An overview of Georgia Workers‘ Compensation What's the big picture? An overview of Georgia Workers‘ Compensation

The State Board of Workers‘ Compensation O.C.G.A. § 34-9-40:  "There is created and established within the executive branch a board to be known as the State Board of Workers' Compensation composed of three members who shall be appointed by the Governor for a term of four years….  The board shall have full authority, power, and the duty to promulgate policies, rules, and regulations for the administration of this chapter…."  The three members include the Chairman and two Directors

Trial Division and Appeals The Trial Division is responsible for conducting hearings in contested cases and ruling on motions There are currently 17 Administrative Law Judges serving 12 territories throughout Georgia ALJ is the trier of fact and law Decisions from the Trial Division can be appealed to the Appellate Division of the State Board The Appellate Division consists of the Chairman and two Directors of the State Board APPEALS PROCESS: Trial Division  Appellate Division Superior Court of the County of Injury Court of Appeals Supreme Court of Georgia

EXCLUSIVE REMEDY O.C.G.A. § 34-9-11 sets out the exclusive remedy provision of the Georgia Workers' Compensation Act.  It provides in pertinent part,  "The rights and the remedies granted to an employee by this chapter shall exclude all other rights and remedies of such employee, his personal representative, parents, dependents, or next of kin, at common law or otherwise, on account of such injury, loss of service, or death; provided, however, that no employee shall be deprived of any right to bring an action against any third party tort feasor, other than an employee of the same employer or any person who, pursuant to a contract or agreement with an employer, provides workers' compensation benefits to an injured employee ...." An injured employee cannot sue their employer or co-workers in tort, and will not be able to recovery for pain and suffering, punitive damages, loss of consortium, et c.    The injured employee does not need to prove negligence, only that he suffered an injury "arising out of and in the course of employment" - O.C.G.A.  § 34-9-1(4)

Workers' Compensation Benefits Temporary Total Disability (TTD) Benefits § 34-9-261 Temporary Partial Disability (TPD) Benefits § 34-9-262 Employee is unable to work or the employer is not able to accommodate work restrictions  Paid 2/3 of Average Weekly Wage  Not more than $575 per week/not less than $50 Not more than 400 weeks Employee is able to work but earning less due to their compensable work injury  Paid 2/3 of the difference between Average Weekly Wage and current earnings Not more than $383 per week Not more than 350 weeks

Workers' Compensation Benefits Medical § 34-9-200     Permanent Partial Disability (PPD) Benefits § 34-9-263 Employee is entitled to all medical care which "shall be reasonably required and appear likely to effect a cure, give relief, or restore the employee to suitable employment.”  400 week cap on medical  Monetary benefit for loss or loss of use of body part, based on Average Weekly Wage and percentage of loss Schedule of income benefits: Bodily Loss                                                       Maximum Weeks  (1)  Arm .................................................................... 225  (2)  Leg ..................................................................... 225  (3)  Hand .................................................................. 160  (4)  Foot ................................................................... 135  (5)  Thumb ................................................................. 60  (6)  Index finger ......................................................... 40  (7)  Middle finger ...................................................... 35  (8)  Ring finger .......................................................... 30  (9)  Little finger ......................................................... 25 (10)  Great toe ............................................................. 30 (11)  Any toe other than the great toe ......................... 20 (12)  Loss of hearing, traumatic         One ear ............................................................... 75         Both ears ........................................................... 150 (13)  Loss of vision of one eye ................................. 150 (14)  Disability to the body as a whole ..................... 300

Workers' Compensation Benefits CATASTROPHIC INJURIES § 34-9-200.1  DEATH BENEFITS § 34-9-265 If an injury is found to be "Catastrophic" the employee will be entitled to income and medical benefits for the remainder of their life (the 400 week cap on TTD and Medical benefits does not apply to employees who have suffered a catastrophic injury) Six criteria for catastrophic designation: Paralysis Amputation of arm, hand, leg, or foot Severe brain or closed head injury 2nd or 3rd degree burns over 25% of body or 3rd degree to 5% of the face or hands Total or industrial blindness Any other injury that prevents the employee from performing any work available in substantial numbers in the national economy $7,500 Funeral expenses  If no dependents, no other compensation  Dependents receive income benefits If spouse is only dependent, benefits shall not exceed $230,000 Child dependent benefits stop at 18 or 22 if enrolled in college, unless physically or mentally incapable of earning a livelihood 

Statutes of Limitation and Notice Employee must give the employer notice of an injury within 30 days.  O.C.G.A. §34-9-80 Employee has 1 year from either the date of injury or last date the employer provided remedial medical care within which to file a claim with the State Board.  O.C.G.A. §34-9-82 Where income benefits have been paid: Employee must request a hearing for additional TTD or TPD benefits within 2 years of the last payment of income benefits Employee must request a hearing for PPD benefits within 4 years of the last payment of income benefits

Board forms (frequently used) WC-1 – Employer's first report of injury WC-2 – Payment or Suspension of benefits WC-3 – Controvert (denial of all or part of a claim) WC-6 – Wage statement (provides basis for computing Average Weekly Wage) WC-12 – Request for copies of Board forms WC-14 – Notice of Claim or Request for Hearing (Employee's form to file claim and toll SOLs) WC-100- Request for Board Mediation WC-102(b) - Notice of representation  WC-104 – Notice to employee of medical return to work with restrictions / allows reduction in benefits from TTD to TPD without actually returning employee to light duty employment  WC-200a – Change of physicians  WC-240 – Notice to employee of suitable employment  WC-R1CATEE – Request for Catastrophic Designation

State Board Resources ICMS – Integrated Case Management System Claim forms filed here by all parties and the Board Will include hearing notices, orders by the Board Other Board Resources:  https://sbwc.georgia.gov/ Publications Board Forms Rules/Statutes  Published Awards