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Georgia Workers’ Compensation Forms – Forms WC-104, WC-240, and WC-R1

The The Georgia Workers’ Compensation system uses forms to provide information about your case.  You want to make sure you receive the benefits you should.  Understanding what these forms mean helps you do that.

The insurance company files some forms that address your ability to return to work.  Those forms include Form WC-104, Form WC-240 and Form WC-R1.  I discuss those forms in this article.

Notice to Employee of Medical Release to Return to Work with Restrictions (Form WC-104)

The insurance company files a Form WC-104 when the doctor release you to return to work with restrictionsThe insurance company should file this form when your workers’ compensation doctor releases you to go back to work with some kind of restrictions.  Under the law, the insurance company should send you a Form WC-104 within 60 days.

This form provides notice that you have been released to return to work.  The insurance company should include a copy of the work restrictions from the doctor with the Form WC-104.

What does a Form WC-104 do?

The Form WC-104 does not affect your case at all immediately.  Your benefits remain the same for now.  Many people see the part of the form that mentions reduced benefits and make the mistake of thinking that will happen immediately.

While benefits stay the same for now, the WC-104 can hurt your case a lot in the future.  Many people cannot find a job within their restrictions.  Assuming you stay on light duty restrictions but are not able to return to work, this form allows the workers’ compensation insurance company to try to reduce your weekly workers’ compensation check.

If your weekly check is more than the maximum temporary partial disability benefits rate, the insurance company will try to reduce your check once one year passes from the time you are released to return to work with restrictions.  The maximum temporary partial disability benefit varies depending on your month and year of injury.

A significant reduction in your workers’ compensation check obviously can make it very difficult for you to survive financially.  Luckily, there are often some things an attorney can do to prevent this reduction from taking place if the insurance company does not do everything exactly right.

Notice to Employee of Offer of Suitable Employment (Form WC-240)

When you receive a Form WC-240, your employer is offering you a light duty job of some kind.  The Form WC-240 will state:

  • The job being offered,
  • Rate of pay,
  • The hours you will work, and
  • The time that you should report to work.  The insurance company should also include a form where your authorized treating physician signed off approving the light duty job.

If you have problems when you return to this job, Georgia law has a process set up to address attempts to return to work.  This process is very detailed.

Sometimes, when you have problems doing the job, the employer must restart your workers’ compensation benefits.  Other times, they do not have to restart them before a hearing.

Several factors affect whether your benefits restart.  Those factors include:

    • Did you attempt the job?
    • How long you attempted the job?
    • Whether your doctor continues to approve the job?

If you simply refuse to attempt the job, the insurance company will probably suspend your benefits.  You can find out more about how the WC-240 process works in this article.

If you have questions or concerns about this, you should seek to get answers quickly.  In most cases, you only have a little more than 10 days from when you receive the Form WC-240 until when you try the job.  Scheduling a free consultation provides a good way to get any questions answered.

Request for Rehabiltiation (Form WC-R1, WC-R1CATEE)A catastrophic designation provides additional benefits not available in regular workers' compensation claims

A Form WC-R1 and a Form WC-R1CATEE are forms used when you suffer or claim that you have suffered a “catastrophic injury”.  If you would like more information about catastrophic designation or the specific types of injuries that can result in a catastrophic designation, you may find our article about catastrophic designation helpful.

What does catastrophic designation mean?

If your case is designated catastrophic, there are at least four benefits that apply to catastrophic injuries that do not apply to other workers’ compensation claims.

If you receive a Form WC-R1, then your employer has probably agreed to have your case designated catastrophic.  If you receive a Form WC-R1CATEE, then you probably have an attorney who has submitted a request for catastrophic designation because this is a form filed by the injured worker or the injured worker’s attorney.

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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