Workers compensation cases can be confusing anywhere, but they start off tricky in Columbus, GA., thanks to geography and Uncle Sam.
The geographical component is Alabama. It’s right across the Chattahoochee River from Columbus. You could work downtown, walk across the Oglethorpe Bridge to Phenix City, Ala., for lunch and be back at your desk in an hour.
Uncle Sam provides Fort Benning, the nearby Army base that sits on the Georgia side of the border between the states. It’s home to more than 100,000 soldiers and their families, and it employs thousands of civilian contractors.
If you get injured on a job and want to know where to pursue your case, confusion often sets in.
“We get a lot of calls from people who live in Alabama and work in Columbus or Muscogee County,” said Ellene Welsh, a workers compensation attorney in Columbus. “And we get a lot of calls from people who are hurt on base.”
They’re usually wondering where to file, where the best benefits might be and how do they get them? Sometimes, the answers are easy. Other times, it can get a little complicated.
And that’s just the beginning of the case. Once the wheels of workers compensation justice get rolling, things can really get bewildering for an injured worker.
Reasons to Hire a Workers Comp Attorney in Columbus
Regardless of where you are injured, the first thing to do is seek medical attention. Emergency care is rarely an issue. It’s the extended care that often leads to problems.
“People call us when the doctors stop paying attention to them,” Welsh said. “A lot of people don’t even know they have a choice in doctors. If they have a back injury that’s getting worse, and they’ve having leg numbness and the insurance company is stonewalling them. That’s when they call us.”
Workers are not generally allowed to choose their own doctors and employers often refer injured workers to “industrial clinics.” That term is not defined by state law, but it’s generally a group of physicians that are affiliated with insurance companies.
Industrial clinics generally don’t have specialists, and doctors are averse to ordering expensive tests. They report findings directly to case managers or directly to insurance adjusters.
In other words, they look out for the insurance company first, then the worker. Feeling you’re not getting proper care is one reason to hire an attorney. Other warning signs include:
- Your employer does not respond in a timely manner to your workers compensation claim.
- Your employer asks you not to file a claim and says the company will pay your medical bills.
- Your employer retaliates against you after you file a claim.
- Your employer disputes whether your injury is work-related.
- Your medical treatment is delayed, or you start getting medical bills.
- You don’t receive benefits that have been agreed on.
Many issues stem from medical diagnoses workers that might not hold up in court. The problem is a lot of injured workers were unaware they could get a second opinion.
“They don’t even know they can go to another doctor,” Welsh said. “In my experience, employers very rarely tell the client what they’re entitled to.”
What Do Workers Comp Attorneys in Columbus Do?
The simple answer is they look out for their clients, and that’s a multi-faceted job. As mentioned earlier, one of the unique things about Columbus is simply knowing where to file a case.
Workers compensation cases that spring from injuries on military bases generally fall under the Defense Base Act. The procedures for civilians are similar in most respects to those if an employee gets hurt on a regular worksite.
Most states require injured workers to pursue their claims in the state where the injury occurred or where their business is located. Chances are if you live in Columbus but work for a company based in Phenix City, your case will go through Alabama’s workers compensation system.
But there are wrinkles that are worth exploring. For instance, if a business contract is written for services expressly outside of Alabama, an injured worker living in Alabama might be able to file in Georgia. That’d be good news for the worker.
“The laws are more favorable to employers in Alabama,” Welsh said. “They’re bad in Georgia, but they’re worse in Alabama.”
All in all, you’d rather be in Philadelphia (or a lot of other places) if you fall off a ladder at work. The average workers’ comp wage is $1,130 a week in Pennsylvania.
In Georgia, the weekly benefit is capped at $675. Sure, it’s cheaper to live in Muscogee County than near the Liberty Bell, but it’s not that much cheaper.
Speaking of cheap, there’s Alabama. Portions of that state’s workers compensation laws were bad enough to be found unconstitutional in 2017, notably a $220 per week permanent partial disability benefit and capping attorney’s fees at 15%.
You’re not going to find many capable attorneys who’ll work for 15%. And the average worker who doesn’t have a legal degree would be ill-advised to be their own advocate.
“You really should not try to do this yourself,” Welsh said. “You’re not going to know the ins and outs of workers compensation law.”
Those ins and outs include:
- Handling negotiations with the employer’s workers’ comp insurance company.
- Filling out all forms and file them properly and on time,
- Helping arrange vocational training if a worker is unable to return to his or her job.
- Managing medical care.
- Making sure your benefits are delivered when promised.
- Arguing against the insurance company’s attorney’s case if your claim ends up before a judge.
How Much Do Workers Comp Lawyers in Columbus Charge?
Fees for workers compensation attorneys in Georgia are based on a percentage set by the state legislature. It’s currently capped at 25%, and attorneys can only receive that fee out of weekly indemnity benefits or a settlement.
There aren’t any upfront fees. If a workers’ comp lawyer tried to charge you for an initial consultation, report them to the Georgia State Bar.
Is legal help worth 25% of an injured workers’ benefits? Only the worker can ultimately answer that, but given the complexities of the legal system and fighting against a lawyered-up insurance company, that 25% might be the wisest investment a worker can make.
“You’re paying me to make sure you’re getting everything you’re entitled to under the Georgia Workers Compensation Act,” Welsh said. “And it’s not much.”
Handling a Workers Comp Case on Your Own in Columbus, GA
Most claims do not require the help of a workers comp attorney. When the system works as intended, you simply have to notify your employer to kickstart the process of filing a workers compensation claim. If things do not work out in your favor, you have the option to appeal a claim denial. This will require the help of a workers comp lawyer, but for reference, the step-by-step guide is detailed below.
Filing a Workers Comp Claim in Columbus
When you file a claim in Columbus, getting the initial form processed and knowing how workers comp works is vital. You can’t let any details slip through the cracks.
The injured employee, the employer and the insurance carrier are the principal players.
- Injured worker notifies employer – Employee has a 30-day deadline to notify his/her employer.
- Insurance carrier investigates the claim – Workers comp will not provide benefits for injuries resulting from misconduct.
- Insurance carrier files a First Report of Injury – Copies will be sent to the State Board of Workers Compensation, the employee and the employer.
- Injured worker receives the workers comp brochure – The brochure is sent by the insurance company, and it contains information about the rights, benefits and procedures for obtaining workers comp benefits.
- Appealing a claim denial – Employees have the option to appeal if their claim is denied.
Filing a Workers Comp Claim for an Occupational Disease
You generally have one year after the date that you knew (or should have reasonably known) of the disease and how it was caused by your employment. With few exceptions (notably asbestosis or mesothelioma), you can’t file a claim for an occupational disease more than seven years after your last exposure to the work hazard.
How to Appeal a Workers Comp Denial in Columbus
There are specific avenues you must follow if your claim has been denied in Columbus and you want file an appeal.
It’s understandable if you’re confused and angry over this roadblock. What happened? Your claim could be denied as a whole (meaning the insurance company doesn’t believe there was an injury) or through a certain aspect (maybe medical treatment with a specific doctor or denial of a specific body part that that the claim says was hurt on the job). The insurance company could assert that your injuries are not catastrophic. It may not believe they were due to a workplace accident.
So how do you appeal? The process can be difficult, so it’s advisable to hire an attorney, who can guide you through any reviews with the Georgia SBWC.
Here are the steps to challenging your denial:
File A Claim
In a 2019 survey of Georgia plaintiffs who received benefits after initially being denied, more than half said they filed paperwork with the SBWC to challenge the insurance company’s decision. The “notice of claim’’ (form WC-14) is good for one year after your injury or last medical treatment provided and two years after your last weekly disability payment. Get used to the details and paperwork. It’s part of the process.
If the Board orders you to appear for mediation, you are required to attend. Georgia has 15 mediation sites scattered all over the state, including one in Columbus. In Georgia, approximately 82% of the appeals cases are solved this way instead of a hearing. But if a settlement can’t be reached, the process continues.
Employee Assistance Office
18 9th Street
Heritage Tower, Suite 200
Columbus, GA 31901
Directions to the Columbus Mediation Site:
It’s an informal legal proceeding that typically takes place at a courtroom in the county where the injury occurred. Your attorney will make arguments and present evidence to a judge, who will make a decision within 30 days.
If you don’t like the judge’s hearing decision, your attorney can go to the SBWC’s appellate division by filing an application for review within 20 days of the ruling. The appellate division makes its decision after evaluating written arguments from both sides.
If the SBWC appellate judge rules against you, there’s one final recourse. You can go to the Georgia Court of Appeals (and subsequently to the Georgia Supreme Court). Your attorney must file that appeal in the county where you were injured within 20 days of the SBWC’s final order.
Eligibility for Workers Comp in Columbus
Nearly every employer in Columbus is required to provide employees with workers compensation insurance. According to Georgia law, any business with three or more workers (including regular part-time workers) must have the insurance and coverage begins on the employee’s first day of work.
There are some exceptions to coverage requirements, including railroad carriers, U.S. Government agencies, farm laborers and domestic servants.
Want to check on your workplace? Coverage can be verified by going to www.sbwc.georgia.gov and clicking on “How Do I verify an employer’s workers’ compensation insurance coverage’’ or by checking through this database.
Benefits: What Does Workers Comp Cover in Columbus?
There are three major categories of benefits in Columbus’ workers compensation laws — medical, lost wages and death benefits — with several sub-categories that help determine how much you might receive and for how long.
Here is a look at each category of benefits and the sub-category that influences how much is paid out and for how long.
Medical Benefits — In Columbus, you are required to use one of the six doctors offered by the company. It’s your choice and you can switch that option once. In that circumstance, the insurer must pay all of your medical bills as long as the doctor says the treatment is for your job-related injury. If you receive weekly benefits, you have the right to ask the SBWC to be examined by a doctor you choose.
When you’re hurt on the job, it’s in everyone’s best interest — the business owner, fellow employees, insurance carrier and certainly you — to have you get well and return to work. Paying medical costs to achieve that goal is the foundation of workers compensation.
Lost Wage Benefits — The bills still must be paid, even when you’re out of work. But in Columbus, the lost wage benefits are among the nation’s lowest for workers compensation.
As of July 1, 2019, the maximum benefit for an injured Columbus worker was two-thirds of the weekly salary up to a maximum of $675. That is an increase of $100 from the previous era, but the state-of-Georgia ranks 46th in maximum benefits in the U.S.
“When it was $575, we were 49th, right behind Mississippi, so now we’ve skyrocketed,’’ Holder said. “Look, we were glad it went up. It’s more money. But it also represents how much we are lagging.
“Unfortunately, this is a very unique situation. Florida has a maximum rate that is indexed each year, based on the per capita income in the state. We wish we had that. We did go up, but it’s still a flat number, not an index.’’
Here’s a look at the various sub-categories for the lost wage payments.
Temporary Total Disability Benefits — This is the maximum benefit (up to $675 weekly). You qualify if that doctor says you can’t work at all or if they put you on “light work duty’’ (and there’s no light duty available).
Temporary Partial Disability Benefits — Temporary partial disability benefits are payable when your doctor says you can go back to work, but only for limited duty with some restrictions. It applies because you are making less per hour or because you are working fewer hours.
The weekly TPD benefit is equal to two-thirds of your average weekly salary up to a maximum of $450 per week. The TPD benefits last for a maximum of 350 weeks (slightly less than seven years) from the date of the accident.
Permanent Partial Disability Benefits — PPD claims are by far the most common type of workers compensation claim (accounting for more than half of all cases nationwide). It can be the result of a work-related injury or an occupational disease. In Columbus, these benefits can be claimed only if you are not receiving TTD or TPD benefits.
PPD benefits are two-thirds of the weekly salary up to a maximum of $675 a week. They are calculated by multiplying the percentage of impairment rating given by the doctor by the number of weeks allowed under the law depending on the type of injury that you have.
Death Benefits — In Columbus, the maximum death benefit is $270,000 (two-thirds of deceased worker’s average weekly wage up to a maximum of $675 for a maximum of 400 weeks). Workers compensation must also cover funeral and burial expenses (up to $7,500).
- Thornton, W. (2017, May 11). A judge ruled against Alabama’s workers’ comp law. Now what? Retrieved from https://www.al.com/business/2017/05/a_judge_ruled_alabamas_workers.html
- (ND) 2021 Statewide Average Announced. Retrieved from https://www.dli.pa.gov/Businesses/Compensation/WC/claims/Pages/Statewide-Average-Weekly-Wage-(SAWW).aspx
- Diamant, A. (2017, May 4) Thousands of Georgians hurt at work report ‘big problems’ getting care. Retrieved from https://www.wsbtv.com/news/2-investigates/thousands-of-georgians-hurt-at-work-report-big-problems-getting-care/518654432/
- N.A. (ND) Fort Benning. Retrieved from http://www.militarybases.us/army/fort-benning/