In situations where an employee becomes deaf or suffers an occupational hearing loss, recovery under the workers’ compensation act can be tough. The statute governing such claims are very technical. For example, an employee (more…)
Benefits
Is the employer required to provide medical treatment because of a workers’ compensation injury?
Yes, the Workers’ Compensation Act provides that “Employer/Insurer shall furnish the employee entitled to benefits under this chapter such medical, surgical, and hospital care and other treatment, items and services which are prescribed by a licensed physician . . . reasonably required and appear likely to effectuate a cure, give relief, or restore the employee to suitable employment.” In other words, the Employer and the insurance company are responsible for the reasonable medical treatment related to the work accident.
Board Rule 200(a)(1) further explains that the: “Employer/Insurer have a duty to provide all reasonable and necessary medical treatment in a timely manner and to give appropriate assistance in contacting medical providers when necessary.” Similarly, the Employer and Insurance company must approve and authorize this treatment without significant delay.
In our experience, many injured workers fall victim to delays and denials of medical treatment as they are not properly trained on what to ask for or what to do. Medical treatment is crucial to properly heal from the work accident. If you have suffered a work related accident and you are unable to get medical care, we recommend you call us at 404-355-3431 to assist you.
What is Compensation for Permanent Partial Disability (PPD)?
The law defines PPD as a disability partial in character but permanent in quality resulting in a loss or loss of use of body members or from the partial loss of use of the injured employee’s body. In other words, the PPD rating is a medical assessment as to whether the work injury permanently affected the injured worker’s range of motion or overall body functioning. Generally, the PPD rating is issued by the authorized treating physician after the injured employee reaches “maximum medical improvement” where the employee is “about as good as he or she is going to get.” The physician will make the determination of the PPD rating by using the American Medical Associations’ Guide to Impairment. This rating will be issued in percentage compared to overall functioning.
Georgia’s Workers’ Compensation Act provides compensation in relation to the physician’s impairment assessment. This table is found in O.C.G.A. §34-9-263 or on our website. In certain circumstances, doctors may disagree as to the ratings and they can differ. Also, you may have the option of seeking a second opinion. If you have any questions about the PPD rating, please contact me at 404-355-3431.
Back injury cases
An injury to an employee’s back or neck can happen suddenly, or over time. For example, many back injuries suddenly occur such as lifting heavy boxes of paper, beverages, or construction material. This immediate pain is also accompanied by a limited range of motion and missed time from work. In these situations, the injured employee may have suffered a herniated disk that may require surgery or aggressive therapy.
Alternatively, workers may have gradual injuries analogous to the proverbial “straw that broke the camel back” These injuries may take time to manifests itself or become “symptomatic”. The question will be whether the employee’s job duties caused or contributed to the employee requiring medical treatment or missing time from work. This analysis will be fact sensitive and may be a question for the treating doctor.
Regardless of whether the on-the-job back or neck injury was “traumatic” or “gradual”, the injured worker is entitled to medical treatment, and in some instances, income benefits.
If you have injured your back at work and would like a free consultation as to your workers’ compensation rights, please contact the Ramos Law Firm.
As an injured worker what kind of medical treatment am I entitled to?
Employers are required to furnish treatment for employees who have been injured on the job. This would include “medical, surgical, and hospital care and other treatment, items, and services which are prescribed by a licensed physician.” This also includes prescription drug medication.
In addition, medical benefits may include counseling, or may include home attendant care, and in some circumstances domestic household services. These benefits may also include newly developed medical procedures under FDA investigation despite the fact that the procedures have not yet been approved by the FDA.
In many instances, employees hurt at work experience delays in authorization, mysterious or last minute request for second opinions, or flat denials of their medical treatment. As medical treatment is crucial, it is important to have someone advocating for you. Not only must this advocate have expertise about the law, but he must be knowledgeable about the physicians treating the injured worker.
If you have been hurt at work and would like a free consultation about your rights to medical care under the Georgia Workers’ Compensation Act, please contact the Ramos Law Firm at 404-355-3431 or via email.
Settling my workers’ compensation case
If you have been injured on the job and you are considering settling your claim, please note that the insurance company does not have your best interest at heart. In fact, they have a vested interested in minimizing your settlement as much as possible.
With that being said, an injured employee and the Employer/Insurer may settle the claim by agreement. There are two types of settlement: (1) compromise and (2) no liability.
A compromise “stipulation” is the vehicle used when the Employer/Insurer has accepted liability and there is a “bona fide dispute” as to future or past benefits. The compromise stipulation include a discussion of the medical treatment as well as the contentions of both parties. The “no liability” stipulation is used when there has been no finding of liability and the parties agree not to pursue a claim under the Workers’ Compensation Act in exchange for money settlement. The parties will keep a contract between them regarding the same.
Both types of settlements must approved by the State Board of Workers’ Compensation. Once the settlement has been approved, the Employer/Insurer must pay the settlement within 20 days or sooner.
If you have questions about settling your workers’ compensation case, and you would like a free consultation, please feel free to contact the Ramos Law Firm at 404-355-3431 or via email.
The business of work injuries
On the job injuries are becoming more common as injuries include claims for carpal tunnel syndrome, epicondylitis, shoulder rotator cuff tears, knee injuries, and herniated or ruptured spinal discs. If one of these injuries happened during the scope and course of your job, then workers’ compensation benefits may be given. These benefits include income benefits as well as medical treatment.
Nationally, approximately $183 billion dollars were spent on workers’ compensations claim in 2008 according to the National Safety Council. These costs included payment for medical bills as well as lost work days. In fact, it is estimated that 3.2 million claims were made in 2008.
As you can see, workers’ compensation is big business. In fact, many insurance companies have teams of lawyers and “adjusters” on their payroll just in case someone files a claim. These insurance companies have sophisticated systems designed to make it difficult for injured workers to receive benefits. If you have been injured at work, it is important to realize that the insurance company will not have your best in interest in mind. In fact, they have every reason to deny your case just to save a few dollars for their company stockholders.
Remember, they are in the business of denying your claim and benefits. If you have a work injury, don’t try to handle your claim alone. If you would like a free consultation about workers’ compensation, please contact Bryan Ramos at the Ramos Law Firm in Atlanta, Georgia, 404-355-3431.
Aggravation of knee problems and workers comp benefits
Suppose a worker has prior knee problems but then re-injures or aggravates the knee while on the job. Would this injury be accepted under workers’ compensation?
Yes, provided that the aggravation or reinjury was the result of the employee’s work duties or responsibilities. While the Employer/Insurer may have a few legal defenses against this claim in certain circumstances, the claim is actionable at first glance.
If the claim is accepted, the employee would be entitled to medical benefits including physician visits, specialist evaluations, physical therapy, prescription medication, durable medical equipment, and mileage reimbursement to and from his or her sessions. There would be no co-payment for this treatment.
If the claim is bad enough to miss work, the employee may be entitled to weekly income benefits. The dollar amount of these benefits (also known as the “comp rate”) would depend on the employee’s average weekly wage. Unfortunately, the comp rate is limited based on the date of injury.
The Ramos Law Firm represents clients with workers’ compensation legal concerns in the Atlanta metro area and throughout Georgia, including Marietta, Decatur, Douglasville, Lithonia, Lawrenceville, Smyrna, Stone Mountain, Norcross, Riverdale and Jonesboro.
If you would like a free consultation regarding your workers’ compensation injury, please contact our firm.
Occupational Deaths: What Happens if a Worker Dies On The Job?
In the event of a compensable injury that results in the death of an employee, the employer is responsible for burial expenses (not to exceed $7,500). If the Employee has “dependents” who are completely dependent upon the employee’s wages for support at the time of the injury, those dependents are eligible for compensation. This is true whether (more…)
