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I had all of my bills paid and received my salary while recovering from injury under workers comp. Am I owed a settlement?

I have spoken with the AIG adjuster and she is stating she is waiting on my MMI from the doctor. She states the only thing left owed are mileage for trips to the doctor.

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Attorney answers (4)

Reputation Level 16
Don't trust the insurance company to tell you whether you are entitled to a settlement. You should talk to a workers' compensation attorney as soon as possible. I'm licensed in Illinois, but I know an attorney near you who may be able to help. Give me a call if you'd like a referral.
2 people marked this answer as good

Reputation Level 9
A common myth in Georgia Workers Compensation is that the insurance company must settle the claim.

If the adjuster is waiting for you to reach MMI or maximum medical improvement, that means she is waiting on the doctor to issue you an impairment or permanent disability rating. If the doctor releases you to full duty, and gives you a zero percent impairment, the insurance company owes you nothing under Georgia Workers Compensation. If you pull up the Georgia State Board of Workers Compensation you will need to look at the forms section and then go to the board forms look for form WC-2, look on page two and that will show you exactly how to calculate any potential permanent partial disability you may be entitled too.

Remember if you are not at maximum medical improvement or feel like you still need medical care you should request a second opinion. Just remember you have time limits on your claim. The time limits depend on if you have received income benefits or not. So I would encourage you to speak with a Georgia Workers Compensation Attorney.

Good luck.

Ty

Reputation Level 12
You may be owed partial benefits if you are returning to a lower paying job and you may be entitled to PPD benefits for any impairment rating ....

GEORGIA WORKERS' COMPENSATION BENEFITS INFORMATION

If you have been injured on the job, he following information is to help you understand the benefits to which you may be entitled pursuant to the Georgia Workers' Compensation Law.

Immediately following an injury on-the-job, you should give notice of your accident to your Employer. A thirty (30) day written notice is acceptable. A claim form, WC-14, must be filed within one (1) year of the accident at the State Board of Workers’ Compensation. If it is not, you will be barred by the STATUTE OF LIMITATIONS.

If you do not know the name of the Workers’ Compensation insurer for your Employer on the date of your injury, you may get their name, address and telephone number by calling this toll free number to the Coverage Division at the State Board of Workers’ Compensation: 1-800-743-5436. This information must be included on the claim form.

TTD (TEMPORARY TOTAL DISABILITY) BENEFITS:­

While you are totally disabled from any work, you are entitled to receive weekly compensation benefits in the amount of two-thirds (2/3) of your gross weekly earnings, not to exceed $500.00 per week effective 7/1/07 (from $450.00 maximum 7/1/05).­ The maximum time that you may be entitled to receive these benefits is 400 weeks, unless your injury is catastrophic (as defined below).­ No compensation is allowed for the first seven (7) calendar days of disability following an injury, unless or until disability exceeds twenty-one (21) days. You must have verification of disability by the doctor. You may elect to receive salary in lieu of compensation if you have sick days.

Your TTD benefits may be suspended with a ten (10) day notice if you are released to return to normal work and you do not actually return to work.

If you are offered a job by your Employer that has been approved by your authorized treating physician, then you must try the job. If you are unable to continue, due to your injury, within fifteen (15) days, TTD benefits may be immediately reinstated. This must be documented by your treating physician, however.

TPD (TEMPORARY PARTIAL DISABILITY) BENEFITS:­

(1)­ If you return to work at a lesser wage due to your injury, you are entitled to two-thirds (2/3) the difference between your pre-accident gross wages and the gross wages you are able to receive at that time, not to exceed $334.00 per week effective 7/1/07 (from $300.00 maximum 7/1/05). ­ The maximum time that you may be entitled to receive these benefits is 350 weeks from the date of the accident.

2)­ After your doctor determines that you are capable of performing work with limitations or restrictions, the insurer may file a form within sixty (60) days of the doctor's determination of the release and inform you that your TTD benefits may be reduced to TPD benefits after fifty-two (52) weeks.

PPD (PERMANENT PARTIAL DISABILITY) BENEFITS:­

After you have returned to work and are earning as much as your pre-accident wages OR after the expiration of 350 weeks from the date of the accident, you are entitled to permanent partial disability payments based upon the doctors disability rating of your injuries. In some cases, there is no permanent disability. There is a certain amount of weeks payable for each body part or for the body-as-a-whole.

For example, if you have an injury to your leg, the doctor may assess a percentage rating to the lower extremity. The Workers' Compensation Law provides that the lower extremity is valued at a total of 225 weeks. Thus, a 10% rating would entitle you to 22.5 weeks of compensation times your compensation rate. (10% x 225 weeks = 22.5 x $500.00 = $11,250.00). The authorized treating physician must certify that any permanent impairment rating is in accordance with the AMA guidelines.

MEDICAL TREATMENT:­100% in GA

Reputation Level 6
Depending on the nature and extent of your injuries you may be owed a permanent partial disability (PPD) rating, should your treating physician decide one is warranted. If you are issued a PPD rating, you may remain entitled to weekly benefits, even after your physician returns you to regular full-duty work. Sometimes this amount may be paid as a lump sum, depending on the circumstances.

If you continue to experience pain even after a physician returns you to light-duty or full-duty work, be sure to request a re-examination or a second opinion from a different physician. I would suggest you contact a workers' compensation attorney who practices in the Atlanta area to more fully discuss your options. Should you have any further questions, feel free to contact me.

Joshua A. Carroll
Buzzell, Graham & Welsh, LLP
563 Walnut Street
Macon, Georgia 31201
(478) 742-8820
jcarroll@bgwlaw.com

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