Head injuries causes serious and potentially long term consequences. We have seen growing awareness of that with the increased concerns about the effects of repeated head trauma in football and soccer.
If you suffer a head injury at work, you need to know how that can affect you and what benefits the workers compensation insurance company should pay. This article will focus on benefits paid in Georgia workers compensation claims for head injuries.
Before we go any further, it is important to state that I am not a doctor or any sort of medical professional. I am a workers compensation attorney. I do not intend for the information in this article to be medical advice but instead merely to serve as legal information about some of the common issues that people who suffer head injuries on the job face in Georgia.
Does Georgia workers compensation law cover head and brain injuries?
Yes. Georgia’s workers compensation law covers all different types of head and brain injuries. But, it is important to understand that what you have to prove to get benefits for head injuries differs depending on what type of head injury you suffer.
Under Georgia’s law, there are essentially three types of head or brain injuries:
Physical head injuries
These types of head injuries are caused by physical force such as:
- Falling and striking your head
- Being struck by an object in the head
- Striking your head in a car wreck
A physical head injury could result in physical damage to your head or skull. You could also suffer damage to your brain.
What you have to prove for a physical head injury is basically the same as what you have to prove for any other type of workers compensation injury. You need to show that the injury arose out of and in the course of your employment. Essentially, this means that you show that it is a work-related injury.
Georgia’s workers compensation law has special rules for strokes. Strokes are treated the same as heart attacks.
The special rules for strokes primarily focus on the type of evidence you must have to support your injury. The rules require that you use at least some medical evidence. This article discusses the rules for strokes in more detail.
PTSD, depression, and anxiety are other types of head or brain injuries. Georgia’s law classifies these as “mental” injuries.
Georgia’s workers compensation rules for mental injuries are even tougher than strokes. Georgia’s law only covers mental injuries when they develop as a result of a physical injury. This means that many people who develop PTSD, depression, or some other psychological condition as a result of performing their job do not receive Georgia workers compensation benefits.
How are head injuries treated differently than other types of injuries?
As I mentioned above, head injuries receive somewhat different treatment with what you have to prove to get your injury accepted. But, the benefits you can receive for your head injury are basically the same as other injuries.
The basic Georgia works compensation benefits are:
- Reasonable and necessary medical treatment for your injury
- Lost wage benefits (temporary total disability or temporary partial disability) if your injury causes you to lose wages
- Permanent partial disability benefits if your injury results in some permanent impairment
All of these benefits have certain rules. For medical treatment, the insurance company should have to pay for the medical treatment you need. But, you usually have to treat with certain doctors off of a list posted by your employer called the panel of physicians. If your employer does not have a panel of physicians, you may be able to pick any doctor you want for treatment.
Will I be able to pick a brain injury specialist off of the panel of physicians?
If your employer has a posted panel of physicians, you probably have to pick a doctor off that list for treatment. Unfortunately, the panel of physicians only has to have six doctors on it. Also, the only medical specialty required to be on the panel is orthopedics.
This means that the panel of physicians may not have a brain injury specialist on it like a neurologist, neuropsychologist, or neurosurgeon. Fortunately, the doctor you pick off of the panel of physicians can refer you to a specialist for specialized treatment.
Are there limits on how long I can receive workers compensation benefits for my head injury?
Georgia law limits how long you can receive workers compensation benefits in most cases. In most cases, your eligibility for temporary total disability and medical benefits ends 400 weeks after your date of injury. That is about 7.5 years after your injury.
It is important to understand that you do not necessarily receive these benefits this long. The limit means that you cannot get the benefits after 400 weeks even if you still need them. Also, you need to know about deadlines that could make you lose your eligibility even earlier that that.
Do these 400 week limits apply in all cases?
No. There are exceptions to these limits. In all cases where your injury occurred before July 1, 2013, the 400 week limit on medical does not apply. It only applies to injuries after July 1, 2013.
Also, some workers compensation cases qualify for a “catastrophic designation”. Six different types of injuries can qualify for a catastrophic designation. The 400 week limits on medical and temporary total disability benefits do not apply in catastrophic cases (but the statute of limitation deadlines still do).
Two of these types of injuries could qualify you for a catastrophic designation if you have a severe head or brain injury. The first is known as (g)(3) which applies to severe brain or closed head injuries which are evidenced by
- Severe sensory or motor disturbances
- Severe communication disturbances
- Severe complex integrated disturbances of cerebral function
- Severe disturbances of consciousness
- Severe episodic neurological disorders
(G)(3) also allows other types of brain and closed head injuries to qualify when the conditions are at least as severe as the five mentioned above.
Even if you cannot qualify for a catastrophic designation under (g)(3), you could still qualify under a part of the catastrophic law known as (g)(6). To qualify under (g)(6), you need to show that your injury keeps you from performing:
- Your prior work; and
- Work available in substantial numbers in the national economy for which you are otherwise qualified
Basically, this means you need to show that your injury keeps you from working at most any job as that job is regularly performed.