Getting hurt on the job is tough enough. But when your workers’ comp checks are late – or worse, they stop coming altogether – it can turn a stressful situation into a financial nightmare. You’re counting on those benefits to cover your bills, buy groceries, and keep life moving while you heal.
So, what can you do if you file a workers’ compensation claim only to have your payments delayed or stopped? In this guide, the workers’ compensation lawyers at Perkins Studdard explain your options step by step, so you know how to handle the situation.
Workers’ Comp Benefits in Georgia
In Georgia, if you’re injured at work and temporarily can’t do your job as a result, workers’ compensation provides medical care and financial support through benefits like the following:
Temporary Total Disability (TTD) Benefits
If your work-related injuries are serious enough that you cannot work at all, you may qualify for Temporary Total Disability benefits. These workers’ comp payments are two-thirds of your average weekly wage, with a state-mandated maximum (as of 2024, the cap is $800 per week). You can receive TTD benefits for up to 400 weeks unless you have a catastrophic injury, in which case benefits may last indefinitely.
Temporary Partial Disability (TPD) Benefits
Suppose your doctor clears you to work with restrictions, such as fewer hours or light-duty tasks. In that case, you may qualify for Temporary Partial Disability benefits, which cover medical care and make up for wage loss if you earn less than before your injury. The maximum weekly amount is $533 (as of 2024) and TPD benefits last for up to 350 weeks from the date of injury.
Permanent Partial Disability (PPD) Benefits
If your injury leaves you with a lasting impairment but you can still work in some capacity, you may qualify for Permanent Partial Disability benefits. They are based on your doctor’s impairment rating and Georgia’s schedule of injuries, which determines how long benefits last. For these permanent disabilities, workers’ comp payments equal two-thirds of your pre-injury wages, up to the state maximum.
Workers’ compensation benefits are meant to provide financial stability and access to medical care during your recovery. But knowing what to do next is important if those checks stop or are delayed.
Why Your Workers’ Comp Benefits Might Be Late or Stopped
There are several reasons why your workers’ compensation payments and benefits might be delayed or cut off. Here are the most common ones:
- Paperwork Problems: Workers’ compensation insurance companies require medical reports to continue timely payments. If there’s missing or incomplete paperwork from your doctor, your medical expenses coverage and wage loss benefits could be delayed.
- Disputes About Your Injury: Your employer or the workers’ compensation insurance company might argue that your work-related injuries aren’t as severe as you claim. If they believe you can return to work, they may try to stop your checks and your treatment plan.
- You Returned to Work (Even Part-Time): If you’ve gone back to work (whether full-time or in a limited capacity) after suffering on-the-job injuries, your benefits could change or stop. Even if your hours are reduced, your employer must report your earnings, which can impact your payments.
- Your Doctor Says You Can Return to Work: Your workers’ comp doctor has a lot of power over your benefits. The insurance company may try to stop your benefits if the doctor says you can return to work.
- You Didn’t Follow Medical Advice: Skipping medical professional appointments, refusing treatment after a medical examination, or not following medical restrictions could give the workers’ compensation carrier a reason to cut off your benefits.
- Insurance Company Errors or Delays: Sometimes, the issue is simply a mistake on the insurance company’s end. They might be slow to process workers’ compensation payments, or an administrative error could cause a delay.
If your payments don’t arrive on time, don’t panic but do take action quickly. Here’s what you should do:
- Step 1: Contact the Workers’ Compensation Adjuster: The first thing to do is call the insurance adjuster assigned to your case. Ask when your workers’ compensation check or electronic payment was sent and if there’s a delay. If a check has already been mailed, it could be a postal issue.
- Step 2: Check with Your Post Office: If the workers’ compensation insurer claims they mailed your weekly benefits check on time, call or visit your local post office to see if it’s held up there. Mail delays happen, but you want to confirm this isn’t a recurring issue.
- Step 3: Keep Track of All Late Payments: In Georgia, insurance companies are required to pay your weekly workers’ comp benefits on time. If they don’t, you may be entitled to applicable penalties. Under O.C.G.A. § 34-9-221, workers’ compensation insurers can be fined 15% extra for each late payment. Keep a record of when your payments arrive in case you need to request these penalties.
- Step 4: Get a Workers’ Comp Attorney Involved: If your payments are consistently late or have stopped with or without an explanation, it’s time to talk to a workers’ compensation lawyer. They can contact the insurance company for you and make sure you receive the medical and weekly income benefits you’re owed, including any penalty payments.
Can Workers’ Comp Stop Your Checks Without Warning?
No. Under Georgia’s workers’ compensation law, your weekly income benefits for workplace injuries cannot be stopped without proper notice. If your payments are cut off, the workers’ compensation provider must send you a formal notice known as a Form WC-2 explaining why. This notice should include medical records or other documentation supporting their decision.
If you receive a notice that your wage replacement or medical benefits are stopping and you disagree with it, contact an experienced workers’ comp attorney immediately. You have legal options to fight the decision and keep your payments going.
What to Do If Your Workers’ Comp Benefits Are Wrongfully Stopped
If your workers’ comp benefits suddenly stop, don’t wait to take action. The sooner you address the issue, the better your chances of getting prompt payments restarted quickly.
1. Take Action Right Away
As soon as you realize your payment hasn’t arrived, check to see if there were delivery issues. As we stated earlier, a delay in workers’ compensation payments are sometimes caused by postal issues rather than an actual stoppage of benefits. If you’re receiving electronic payments, call your insurance adjuster. If you don’t get a clear answer, move on to the next step.
2. Request an Explanation in Writing
Under Georgia law, benefits to injured workers cannot be stopped without notice. If your workers’ compensation payments have been cut off and you haven’t received anything in writing, request a formal explanation from the workers’ compensation insurance company. This document should:
- State the reason your benefits were stopped.
- Include supporting medical reports or other justification.
- Provide information on how to challenge the decision.
If the insurance carrier refuses to provide this information, a Georgia workers’ compensation attorney can step in and demand it for you.
3. Appeal the Decision
If you believe your benefits were stopped unfairly, you have the right to appeal. This appeal process can be complicated, but a workers’ comp attorney can:
- File the necessary paperwork to challenge the decision.
- Gather medical evidence from your health care provider proving you’re still entitled to benefits for injured workers.
- Represent you in hearings before the Georgia State Board of Workers’ Compensation.
It is important to note that time is critical here. There are deadlines for filing appeals, so don’t delay in taking legal steps to address the issue.
4. Seek Late Payment Penalties
If your weekly checks were being sent late before they stopped completely, you may be entitled to extra compensation. Under Georgia law, insurance companies must pay on time or face a 15% penalty. They must also provide back pay if benefits were wrongfully stopped. A workers’ comp lawyer can calculate how much extra money you may be owed and make sure you receive every dollar of unpaid compensation.
If your workers’ comp benefits stop without warning, don’t let the insurance company get away with it. Take immediate action, demand answers, and if necessary, get legal help to fight for the payments you deserve.
Have Your Workers’ Compensation Benefits Been Delayed or Stopped?
In Georgia, workers’ comp laws are intended to protect injured workers, but insurance companies don’t always play fair. Knowing your rights, and having an experienced attorney on your side, can help you overcome any obstructions in getting the benefits you’ve rightfully earned.
If you’re struggling with late or missing checks, don’t wait to get help during this challenging time. A knowledgeable workers’ comp lawyer at Perkins Studdard can step in, fight for your payments, and make sure the insurance company follows the law. For more information or to speak to an experienced lawyer, contact our team today for a free initial consultation.
