Sometimes, what you don’t know can hurt you. While certain aspects of workers’ comp practice are less complicated than handling jury trials in liability cases, there are many rules that make workers’ compensation cases a mine field for someone trying to handle a case on their own in Marietta and greater Atlanta.
Having said that, if you have a medical only case, meaning there was no lost time, and you are able to go back to work right away, then you probably don’t need a lawyer. However, even in these small cases sometimes the employer and insurance company will refuse to pay for the medical bills.
When do you need a lawyer?
If your case involves lost time and you are being paid indemnity benefits for a Marietta or greater Atlanta work injury claim, you probably do need an attorney, particularly if your injury is serious and symptoms are long-lasting.
I have litigated hundreds of workers’ compensation claims against employers in Marietta and all over greater Atlanta and north Georgia. Almost without fail at the two month mark of an injured worker being on light duty or on comp benefits, the employee/employer relationship breaks down. At that point, even if the employer was supportive of the employee at first, the relationship becomes adversarial. It is for this reason you need an attorney experienced in handling workers’ comp claims to represent you.
Helping you know your rights.
Will you know your rights without an attorney? Of course not. The insurance companies have an army of experienced adjusters and defense attorneys who know the rules and will do their best to lessen the value of your case. They are not playing fair and they do not care about you or your family or whether you can pay rent.
For example, did you know under Rule 240, the insurance company can suspend your benefits just because you do not know the rules?
Let’s say you are out on light duty and you know with your restrictions there are no jobs you can do. If the employer makes up a job and gets the doctor to sign off on it, the adjuster can send you a form WC-240 telling you to come back to work and do this fake job or at least a job they have never had anyone to do before.
You may not want to do that job because you feel (1) you are still in a lot of pain and you believe that sitting on a stool all day in one position will set you back medically and (2) you know the job is not a job anyone has ever done and you have been told by your boss before that there is no light duty. If you decide to simply not show up for the job, the insurance company will happily file a WC-2 to suspend your income benefits unilaterally without a hearing and they have a right to do so.
There are ways to prevent this from happening, but you will need an experienced workers’ compensation attorney from Marietta or Atlanta to guide you through this process. I am posting Rule 240 below to give you an example of how complicated this can be and this is only one of the many rules!
Get Help Quickly!
Don’t wait until things go ‘south’ to contact a workers compensation lawyer. Schedule a free consultation with an Atlanta area lawyer to discuss your case and decide if and/or when to enlist the help of a lawyer. Call (770) 284-3737 to schedule your free consultation.
Georgia State Board of Workers’ Compensation, Rule 240
(click here for a link to the PDF – Rule 240 is on page 72)
(a) For suspension and reinstatement of income benefits by interlocutory order generally, see Board Rule 102D.
(b) When an employee unjustifiably refuses to accept employment which has been approved by the authorized treating physician(s) suitable to his/her impaired condition and offered to the employee in writing, the employer/insurer may suspend payment of income benefits to that employee without an order of the Board in the following manner:
(1) File with the Board a Form WC-2 and Form WC-240 certifying that at least ten days before the employee was required to report for work he/she was notified on the completed Form WC-240 mailed to the employee and his/her attorney that there was a suitable job available, that it was approved by his/her authorized treating physician(s) after an examination within the last 60 days, and refusal to attempt to perform the job would result in the suspension of payment of weekly income benefits to the employee. The employer/insurer shall provide to the employee and legal counsel a copy of any job description/analysis in reference to subparagraph (3)(i), (ii) and (iii) at the time of submission to the authorized treating physician(s).
(2) If filing via EDI, section (b)(1) shall be followed and the employer/insurer shall simultaneously mail to, or electronically file with, the Board the filed Subsequent Report of Injury (SROI) or Form WC-2 and a copy of the served Form WC-240 and supporting medical report from employee’s authorized treating physician. Pursuant to Board Rule 60(c), all documents filed with the Board shall contain the employee’s name, date of injury, and Board claim number. Any document that does not contain this information shall be rejected by the Board. Copies of all filings shall be served on the employee and the employee’s attorney, if represented.
(3) Attached to the Form WC-240 shall be:
(i) A description of the essential job duties to be performed, including the hours to be worked, the rate of payment, and a description of the essential tasks to be performed;
(ii) The written approval of the authorized treating physician(s) of the essential job duties to be performed;
(iii) The location of the job, with the date and time that the employee is to report to work. 71 Attaching a properly completed Form WC-240A will satisfy the requirements for making a proper offer of employment as set forth herein.
(4) If the employee attempts the proffered job for less than eight cumulative hours or one scheduled workday, whichever is greater, or refuses to attempt to perform the proffered job after receiving the above notification, the employer/insurer shall be authorized to suspend payment of income benefits to the employee effective the date that they unjustifiably refused to report to work.
(c) Should the employee accept the employment offered by the employer/insurer and attempt the proffered job for eight cumulative hours or one scheduled workday, whichever is greater, but fail to continue working for more than the prescribed fifteen (15) scheduled work days, the employer/insurer, whether or not they have sent a WC-240, shall immediately reinstate payment of income benefits and shall file with the Board and serve upon the employee the appropriate Form WC-2 reflecting the reinstatement of income benefits.
(i) Failure to immediately reinstate benefits pursuant to Board Rule 240 (c), shall result in the waiver of the employer/insurer’s defense of the suitability of employment for the period of time the employer/insurer did not pay the employee’s weekly income benefits when due.
(ii) When the employer/insurer immediately reinstates benefits pursuant to Board Rule 240 (c), the employer/insurer are entitled to seek reimbursement of such benefits at a hearing addressing the suitability of the proffered employment.
(d) When calculating the fifteen (15) scheduled work days provided by statute, the employer/insurer shall include as a work day each day or part thereof during which the employee is scheduled to perform his/her job duties.
(e) The employer/insurer shall also be entitled to suspend payment of weekly benefits to the employee pending a hearing by an order of the Board finding an unjustifiable refusal of the employee to accept employment procured for him/her suitable to his/her capacity. A motion requesting this order may be made simultaneously with the filing of a request for hearing or at any time during the pendency of the hearing and award and shall be filed on Form WC-102D, and must be accompanied by an affidavit from the employer setting forth that suitable employment has been offered to the employee as set forth in (b) above, the offer is continuing, and analysis of the job is attached. The employer/insurer shall have the employee examined by the authorized treating physician(s) within 60 days prior to this request for suspension of income benefits. No request for suspension of income benefits for failure to accept suitable employment shall be granted unless the authorized treating physician(s) approve(s) the job offered by the employer/insurer. A party who objects to this motion shall file their response on Form WC-102D with the Board within 15 days of the date of the certificate of service on the request, and shall serve a copy on all counsel and unrepresented parties.
(f) The Board may also issue an interlocutory order reinstating weekly income benefits pending a hearing. A party making this motion shall file Form WC-102D, and shall serve a copy, along with a copy of supporting documents, on all counsel and unrepresented parties. A motion requesting this order may be made simultaneously with the filing of a request for hearing based on a change in condition or at any time during the pendency of the hearing and award and must be 72 accompanied by an affidavit of the employee setting forth his contentions, along with current medical records when applicable. A party who objects to this motion shall file Form WC-102D with the Board within 15 days of the date of the Certificate of Service on Form WC-102D and shall serve a copy on all counsel and unrepresented parties.
(g) In the event the employee’s weekly benefits are suspended pursuant to O.C.G.A. §34-9-240(b)(2), the employer/insurer shall comply with O.C.G.A. §34-9- 263 and Board Rule 263.