What’s the Difference Between a Workers’ Compensation and a Personal Injury Claim in Georgia?
Personal injury and workers’ compensation claims differ significantly. Although both compensate a person for injuries, a workers’ compensation claim pays only limited benefits for losses in job-related injuries and illnesses without regard to fault. A personal injury claim can arise in any context and pays for all a person’s related losses if someone else is at fault for the accident.
What Is Workers’ Compensation?
Contents
- 1 What Is Workers’ Compensation?
- 2 What Is a Personal Injury Claim?
- 3 Do I Have to Go to Court to Receive Workers’ Compensation Benefits?
- 4 What Are the Differences in Compensation Between Workers’ Compensation and a Personal Injury Claim?
- 5 Is It Possible to File a Personal Injury Lawsuit After a Work-Related Accident?
- 6 Contact a Georgia Personal Injury and Workers’ Compensation Lawyer
The workers’ compensation system provides benefits to injured workers. In Georgia, an employer with three or more employees must carry workers’ compensation insurance.
You are entitled to benefits if you get hurt while doing your job or if your work causes you to become ill. Benefits pay for all authorized doctor’s visits, physical therapy, hospital bills, prescriptions, and other medical-related expenses. They also replace two-thirds of your average weekly wage before the injury or illness up to a maximum cap.
Your employer’s workers’ compensation insurer should provide benefits for your medical care and lost wages regardless of who is at fault for the accident. However, you might be unable to collect benefits if any of these circumstances apply:
- You got hurt while engaging in horseplay
- You willfully refused to use proper safety devices
- The accident occurred while you were under the influence of drugs or alcohol
- You are an independent contractor
- You purposely injured yourself to receive benefits
What Is a Personal Injury Claim?
A personal injury claim is a legal dispute that arises when someone’s negligent actions cause someone else to be injured. The at-fault party should be liable for the injured party’s medical bills, lost income, pain, suffering, and other related losses.
Typically, the insurance company provides compensation in the form of a settlement. However, pursuing a lawsuit is necessary if the insurer denies the claim or offers an unfair settlement.
Common types of accidents that lead to personal injury claims include:
- Car accidents
- Truck accidents
- Premises liability
- Slip and fall
- Dog bite injuries
- Motorcycle accidents
- Pedestrian accidents
Do I Have to Go to Court to Receive Workers’ Compensation Benefits?
It depends. You should receive benefits for your medical care and lost wages. However, court intervention is sometimes necessary if the insurer pays lower benefits than are owed to the employee or denies the claim entirely. A hearing might also become necessary if, for example, a dispute arises over your ability to return to work.
If you believe the workers’ compensation insurance company unfairly denied your claim, underpaid your benefits, or took another action you dispute, you can file an appeal.
Four levels of appeals are available depending on the situation:
- Administrative Law Judge (ALJ) hearing – The first level of appeal is a hearing with an Administrative Law Judge. The judge will consider the evidence you and the other party present and issue a decision.
- Appellate Division appeal – If unsatisfied with the ALJ’s decision, you can file an appeal with the Appellate Division of the State Board of Workers’ Compensation (SBWC). The Board will decide whether to return the case to the ALJ or confirm, overturn, or amend the previous ruling.
- Superior Court appeal – The next appeals level is an appeal with the Superior Court. The court will review the evidence from the initial claim and determine whether to overturn the Appellate Division’s ruling.
- Georgia Court of Appeals – The next available appeal is to file with the Georgia Court of Appeals, which could review the decision and determine whether to overturn it.
- Georgia Supreme Court – The final level of appeal is the Georgia Supreme Court if the court agrees to hear the case.
What Are the Differences in Compensation Between Workers’ Compensation and a Personal Injury Claim?
The primary differences between workers’ compensation and personal injury compensation include:
- Coverage – Workers’ compensation benefits only cover job-related injuries and occupational illnesses for covered employees. Personal injury compensation pays for injuries in any accident if someone else is at fault.
- Timeline – Workers’ compensation coverage starts much sooner than compensation from a personal injury claim. If you meet the requirements for benefits, you should receive your first payment within 21 days of missing your first day of work or experiencing a reduction in wages due to the injury or illness. A personal injury claim can take months or even years to resolve before the injured party receives the money owed to them.
- Losses – Personal injury claims pay for all losses, including non-economic losses like pain and suffering. Workers’ compensation only pays for a portion of lost wages, medical expenses, and funeral expenses.
- Evidence – In a workers’ compensation claim, the insurer pays regardless of fault. You don’t have to prove someone else caused your injury. You only need to show your injury occurred while you were working. Personal injury claims require evidence establishing liability. You must prove another party is at fault for the accident and your injury happened in the accident.
Is It Possible to File a Personal Injury Lawsuit After a Work-Related Accident?
Workers’ compensation laws prohibit employees from suing their employers if they participate in the system. That means you usually can’t file a lawsuit against your employer for your work-related injury.
However, on-the-job accidents often occur due to a third party’s negligence. If someone other than your employer or a co-worker was responsible for your injury, you might be entitled to compensation in a third-party lawsuit.
A contractor, subcontractor, or maintenance worker might create dangerous conditions that lead to an accident. For example, if a non-employer contractor leaves tools lying around, causing you to trip and break your ankle, you could file a lawsuit against them. Instead of pursuing compensation only for your medical bills and lost wages, you can also recover money for your non-economic losses.
A manufacturer might be liable for a workplace accident. Manufacturers are responsible for supplying dependable and safe equipment, tools, machinery, and other products. A defective product or faulty part could injure the user. If a product malfunctioned while you used it and caused your injury, you could file a products liability claim against the manufacturer.
Contact a Georgia Personal Injury and Workers’ Compensation Lawyer
A work-related injury or illness can have long-lasting consequences. Pursuing compensation is challenging, especially when you must seek treatment to try to recover. The entire process can be overwhelming to handle alone.
Fortunately, you can seek legal representation for assistance with your claim. R. Alan Cleveland, LLC, has a reputation for successfully representing injured people in Georgia. We provide personalized service and use carefully crafted legal strategies to seek the best possible outcome for accident victims.
If you sustained an injury in an accident due to someone else’s negligence or if you were injured on the job, contact R. Alan Cleveland, LLC, today for a free consultation. Let us get started on your case.
An Athens resident Alan Cleveland grew up in Rockdale County. As a founding partner of the personal injury law firm of R. Alan Cleveland, LLC he proudly serves his community and provides skilled representation to injury victims and their families all around Georgia. Alan earned his undergraduate degree from the University of Georgia and went on to graduate, summa cum laude, from Atlanta’s John Marshall Law School. He is also a graduate of Gerry Spence’s renowned Trial Lawyers College (TLC) in Wyoming. In his free time, Alan frequently speaks at continuing legal education seminars. He also volunteered as a youth baseball coach and assists with Georgia’s high school moot court competition held annually. Alan serves as a Trustee of Historic Athens and is a member of the Development Authority of the Unified Government of Athens-Clarke County.
