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Does Workers Compensation Cover Back Injuries?

Back injuries at work causes serious problems for many people.  Back injuries make up about one of every five injuries that occur at work.  Some of the common causes are:

  • Performing heavy lifting, on a single occasion or repetitively
  • Bending to lift
  • Slipping and falling
  • Falling from heights
  • Car wrecks or other motor vehicle accidents

These are just some common causes of back injuries.  There are other causes as well.

After suffering a back injury in the workplace, you will need medical treatment and may also have difficulty doing your job.  Work-related injuries are generally covered by workers compensation.  So, what happens when you injured your back on the job?

Doctor reading spinal x rayDoes Georgia workers compensation law cover all back injuries that happen at work?

Yes and no.  Under Georgia’s workers compensation law, back injuries are generally covered when they happen as a result of you doing your job.  But, there are some situations where the insurance company may try to deny your claim because of some technicalities around your injury.

Some common examples of this are:

There are a few other technicalities other than these that an insurance company might try to use to deny coverage of your injury.  Otherwise, they should cover your injury if it happened at work.  Covering your case means that you will receive the benefits for which you are eligible under Georgia’s workers compensation law.

But, the insurance company will still try to limit your workers compensation benefits even if they decide to cover your case.  They likely will argue about whether you can go back to work and whether you need the medical treatment that the doctor has recommended.

How do I file a workers compensation case for a back injury?

There are two basic ways to file a workers compensation case in Georgia.  The first is to report your injury to your employer.  This report could either be oral or written.

When you report an injury to your employer, your employer should then report it to their workers compensation insurance company.  The insurance company will do some investigation before ultimately deciding to accept or deny your case.  The law in Georgia gives the insurance company  21 days from when you first become disabled to make this decision, but insurance companies often fail to meet this deadline.

If they accept your case, they should start paying you workers compensation benefits.  I will discuss what those benefits are in the next section.

If they deny your case, you should receive a document called a Notice to Controvert.  This will either be a Form WC-1 or a Form WC-3.  But, insurance companies sometimes fail to file these forms even when they deny your case so do not be surprised if you do not receive notice of the denial.

The second way to file your workers compensation case is to file a Notice of Claim or a Request for Hearing.  Both these documents are filed on the same form, the Form WC-14.  This form is filed with the Georgia State Board of Workers’ Compensation.

This second way of filing your case is more technically correct.  While you can simply notify your employer orally or in writing and hope they do what they should, the filing of the Form WC-14 provides some additional protections.  It can protect you against certain deadlines called statues of limitations that could cause you to lose your case.  But, you need to know that Georgia’s workers compensation law has several different statutes of limitations that can apply and the Form WC-14 must be filed properly to provide any protections against any of these deadlines.

What benefits does workers compensation pay for a back injury?

Georgia’s workers compensation law provides three basic types of benefits:

Each of these benefits has specific rules associated with them that explains the amount that workers compensation has to pay and when the benefits start or stop.  Just click on the links above for more specific information about each of these benefits.

Man getting off couch with back painCan I pick the doctor to treat my injury?

Making sure you see a well-qualified doctor is one of the most important factors for recovering from a serious injury.  The rules that govern what doctor you can treat with depend on whether your employer followed certain rules about posting a panel of physicians and explaining it to you.

If your employer followed the rules, you will probably be limited to picking a doctor from your employer’s panel of physicians.  But, even in this situation, you have some choice of doctors.  Also, you have a right to change to a different doctor on the list if you get unhappy with your initial choice, and there are others ways to try to change doctors again.

If your employer did not follow the rules about posting the panel of physicians, you may can pick any doctor you want.  This can be very important because you do not get limited to one of six doctors or so that your employer picked to put on their panel of physicians.

Will the workers compensation insurance company make sure I receive all the benefits and medical treatment I should?

Probably not.  It is not in the insurance company’s best interest to make sure you receive all the benefits you should.

When you get hurt at work, you have a case that starts costing the insurance company money.  It costs them money when you go to the doctor.  It costs them money when they pay a weekly workers compensation check.  It costs them money to pay the adjuster and case manager to work on your case.

Generally, insurance companies are for profit businesses.  They make money by charging premiums to their policyholders and then investing that money.  When someone gets hurt, they have to pay money out.  They make more money by trying to pay out less to you on your case.

If you want to make sure you receive all the benefits you should under the workers compensation law, you need to have a very good understanding of Georgia’s workers compensation law and be prepared for fights with the insurance company or have someone representing you who has a very good understanding of the law and will fight for you.

Do I have to return to work at the company where I got hurt?

No.  You do not have to return to work at the company where you got hurt.  But, there are certain situations where you may need to, especially if they offer you a light duty job.

Georgia has very specialized rules about light duty job offers in workers compensation cases.  These rules control what your employer needs to do to offer you a light duty job.  They also control whether your benefits will restart if you attempt a light duty job but cannot continue doing it.  Because these rules are so specific, it is very important to have a complete understanding of them if a light duty job comes up in your case.

Other than the light duty job offer, you generally are not required to return to work at the company where you got hurt.  Many people do not end up returning to work for the company because they have concerns over whether the company will keep them around long term after an injury or whether they will be able to continue doing their regular job with the limitations from their workers compensation injury.

When does my back injury workers compensation case end?

Your workers compensation back injury case can end in a couple of different ways.  One of the most common ways a workers compensation case ends is through settlement.  Settlement is not anything you ever have to do, but it is often a good option.  This article discusses more about workers compensation settlements in back injury cases.

If your case does not settle, then your case will probably end when you reach the limits on workers compensation benefits.  Under Georgia law, there are limits for each different type of workers compensation benefit:

  • Temporary total disability benefits – 400 weeks from date of injury with some exceptions; also, there are statutes of limitations that apply
  • Temporary partial disability benefits – 350 weeks from date of injury with some exceptions; also, there are statutes of limitations that apply
  • Medical treatment and testing – 400 weeks from date of injury with some exceptions
  • Permanent partial disability benefits – depends on the rating given by the doctor; also, there are statutes of limitations that apply

These limits are the longest period of time you can draw benefits (subject to the exceptions).  It does not necessarily mean that you will receive benefits that long.

What if I have other questions about workers compensation?

Georgia’s workers compensation system can be very confusing.  You have to worry about getting the treatment you need and paying your bills while also worrying about not missing any deadlines that could cause you to lose your right to receive workers compensation benefits.

If you have questions, I would recommend that you try to get answers.  To find out more about how to schedule a time to talk to me about your workers compensation questions, just read this short article.

Jason Perkins is an attorney who specializes in representing injured workers.  He regularly publishes videos and write blog articles about Georgia’s workers compensation system and issues that are important to injured workers and their families. To be notified of Jason’s new workers compensation videos, subscribe to his Georgia Workers Compensation Video Series channel on YouTube by clicking the subscribe button below.

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Jason Perkins

Workers' Compensation Attorney

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