When a workers compensation injury keeps you out of work in Georgia, you rely on the workers compensation check that the insurance company pays you. This temporary total disability check replaces the wages that you lose when you are unable to work.
But, Georgia law does have limits on how long the insurance company has to pay these weekly checks. Knowing about and understanding these limits can help you make good decisions about your workers compensation case.
There are three types of weekly workers compensation checks in Georgia. In this article, I am going to focus on temporary total disability (TTD) benefits. The two other types of weekly benefits are temporary partial disability and permanent partial disability.
Can the insurance company just stop paying my weekly TTD check?
They can, but they will probably have to pay assessed attorney’s fees and late penalties if they do. Georgia’s workers compensation law requires the insurance company to have a valid reason to stop your weekly check. Georgia’s law also requires them to file a Form WC-2 that states the reason that they are stopping your check.
Does my weekly check stop if the doctor says I can go back to work on “light duty” restrictions?
No. Even if the doctor says your are physically capable of doing restricted work, your workers compensation TTD check will continue. I do need to clarify this point because there are a couple of things that could cause your check to stop in this situation.
First, your check could stop if the employer offers you a suitable light duty job. In this situation, your check could stop if you go in and attempt the job or if you refuse to attempt it.
Georgia has very specialized rules about light duty job offers and how they affect your benefits. To learn more about those light duty job rules, just read this article.
Your TTD weekly checks will also stop if you return to work after your doctor releases you to light duty. If you are working, you are not entitled to temporary total disability but you might be entitled to temporary partial disability benefits if your injury causes you to make less.
Can the insurance company stop paying my check if the doctor places me at maximum medical improvement?
No. Georgia law does not let the insurance company automatically stop your temporary total disability benefits when you reach maximum medical improvement.
Maximum medical improvement is the point at which your doctor has provided the treatment that you need for your injury and does not expect you to get substantially better. If you are not completely better, you may receive a PPD rating and permanent work restrictions.
If you have permanent work restrictions, your injury may continue to keep you from working even after you reach maximum medical improvement. If it does, you should continue to receive your weekly TTD benefits.
What happens when the doctor gives me a permanent partial disability rating and releases me?
This will likely happen when you reach maximum medical improvement. As I discussed in the section above, your weekly workers compensation check should continue as long as your injury continues to keep you out of work.
Will my weekly check stop if I return to work?
Yes. You only receive temporary total disability benefits when your injury keeps you from working. If you return to work, those benefits should stop.
This is true regardless of whether you go back to work with the company where you were injured or a different company. In both situations, your workers compensation checks should stop when you actually return to work.
If you return to work, you should notify the workers compensation insurance company that you have returned so that they do not continue to pay you temporary total disability benefits. If they continue to pay you temporary total disability benefits after you return to work, you should not cash those checks. There are potential penalties for receiving temporary total disability benefits when you are not entitled to them.
There is one specialized situation where you can receive temporary total disability benefits even though you return to work. It comes up in the case where you have more than one job at the time of your workers compensation injury. If your jobs qualify as concurrent dissimilar employment, you might be entitled to continue drawing TTD benefits when you return to work at one of your jobs. But, this area of the law is extremely complicated.
What happens if the doctor says I can return to work without restrictions?
If your authorized treating physician says that you can return to work without restrictions, the workers compensation insurance company will probably file a Form WC-2 to notify you that they are stopping payment of TTD benefits. In this situation, Georgia law allows them to do so.
This can happen even if you do not actually go back to work. Georgia law allows the insurance company to stop your weekly check in this situation because your injury cannot be keeping you out of work if you do not have any work restrictions. But, the insurance company has to file paperwork properly to stop your check.
While the insurance company can stop paying your check if they file the paperwork properly, you can fight about getting your check restarted if you believe that you still have limitations from your injury. Many times, my clients get released to return to work without restrictions by a company doctor even though their injuries still affect their ability to work. When we prove to a judge that they still have limitations, their benefits get restarted.
Are there other times that the insurance company can stop my check?
Yes. Most of the reasons that the insurance company can stop your weekly check are listed in Section C of the Form WC-2.
Also, Georgia law has limits on how long the insurance company has to pay temporary total disability benefits. In most cases, the maximum time you can receive temporary total disability benefits is 400 weeks from your date of injury. Also, you may stop receiving temporary total disability benefits sooner if the insurance company files a Form WC-104 which ultimately converts your weekly checks to temporary partial disability.