Does Workers Compensation Cover My Injury?
The basic idea of Georgia workers compensation is that it covers work-related injuries. But, what does “work-related” mean?
Usually, this mean that you suffer an injury at work. After this injury, workers compensation pays for your medical treatment and pays you weekly benefits if your injury causes you to miss work.
Unfortunately, some recent Georgia court decisions have created some confusion about what a work-related injury is. This has led to many insurance companies trying to deny claims for injuries that most people would consider “work-related”.
The general rule is that your employer’s insurance company must pay workers compensation benefits when you suffers an injury by accident arising out of and in the course of employment. “Arising out of and in the course of employment” are the legal words that Georgia law uses to mean “work-related”.
I mentioned recent court decisions earlier. These court decision have focused on the term “arising out of employment”. Georgia courts have previously said that the words “arising out of employment” basically means that the job caused the injury.
But, some Georgia court decisions have made it more difficult to prove that the job caused the injury. In one decision, the Georgia Court of Appeals decided that a nurse who injured her knee while turning to give a glass of water to a patient did not have an injury arising out of the employment. Another Georgia Court of Appeals decision determined that a firefighter who injured her knee when she was following an order of her supervisor was not covered.
I think that a nurse is doing her job when she gives a cup of water to a patient. I also believe that a firefighter is doing her job when she follows a command from a supervisor.
As I mentioned earlier, these court decisions created confusion about what a “work-related” injury is. This can create difficulty for you when you get hurt at work since the insurance company may use these decisions to fight about whether your injury is covered by workers compensation.
When will this come up in my workers compensation case?
Georgia’s workers compensation law has some basic rules about what happens when you report a work injury. Your employer has 21 days to either accept or deny your claim.
If you employer denies your claim, you will probably receive a Form WC-1 or Form WC-3 controverting (a fancy word for denying) your claim. The insurance company should indicate the reason that your claim is being denied on this form. Often, they will say something vague like “the injury did not arise out of or in the course of the employment”.
Can I fight a denial of my claim?
Yes. If your claim is denied, it is important to understand that this is not the end of your case. You have a right to request a hearing and prove your case in court.
It may no longer be enough to prove that you were injured doing your job. You may have to prove more than that to make sure that you win your case and receive workers compensation benefits. You will probably have to prove a greater connection between your job and your injury.
These court decisions focusing on whether an injury arises out of employment have made this area of the law even more complicated than it used to be. To have a good chance of succeeding in court, you will need a good workers compensation attorney who has reviewed these decision and can show why your injury should be covered by workers compensation.
How can I discuss my case with a workers compensation attorney?
Talking to a workers compensation attorney about your case is easy. I provide free consultations in workers compensation cases so that you can talk to me about your case without having to worry about what it will cost you. This gives you the opportunity to find out how I could help you before you make a decision about hiring me.
If you would like to go ahead and set up a free consultation, it is easy to do and only takes a few minutes. Just call our office at (770) 214-8885 or complete and submit our free consultation request form.
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.
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