Qualifying for Disability Benefits
To receive “Temporary
Total Disability Benefits” or TTD benefits you must be disabled from
working. Your treating physician must state you are “off-work” or totally
disabled, or your physician must place restrictions on your work abilities
(such as no lifting or bending) and your employer cannot or will not make
you work within these restrictions.
There Are Very Specific Requirements to Qualify
You must be out of work at least seven days
before you are entitled to receive disability
benefits. You will not receive benefits for this first week unless you are
out at least 21 days. The employer/insurer has 21 days to make the first
payment of TTD benefits.
Upon starting your disability payments, the
employer/insurer is required to file a “Form WC-1, First Report of Injury”
or a “Form WC-2, Notice of Payment or Suspension of Benefits” with the
State Board of Workers’ Compensation to notify them of the amount of the
disability payment and the starting date, with a copy to you.
Be sure to obtain a form from the physician
stating whether you are out of work or subject to work restrictions.
Deliver a copy of the form to your employer and if on restriction, give
the employer an opportunity to provide work within your restrictions. If
there is no work within your restrictions, the employer is required to
notify the insurance company and benefits will be paid to you.
If your employer does have work for you within
your restrictions, but you receive less than your average weekly wage, you
will be entitled to receive “Temporary Partial Disability” (“TPD”)
benefits for your wage loss. In this situation, ensure that your employer
notifies the insurance adjuster of your gross weekly wage.
If your TTD or TPD benefits are suspended
because your physician says you are capable of working without
restriction, or because you have returned to restricted work at your
pre-injury wage rate, within 30 days of the suspension, the
employer/insurer must send a written request to your physician to issue an
“impairment rating.” An impairment rating is a percentage of disability
from the injury to either your whole body or a portion of your body
calculated according to American Medical Association guidelines. This
rating is different from a work restriction and you may have an impairment
rating even if you are not subject to work restrictions. Once issued, the
employer/insurer has 21 days to make either a weekly payment or a lump-sum
payment to you, at their option. These benefits are the permanent partial
disability or PPD benefits. The number of weeks of benefits you receive
depend upon the body part affected and the percentage of impairment.
Q1. Is my employer required to provide a job
to me within my work restriction?
No. Under workers’ comp laws, the
employer/insurer is required to either provide work to you within your
restrictions or to pay your weekly disability benefits. The
employer/insurer has the choice of paying you benefits or providing you
with a light duty job.
Aside from workers’ comp laws you may have
additional rights if your employer has a collective bargaining agreement
with a union or if you have a written employment contract that provides
additional protection. Contact your union rep or review your employment
The Americans with Disabilities Act (ADA) may
give you additional rights. Check with a qualified attorney or contact the
United States Equal Employment Opportunity Commission (EEOC).
Q2. I was injured on my job and working light
duty when my employer’s factory closed. I have looked for work within my
restrictions without success. Am I entitled to disability benefits until I
can find another job?
If you are subject to work restrictions and
you lose your job for reasons unrelated to your injury, you may be able to
qualify for disability benefits. You have to make a good faith search for
other employment. If you cannot obtain a job within your restrictions, the
administrative law judge who hears your case may infer from your efforts
that the reason you are not working is because of your injuries and award
Q3. If I need to perform a good faith job
search to establish I am disabled, can I limit my search to jobs within my
Generally speaking, you should look for jobs
within your restrictions that you feel qualified to perform, whether those
jobs are within your existing profession or not. For instance, if you
worked as a construction laborer when you were injured, you are unlikely
to find light work in the construction industry. In such a case, you would
need to look for jobs outside the construction industry that are light
enough for you to perform.
Q4. I was working within my restrictions when
my employer terminated my employment because I could not perform my
regular job. Do I have to look for a job before I receive disability
It is always a good idea to try to find other
work if you are terminated or laid off. But if your job injury or
restrictions played any part in your termination, you will be entitled to
workers’ compensation benefits without having to make a good faith search
for other employment.
Q5. Is my employer permitted to fire me
because I filed a workers’ comp claim?
Yes. Under Georgia law you are an “at-will”
employee unless your employer has a collective bargaining agreement with a
union or you have a written employment contract. An employer may fire you
for any reason or no reason, but your employer may not terminate your
employment for a reason that violates federal laws such as discrimination
because of your race, sex, age, disability or religion. There is no
Georgia law that prevents an employer from terminating your employment
because you filed a workers’ comp claim. If you are subject to work
restrictions when you are fired, you may be entitled to disability
benefits under workers’ comp. If your job is covered by a collective
bargaining agreement, you may be able to file a grievance. Contact your
union steward or officer for more information.
Q6. If I am receiving workers’ compensation
benefits when my employer fires me, will my benefits be affected?
No. If your employer terminates your job while
you are receiving either weekly benefits or medical care for your work
injury, this should not affect your entitlement to benefits.
Q7. What if I am out of work receiving
workers’ compensation benefits and I choose to retire so that I can
receive my retirement pension? Will my right to continued benefits under
workers’ compensation be affected by retirement benefits?
If you are totally disabled, or if your
employer is not offering you light duty within your restrictions, your
decision to retire should not affect your workers’ compensation benefits.
Q8. I was injured on my job just before being
fired for reasons unrelated to the injury. I did not think the injury was
that serious, but now it is getting worse. Am I permitted to pursue a
claim for benefits?
If you were injured on your job and the injury
was reported either before or after you were fired, but within the
required time period, you can still pursue your claim for medical care and
benefits. However, claims asserted for the first time after losing one’s
usually looked upon as suspect by employer/insurers.
Q9. If the Social Security Administration
determines I am disabled, will I be able to qualify for disability
benefits under workers’ compensation?
A finding of disability by the Social Security
Administration is a strong indication you are disabled. However, Social
Security is a separate federal system. Each system has its own rules and
regulations. Therefore, the Social Security Administration’s (or the
Veterans Administration’s) finding of disability will not automatically
qualify you for disability benefits under workers’ compensation. If you
are disabled under workers’ compensation, however, qualifying for Social
Security Disability is relevant to whether your work injury is