Board Rule 220. Computing Days of Disability Preceding Payment of Compensation

(a)  The date of disability is the first day the employee is unable to work a full day.  If, however, the employee is paid in full for the date of injury, the date of disability shall begin the next day following the date of injury.

(1)  The day or days considered lost because of disability to work shall be counted from the first seven calendar days of disability even though the days may not be consecutive.

(2)  Intervening days, which are not scheduled workdays, during disability or preceding a return to work, are days of disability.

(3)  Disability shall end on the day of the return to work.

(b)  Entitlement to benefits for the first seven days of disability, or any part thereof, requires 21 consecutive days of disability.  The employer/insurer shall pay compensation for the first seven days of disability on the 21st consecutive day.

(c)  An injured employee who receives regular wages during disability shall not be entitled to weekly benefits for the same period.

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Board Rule 221. Method of Payment

(a)  Payment shall be made to the address of record or account specified by the claimant, in cash, by negotiable instrument, or upon agreement of the parties by electronic transfer.  Payment by negotiable instrument shall denote the pay period which the payment represents.  Mailed payments shall be sent to the claimant in accordance with the procedure prescribed by O.C.G.A. § 34-9-221(b).

(b)  For the purpose of calculating time periods, the date of injury shall be deemed to be the date of disability and a week shall be deemed to be seven calendar days.  See Rule 220(a).

(c)  In all cases, including payment of salary for compensable disability, upon making the first payment and upon suspension of payment, Forms WC-1 or WC-2 or, in case of death, Form WC-2A shall be filed with the Board.  If the Forms WC-1 or WC-2 show payment is less than the maximum weekly benefit under either O.C.G.A. § 34-9-261 or O.C.G.A. § 34-9-262, as applicable, a Form WC-6 or other sufficient explanation shall be filed with the Board with the accompanying Form WC-1 or WC-2.  To report any change in weekly benefits, payment of salary during period of compensability, classification, or rating of disability, a Form WC-2 shall be filed with the Board.  An injured employee who receives regular wages during disability shall not be entitled to weekly benefits for the same period.

(d)  To controvert in whole or in part the right to income benefits or other compensation, use Forms WC-1 or WC-3.  Failure to file the Forms WC-1 or WC-3 before the 21st day after knowledge of the injury or death may subject the employer/insurer to an assessment of penalties or attorney's fees. See paragraphs (2) and (3) of subsection (b) of O.C.G.A. § 34-9-108.

(e)  Any penalty for late payment shall be stated as a separate item on Forms WC-1, WC-2 or WC-2A.

(f)  Accrued benefits payable under the terms of an award are due on the date the award is issued.

(g)  Within 30 days after final payment of compensation, a final Form WC-4 shall be filed with the Board.

(h)  Subsection (h) of O.C.G.A. § 34-9-221 applies only when income benefits are being paid under Forms WC-2, WC-2A, or subsection B of Form WC-1.  To suspend payment on the ground of a change in condition, file Forms WC-2 or WC-2A.

(1)  A Form WC-3 shall not be used to suspend benefits where the only issue is length of disability.  In these cases, suspend benefits by filing a Form WC-2 or follow procedure outlined in Rule 240.  If liability is denied subsequent to commencement of payment, but within 60 days of due date of first payment of compensation, file Form WC-3 in addition to a Form WC-2.

(2)  If income benefits have been continued for more than 60 days after the due date of first payment of compensation, benefits may be suspended only on the grounds of a change in condition or newly discovered evidence.  File Forms WC-2 or WC-2A.  When controverting a claim based on newly discovered evidence, file Form WC-3 also.

(i)

(1)  Suspension of benefits at any time on the ground of change in condition requires advance notice of 10 days unless the employee has actually returned to work.

(2)  The date of filing with the Board, in the absence of compelling evidence to the contrary, shall be considered the date of notice.

(3)  The date affixed by the Board to Forms WC-2 or WC-2A, in the absence of compelling evidence to the contrary, shall be considered the date of notice.

(4)  When suspending benefits for release to return to work without restrictions, the employer/insurer shall attach to the Form WC-2 a copy of the supporting medical report from employee's authorized treating physician, who must have examined the employee within sixty days of the effective date of the release.

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Board Rule 61(b)(2). Form WC-2. Notice of Payment of Suspension of Benefits

File Form WC-2 to commence, suspend, or amend the weekly benefit payment under O.C.G.A. § 34-9-261, O.C.G.A. § 34-9-262, or O.C.G.A. § 34-9-263, including payment of salary for compensability, or when a change in disability status occurs after Form WC-1 has been properly filed with the Board.  File when suspending O.C.G.A. § 34-9-261 benefits and commencing O.C.G.A. § 34-9-262 benefits pursuant to § 34-9-104(a)(2)Mail a copy of the Form WC-2 and attachments, if any, to the employee and their attorney, if one has been retained.  See Rule 221.  If the last payment is intended to close the case, file final Form WC-4.

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Board Rule 61(b)(4). Form WC-3. Notice to Controvert

Complete Form WC-3 to controvert when a Form WC-1 has previously been filed.  Furnish copies to employee and any other person with a financial interest in the claim including, but not limited to, the treating physician(s) and attorney(s) in the claim.  See subsections (d), (h), and (i) of O.C.G.A. § 34-9-221 and Rule 221.  In addition, complete and file a Form WC-4 within 180 days of the date of the controvert.

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