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workers’ comp law

A typical workers compensation claim when an employee suffers back strain or herniation

A common workers’ compensation scenario involving a back injury goes like this:

The injured worker will feel pain in his back or spine, be directed to a Concentra, Urgent Care, or Choice Care in Atlanta or DeKalb County, and the “doctor” may dismiss the worker with a “back strain or sprain.”  Hopefully, an x-ray will be done and the worker will be given some prescription medication.  However, the injured worker may remain in pain.  After a few days, the employee (hurt at work) would return to the industrial clinic complaining of pain.  Hopefully, an MRI would done.

If the MRI scan demonstrates a disc herniation, this means that there may be a tear in the outer ring of a spinal disc.  Generally, inflammation may occur and cause pain.  The symptoms may depend on the level where the herniation occurred and whether it is touching a nerve.  For example, a herniation in the low back may cause pain in the buttocks or down the injured worker’s legs.  Treatment for back pain may include physical therapy, and potentially surgery.  It is important that injured workers understand their course of treatment and options.

If the employee’s pain is bad enough that he or she is losing time from work, he or she may be entitled to income benefits under the Georgia Workers’ Compensation Act, in addition to the medical treatment (provided at the expense of the Employer/Insurer).  There also may be a permanent impairment rating issued  at some point in the life of the claim.

The employee tends to feel lost between the pain level, trying to maintain their life and navigate the workers comp claim. If you find yourself or someone you know in this position, have them contact our office for a consultation. We can help so that you can focus on getting better.

If you need some advice as to your rights under the workers’ compensation system, please contact our office at the Ramos Law Firm.

Death benefits and Foreign (Alien) Dependents

In the unfortunate and tragic death caused by a work accident, the deceased employee’s spouse or children may be entitled to workers’ compensation benefits.  O.C.G.A. § 34-9-13.  There was an issue as to whether alien or foreign dependents were limited or excluded from these death benefits.  The Workers’ Compensation Act (prior to 1995) made an unlawful distinction (more…)

Change of condition; Fictional New Date of Accident

What happens when an employee is hurt on the job, comes back, but then goes back out because of the work injury?  The problem that presents is itself is whether the reason for the disability is a “change of condition” of the previous injury or a “fictional new date of accident”.  The distinction can be confusing and may have an impact on whether the employee has a statute of limitation problem.  (more…)

If I had a beer shortly before my work injury, am I barred from receiving workers’ compensation benefits?

Generally, no compensation is allowed for an injury or death due to an employee’s “willful misconduct.”  O.C.G.A. §34-9-17.   Moreover, if the injury or death of the employee is due to (more…)

Does an injured worker have the right to a second opinion or independent medical evaluation?

Generally, an employee has the right to one independent medical examination with a physician of the injured worker’s choosing.  The doctor must be in Georgia or within 50 miles of the injured worker’s residence.  This second opinion or independent medical evaluation will be (more…)

Messing up my workers’ compensation case

Recently, I had a Piedmont Hospital employee ask me how most clients “mess up” their workers’ compensation case.  After some thought, I advised her that the most common issue clients have is not (more…)

What is a “workers’ compensation mediation?”

Generally, a mediation is a form of alternative dispute resolution.  The idea centers around the parties’ interest in finding a solution to the issue before the court, tribunal, or worker’s compensation board.  This process (more…)

Hearing loss due to job duties

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…)

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.

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.