Serious injuries often cause you to miss time from work. Some serious injuries cause permanent impairment which means you do not ever fully recover from the injury.
Georgia workers compensation law provide benefits for you when you miss time from work or suffer a permanent impairment as a result of a work-related injury. These benefits are known as:
- Temporary total disability benefits
- Temporary partial disability benefits
- Permanent partial disability benefits
Workers compensation benefit checks should provide the income you need to pay bills and survive when you are out of work after an injury. But, what do you do when the amount of your workers compensation benefits is not enough for you to get by? Can you get your workers compensation benefits increased to cover the amount of your bills?
Will my workers compensation benefit checks increase on their own?
Will my workers compensation benefit checks increase on their own?The workers compensation insurance company determines the amount of your benefit checks. If you take no action, your workers compensation checks will not increase on their own. Unfortunately, Georgia workers compensation does not have a cost of living adjustment built in for when there is higher inflation or other things outside of your control that can make it very difficult to survive on your check amount.
Sometimes though, there are things you can do to get your check amount increase. When they determine your check amount, the insurance company should follow the Georgia rules and laws that determine your check amount. But, insurance companies do not always follow those rules. So, they may calculate your check amount incorrectly.
One of the things that the insurance company should do is send you a document showing how they calculated your check amount, This document is called a Form WC-6 Wage Statement. You can find a copy of a blank version of that document here.
The insurance company has to file this Form WC-6 if they pay you less than the maximum workers compensation benefit amount for the date of injury. This means that you should receive this form unless you receive the maximum check amount that you can receive.
Despite this requirement, many insurance companies do not file this form when they should do so. When they do not file this Form WC-6, it makes it difficult for you to determine whether they have paid you correctly or not.
What can I do if a Form WC-6 was filed by the insurance company?
If the insurance company filed a Form WC-6, it should show the wages they are using to calculate your average weekly wage. The average weekly wage determines your proper workers compensation benefit amount.
Even if the insurance company files a Form WC-6, there are three common reasons that the insurance company does not calculate your benefit check amount correctly:
- The wages the insurance company listed on the Form WC-6 are incorrect
- The wages are correct, but the insurance company calculated the average amount of the wages incorrectly
- Your wages are listed correctly on the Form WC-6, but you did not work substantially the whole of the 13 weeks before your injury
If the insurance company did any of these three things above, there is a good chance that the insurance company did not calculate your workers compensation check amount correctly.
Can I apply for an increase in workers compensation benefit checks?
Yes. You or an attorney representing you in your case can request a hearing with a workers compensation judge to try to get your workers compensation benefits checks increased when the insurance company has not calculated the amount correctly.
When a hearing is requested, a court date will be set. The insurance company will hire an attorney to represent them. That attorney will send written questions known as interrogatories and request documents associated with your case.
The insurance company’s attorney will also schedule your deposition where they ask you questions under oath. This deposition normally lasts an hour or two.
If you have an attorney representing you, your attorney will do most of the work in answering the interrogatories, preparing you for the deposition, and dealing with the requests for production of documents. Your attorney will also prepare you for going to court in front of the judge and present the evidence and arguments necessary to try to win your case in court.
What do I do if a Form WC-6 was not filed by the insurance company?
If the insurance company does not file a Form WC-6 and you are not receiving the maximum check amount, they have not follow the workers compensation rules. In this situation, you can try to get a judge to force them to file the Form WC-6. If you are successful in getting a WC-6 filed, then you can review the WC-6 as mentioned above to determine if the insurance company made mistakes in calculating your check amount.
Even if the insurance company does not file a Form WC-6, an attorney representing you can still review your case to determine if your workers compensation checks amount were calculated correctly. An attorney can do this by obtaining your payroll records and then completing the calculations to determine what your workers compensation check should actually be. If the check amount has been calculated incorrectly, an attorney can then take the steps to get your check amount increased.
Many of the clients I represent are able to get their workers compensation benefit checks increased because they have been calculated incorrectly. We show the insurance company that the check amount has been calculated incorrectly or go to court and prove that to a judge.
When this happens, my clients draw a higher check amount and also potentially get backpay and late penalties for the underpayment amounts. This can make a big difference in having the income you need to pay your bills while you recover from your work injury.
