Atlanta Workers Compensation Law : Atlanta Workers' Compensation Lawyer & Attorney : Seth Bader Law Firm : Construction Accidents, Repetitive Motion Injuries, Disability : Atlanta, Marietta, Roswell, Georgia

Advance Payment - a partial lump-sum payment

Average Weekly Wage - the wage upon which indemnity benefits are calculated; usually this is based upon the average of the injured worker's weekly wages during the thirteen weeks immediately before his or her accident

Claim - a request for payment of money, medical treatment, or other available workers' compensation benefits based upon the occurrence of an occupational injury or illness

Closed Claim - a claim in which all benefits due have been paid and/or a claim that has been settled in its entirety

Compensable Claim - a claim that qualifies the injured worker or dependents for workers' compensation benefits under the law

Indemnity Benefits (Income Benefits) - payments made to the injured worker as a result of his or her compensable lost time from work or payments made to dependents of a deceased worker whose death resulted from his or her occupational injury or illness

Indemnity Claim - a claim for which at least one day of indemnity benefits has been paid

Lost-Time Claim - a claim in which an injured worker has missed more than seven days of work as a result of a disabling occupational injury or illness

Lost Work Days - days that an injured worker missed as a result of his or her occupational injury or illness; lost work days does not include the day of the injury or any days during which the injured worker was not scheduled to work

Lump-Sum Payment - a single payment of all remaining weekly income benefits (or permanent partial disability benefits)

Medical-Only Claim - an occupational injury for which medical benefits are being paid or authorized, but for which no income benefits have been paid

Nature of Injury or Illness - the physical characteristics and/or medical diagnosis of an injury or illness, such as a sprain, a herniated disc, a second-degree burn, an amputation, etc. 

Open Claim - a claim in which workers' compensation benefits may still be paid

Part of Body - the part or parts of the body of the injured worker directly affected by the injury or illness for which the worker is seeking or receiving workers' compensation benefits

Permanent Partial Disability - disability that is partial in character but permanent in quality; results from a loss of use of body members or from partial loss of use of the body as a whole

Processed Claim - a claim for which data from at least one case progress report and/or first report of injury has been entered into the State Board's Integrated Claims Management System

Temporary Partial Disability - disability that is partial in character but temporary in quality; able to perform work at a reduced rate of pay for no more than 350 weeks immediately following an occupational injury and before the employee has reached maximum medical improvement

Total Disability - disability that is total in character and either temporary or permanent quality; unable to perform any work for pay as a result of an occupational injury or illness

Type of Accident - the event that directly resulted in the injury or illness

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If you have not already reported your accident and injury to your employer, you should do so immediately!  If you fail to provide your employer with timely notice of your on-the-job injury, you may be barred from recovering any workers' compensation benefits.

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You have one (1) year from the date of injury to file a claim with the State Board of Workers' Compensation.  If, during that year, you received remedial treatment from your employer for your work-related injury, you have one (1) year from the date of the last remedial treatment from your employer to file a claim.  Also, if you continued to work after your injury until you were forced to stop working due to a gradual worsening in your condition, you may be able to file a claim within one (1) year of the date you were forced to stop working.

If you received weekly income benefits as a result of your work-related disability, you have (1) year from the date of the last remedial treatment or two (2) years from the last payment of weekly income benefits to file a claim for additional compensation.

If your claim is based on an occupational disease, you have one (1) year from the date you became aware of your disease or, in the exercise of reasonable diligence, should have know of the relationship between your condition and its employment.  Any claim based upon an occupational disease must be filed within seven years of the last date you were exposed to the work-related hazards that caused your disease; however, if your claim is based upon a diagnosis of asbestosis or mesothelioma resulting from exposure to asbestos, you have one (1) year from the first date of disability following your diagnosis to file a claim.

While we strongly recommend filing a claim as quickly as possible, there are circumstances in which an injured worker can file a claim after the applicable deadline (statute of limitations) in his or her case; therefore, if you have missed the applicable deadline in your case, or if you think you are close to missing the applicable deadline, we strongly recommend that you immediately contact an experienced workers' compensation attorney.

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(a)  The rules of the Board are subject to amendment at any time. The Board may adopt additional rules whenever deemed necessary.  However, except in extraordinary circumstances, rule changes will only be considered and adopted annually, to be effective on July 1 of each year.

(b)  Prior to the adoption, amendment, or repeal of any rule, other than interpretive rules or general statements of policy, the Board shall:

(i)  Provide a copy of the proposed rule to the Chairperson of the Board's Advisory Council.

(ii)  Provide a copy of the proposed rule to the Chairman of the Senate Industry and Labor Committee and the Chairman of the House Industrial Relations Committee.  At the request of the Chairman of the Senate Industry and Labor Committee or the Chairman of the House Industrial Relations Committee, the Board shall hold a hearing on the proposed changes.

(c)  Upon receipt of notice of a work-related injury, the Board shall assign a claim number.  All subsequently filed forms, reports, or any other correspondence or documents related to or concerning such work-related injury shall have affixed thereto the assigned claim number, date of injury, and claimant’s name.  Failure to include this information with the filing may result in the rejection of the filing with the Board.

(d)  Written instructions on all workers' compensation forms are deemed to be included in these rules.

(e)  The Board shall have the power to issue writs of fieri facias in order to collect fines imposed by any member of the Board or any Administrative Law Judge against any person.  Such writs may be enforced in the same manner as a similar writ issued by a superior court.

(f)  Pleadings, forms, documents, or other filings may be filed with the Board by facsimile transmission or by electronic mail only to Board designated ICMS fax numbers or electronic mail addresses.  No pleadings, forms, documents or other filings, with the exception of a notice of claim filed on the final day allowed pursuant to statute, will be accepted by facsimile transmission or electronic mail to non-designated ICMS fax or numbers or electronic mail addresses unless specifically permitted or requested by the Board.  The name of the person permitting or requesting the facsimile transmission or electronic mail shall be provided simultaneously.  The certificate of service, showing concurrent service upon the opposing party by facsimile transmission or electronic mail, if available, shall be a part of any facsimile transmission or electronic mail.  Failure to include a certificate of service shall invalidate the filing.  All facsimiles or electronic mail transmissions must be identical to the originals and must be legible.  The Board, within its discretion, may transmit documents by facsimile or electronic transmission.

(g)

(1)  Pursuant to Code Section 10-12-2 et seq, when a signature is required for any electronic filing with the Board, the party or attorney shall type his or her name in the appropriate fields on the document or Board form submitted for filing.  Submission of a filing in this manner shall constitute evidence of legal signature by those individuals whose names appear on the filing.

(2)  Any party or attorney challenging the authenticity of an electronically filed document or electronic signature on that filing must file an objection to the document within 15 days of receiving the notice of the electronic filing.  The burden shall be on the party challenging the authenticity of the signature.

(h)  In order to create a workers’ compensation ICMS file at the Board, a Form WC-1 or Form WC-14 shall be filed with the Board.  Any document or form filed with the Board, when either a Form WC-1 or Form WC-14 has not been previously filed, shall be rejected by the Board.

(i)  Only the original of any form, document, or other correspondence shall be filed with the Board. Duplicate originals shall not be filed with the Board.  Where providing a courtesy copy to an Administrative Law Judge or the Board, that document shall be identified clearly and prominently as a courtesy copy.

(j)  Service upon a party or attorney of any form, document, or other correspondence shall be by electronic mail.  Whenever electronic mail is not available, service shall be by U.S. Mail.

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(a) Any defense as to the time of filing a claim is waived unless it is made no later than the first hearing.

(b) A party filing a claim should file Form WC-14 with the Board and serve a copy on all other parties.

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File to open a claim, request a hearing, or request a mediation conference.  Furnish a copy of Form WC-14 to all other parties. (A request for hearing by an employee will be considered only after the time required of the employer/insurer to make the first payment of income benefits has expired as provided in O.C.G.A. § 34-9-221.)

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A party or attorney shall file this form with the Board when requesting correction of a mistake concerning the employee's name, social security number, date of injury, or county of injury on a previously filed Form WC-14.  A Form WC-14A shall not be used to change an address of record, add additional parties, or additional dates of injury.  A new Form WC-14 shall be filed with the Board to add or amend any information pertaining to the employer, the insurer, the servicing agent or part of body injured, and to add an additional date of injury, hearing issue, or mediation issue.

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The employer/insurer shall file:

(A)  Within 48 hours of the employer's acceptance of a catastrophic injury as compensable, simultaneously with the Form WC-1, naming a catastrophic supplier;

(B)  Within 15 days of notification that rehabilitation is required to request a rehabilitation supplier;

(C)  When the employer/insurer requests a supplier for cases with dates of injury prior to July 1, 1992;

(D)  When the employer/insurer requests a change of supplier;

(E)  To request reopening of rehabilitation; or

(F)  Upon request of the Board.

The employee or employee's attorney shall file a Form WC-R1 to request appointment of a supplier for cases with dates of injury prior to July 1, 1992, for change of supplier or reopening of rehabilitation.

A case party shall file a Form WC-R1 when a stipulated settlement provides for rehabilitation and rehabilitation is not already on the case.  A case party may file a Form WC-R1 to request an extension of vocational rehabilitation services for cases with dates of injury prior to July 1, 1992.

All required information shall be supplied and shall be legible.  The certificate of service must be completed and the date mailed must be indicated.

• Form WC-R1/Request for Rehabilitation
  

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