Am I Covered?
If you are injured while “on the clock,” then you are most likely eligible for workers’ compensation benefits under Georgia law. Any injury that occurs while you are performing tasks that arise “out of and in the course of employment” is covered.
The most straightforward cases are those in which an employee suffers a specific injury while performing his or her job. Examples of these clear-cut cases include:
- falling off a ladder
- falling from a loading dock
- forklift accidents
- back injuries from lifting or twisting
- knee or other joint injuries
- crush injuries
These kinds of cases should be “picked up” by your employer and its insurance company, meaning that weekly wage benefits should be paid and medical care authorized. You may have other problems but an “accepted” claim is a good start.
Other types of injuries may result in problems with the insurance company. Examples of potential problems area cases include:
- repetitive motion injuries – where the damage did not result from a specific incident but was the result of activity over a period of time
- injuries where the damage does not appear for one or more days – for example, back injuries sometimes do not become apparent for days or even weeks
- unwitnessed injuries – where the employer questions whether you got hurt on the job at all
- injuries claimed by new employees
Employers hate work injury claims because these claims make their insurance premiums go up. You may find that an supervisor or HR contact who was previously pleasant and supportive may undergo a significant attitude change due to your work injury claim.
Defenses Used by Employers and Insurers to Deny Claims
Employers will try to deny claims that do not “arise out of and in the course of employment.” Examples of claims that may be denied include:
- injury while coming to, or leaving from your work site
- injury during a lunch or break time
- injury that occurs while you are engaged in “horseplay”
- injuries that occur while you are at home
- injuries that occur while you are intoxicated or under the influence of drugs
- injuries that occur to a part of your body when there was a misrepresentation about that body part on an employment application
Even Legitimate Worker’s Comp Cases May Be Challenged
Employers and insurers will look for any flaw in your case to deny coverage or to reduce settlement value. In my experience, workers’ compensation law is one of the most adversarial, contested areas of Georgia law.
Employers will use surveillance — hiring private investigators to “tail” you, hoping to capture you doing some activity on videotape that contradicts your claim of injury. Witnesses who are currently employed will be pressured not to support you. Doctors on your employer’s posted panel will minimize your symptoms and release you to work before you are ready.
If you have been injured while on the clock, you should assume that your employer will challenge your claim, either now or in the future. You should not assume that your employer or the insurance adjustor has your best interests at stake. Instead, contact a qualified, experienced worker’s compensation attorney as soon as possible to learn more about how you can maximize the benefits to which you are entitled under Georgia law.
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