insurance company supposed to pay me?
The weekly amount you receive will depend on a couple of things:
- The type of workers’ compensation check you are receiving
- Your average weekly wage before your injury
If you are unable to work because of your injury, you will usually receive temporary total disability benefits. The amount you receive in temporary total disability each week will depend on your average weekly wage. But, each week should be the same amount .
The same rule applies to the benefits the insurance company pays if you have some form of permanent impairment. These are called permanent partial disability benefits.
In most situations, the amount of your temporary total disability benefits or permanent partial disability benefits is two-thirds of your average weekly wage from the thirteen weeks before your injury. I say in most situations because there are maximum and minimum amounts to these types of benefits where the two-thirds rule does not necessarily apply. This article I wrote provides more detail about how your weekly amount should be calculated.
If you are working but making less money per week than you were before your injury, then you have to look at one other thing besides your average weekly wage. You also have to look at the amount that you are making each week after your injury because the insurance company only has to pay you two-thirds of the difference between what you made before your injury and what you made afterward. These benefits are called temporary partial disability benefits.
How do I know if the insurance company calculated my check correctly?
You need to know a few different things to determine if the workers compensation insurance company calculated your check amount correctly:
- The maximum check amount for your date of injury
- The average of your earnings for the 13 weeks before you got hurt
- Whether you worked “substantially the whole ” of the 13 weeks before you got hurt
The maximum check amount varies depending on when you were injured. It is set by the date you were injured. At the time I am writing this article, the maximum check amount is $675 per week. But, if you were injured before July 1, 2019, the maximum amount may be $575 (or even less if your injury was before July 1, 2016).
If you are receiving the maximum check amount for your date of injury, then your check amount cannot be increased. If you are receiving less than the maximum amount, then you need more information about your earnings before your injury to verify that your check is correct.
The insurance company should have filed a Form WC-6 wage statement when they started paying you. This form demonstrates how the insurance company calculated your check by showing the wages they used to calculate it. But, insurance companies often fail to file this form. If they do not file it, you may need to gather your own wage information.
The other thing that matters is whether you worked “substantially the whole of the 13 weeks” before your injury. If you did not work “substantially the whole” of this 3 month period, then the law sets up other ways for determining your correct workers compensation check amount.
Can I get my check amount increased?
Yes. You can get your check increased if the insurance company is underpaying you. I am often able to get check amounts increased for my clients because the insurance company has calculated their check incorrectly.
Getting paid the correct check amount is important because it affects the amount you receive each week you are out of work. Also, the insurance company will have to go back and fix the weeks they paid incorrectly, so you may be entitled to some backpay if your check gets increased.