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Monetary Benefits

If you are totally or partially disabled from working due to a job injury, or if you have a permanent impairment, you will be entitled to receive workers’ compensation weekly benefits.

There Are Three Kinds of Money Benefits

  • “Temporary Total Disability” or TTD — If you are unable to work due to your injury, you will receive a weekly benefit check equal to two-thirds of your average weekly wage. You can receive this payment up to 400 weeks from your date of accident. For accidents occurring on or after Jul. 1, 2013, the cap on the TTD weekly benefit is $525. For accidents occurring before Jul. 1, 2005, see the chart in the Appendix I to determine the cap on the date of your accident.
     

  • “Temporary Partial Disability” or TPD — If your work abilities are restricted due to a work injury and you are working in a lighter duty job for your employer or someone else and as a result have a loss of income, you will receive a weekly benefit equal to two-thirds of the difference between your average weekly wage before the accident and your weekly wage on the lighter duty job. You can receive this payment up to 350 weeks from the date of your accident. For accidents occurring on or after Jul. 1, 2013, the cap on the TPD weekly benefit is $350. For accidents occurring before Jul. 1, 2013, see the chart in the Appendix I to determine the cap in effect on the date of your accident.
     

  • “Permanent Partial Disability” or PPD — If you are injured, you may receive an “impairment rating” or percentage of disability from your doctor in accordance with American Medical Association guidelines. If you receive such a rating and are not otherwise receiving TTD or TPD, you are entitled to receive PPD benefits. PPD weekly benefits are equal to the payment you would receive for TTD. However, the number of weeks you can receive the benefits depend on the percentage of impairment and the body part affected. For example, if you have a permanent loss of use of your right arm but continue to work at your full wage, under workers’ compensation rules you could receive 225 weeks of benefits at the total disability rate, which is your PPD benefits. If your physician states you have only a 10 percent impairment to your arm, rather than a total loss of use, you would be entitled to 22.5 weeks of PPD benefits.

Questions

Q1. Once my weekly benefit starts, how often will I receive a disability check?

Generally, disability benefits must be paid once a week. If the payments are being issued from within Georgia, so long as the check is postmarked by the last day of the seven-day pay period, it is considered timely. If issued from out of state, the check must be postmarked not later than three days before the end of the seven-day pay period.

Q2. Am I entitled to a late fee if the employer/insurer does not pay my weekly disability check in a timely manner?

Yes. If the check is not mailed on time, the employer/insurer must pay you a 15 percent late penalty. Your disability checks may not arrive the same day each week. The check must be mailed within the weekly time period, but it may be mailed on any of several different days.

Q3. Can I recover compensation for my pain and suffering or the mental distress I have suffered?

An injured employee is not entitled to compensation for his or her pain and suffering, mental distress, or other items for which people injured in non-work-related accidents may receive. This was a key reason for workers’ compensation laws: to protect a covered employer from these claims.

Q4. What if my injuries prevent me from ever being able to return to work? Will my benefits stop after 400 weeks?

The disability benefits will usually stop at 400 weeks whether you can return to your employment or not. However, some people have injuries that are so severe they are considered “catastrophic.” Catastrophic injuries include spinal cord injuries resulting in partial or total paralysis, amputations of an arm, hand, foot or leg involving loss of the appendage, severe brain injuries, second- or third-degree burns over 25 percent of the body or third-degree burns over 5 percent or more of the face or hands, and total blindness. Catastrophic injuries may include other injuries that are so severe that the injured worker could qualify for Social Security Disability benefits. If your injuries are designated catastrophic, there is no limit on the number of weeks you can receive weekly benefits.

Q5. As a result of me being injured, my spouse has taken time from work to take care of me. Can I receive additional compensation?

You as an injured worker will not receive any additional money benefits. If the treating physician states you need home health care, your spouse may be entitled to payment for caring for you as a “home attendant.”

Q6. Is my spouse or children entitled to receive anything for my work-related injuries under workers’ compensation?

Except in death cases, family members are not entitled to receive anything for “loss of consortium” or similar claims when a spouse or parent suffers a loss due to a work injury. The weekly benefits described in this section are the only funds the law requires your employer and its insurance company to pay directly to the injured worker.
The exclusive remedy bar also applies to family members. They are not permitted to sue the employer or insurer. (See “Workers’ Comp-Your Sole Remedy” at page 12).

Q7. How is my average weekly wage calculated?

Your “average weekly wage” (“AWW”) is calculated by taking the total of all wages, salary, bonuses, sick pay, vacation pay and certain benefits (such as meal allowances) you were paid by the employer for the 13-week period just before your date of accident and dividing this amount by 13. This amount is based on your gross wage and not on your net or take home pay.

Q8. What if I was on the job less than 13 weeks when the accident occurred?

In some instances, the insurer may use the average weekly wage of a co-employee who was performing a similar job with the same employer. If there are no similar co-employees, then the insurer should use the employee’s agreed full-time wage. For example, if the employee is hired to work 40 hours per week at $11 per hour, the average weekly wage is $440.

Q9. What if I had taken time off from work without pay during the 13-week
period?

Georgia law states that to use the 13-week method, the injured worker must have worked “substantially the whole” of the 13 weeks. If you only worked nine weeks during the 13-week period, for example, the insurer should use the average weekly wage of a similar co-employee or your full-time wage if there are no similar co-employees.

Q10. I was injured after the holidays when we were very busy and I worked a lot of paid overtime and also received a Christmas bonus. Is the overtime and bonus included?

Yes. AWW includes any compensation you received from your employer, including wages, overtime, commissions and bonuses.
Q11. What if I worked more than one job during the 13-week period?
If you worked for more than one employer doing similar jobs during the 13 weeks before the accident, the wages and other compensation you received from each job should be included in your average weekly wage. This is called “concurrent similar employment.” (See “Second Jobs and Side Businesses” at page 51).

Q12. Am I entitled to review the calculation of my average weekly wage?

Yes. If you are paid less than the maximum benefit rate, the insurer is required to send you a “Wage Statement” with a weekly breakdown of your wages for the 13-week period.

Q13. Are any of the money benefits from workers’ compensation taxable?

No. The weekly disability benefits of TTD, TPD and PPD are not subject to state or federal taxation. Your employer or the insurer should not deduct tax payments and you do not have to declare the income from your workers’ comp claim. Consult with your tax preparer for more information.

Q14. I receive a base salary plus commissions. Because of my injury I have not been able to meet with potential customers, so even though my base salary is the same I have had a drop in my commissions. Can I be compensated?

If you can show that your wage loss was due to your work injury or its restrictions, you are entitled to receive TPD benefits for the loss in income due to lower commissions.

Q15. Does my weekly benefit check ever increase?

No. Unless there is an error in its computation, the amount of your TTD weekly check is fixed as of the date of your accident and does not increase, even for inflation. If your weekly benefit is capped at the maximum rate in effect on the date of your accident and the cap goes up, your benefit check will not increase.

Q16. Does my weekly benefit check ever decrease?

Possibly. If your doctor releases you to limited duty, but your employer does not have work for you, your employer or their insurer has the right to send you a written notice that in one year your benefit will be lowered from your total disability rate to the temporary partial disability rate cap in effect on your accident date. Your benefit amount will decrease even though you are not working.

Q17. My employer has a wage continuation plan that pays me if I am sick or injured and unable to work. The plan will continue my salary for up to 12 weeks. How will this affect my benefits if I am off work due to my work injury?

If your employer pays your full salary pursuant to a wage continuation plan, they do not have to pay workers’ comp disability benefits at the same time.

Q18. I have received workers’ compensation benefits for over a year and things have gotten difficult for me financially. I need extra funds to pay bills and to stop the creditors from threatening to repossess my automobile. Can I receive extra money to help in this situation?

If you have received weekly benefits for at least 26 weeks, you may petition the State Board for an advance payment in a specific sum. If the State Board determines that it is in your best interest to prevent extreme hardship or is essential to your rehabilitation, the Board will order the insurer or self-insured employer to pay the amount requested or some other amount.
Sometimes, it is possible to negotiate an advance payment with the insurance company without having to file a formal petition with the State Board. If an advance payment is made, the insurer is entitled to be repaid the advance plus 5 percent interest per year from future disability benefits, usually PPD benefits.

This is not a settlement of the case and should not otherwise affect your entitlement to medical care or disability benefits.

Q19. What is a case settlement?

Sometimes it is appropriate to settle your workers’ compensation case, which usually means your claim will be closed in return for a lump-sum payment. Closing the claim means terminating any further right to receive disability benefits, medical care or other benefits to which you are or may be entitled.

Determining what your claim is “worth” for settlement involves an analysis of your future needs and the exposure faced by the employer/insurer. This is not a simple task. If the adjuster offers you a settlement, you should check with a qualified attorney.
 

 

 

 
 

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The Barnett Law Firm
150 E. Ponce de Leon Avenue, Ste 225,
  Decatur,  GA. 30030   •     404.378.1711 

 
 
 
 
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