Georgia law requires every business with three or more employees to provide workers’ compensation insurance, with limited exceptions and several special considerations.
Georgia requires any business that regularly employs three or more people to have workers’ compensation insurance. “Regular” refers to any person who works for a business on a regular basis, even if it is part-time.
If a business is incorporated, corporate officers are considered employees. Georgia allows up to five officers to waive coverage on themselves. However, waiving coverage does not mean that they don’t count for the purpose of being a business that employs three or more people.
Georgia law requires that regular part-time employees are covered by workers’ comp. This would include someone who only works on weekends, for example, as long as the employee works for the business on a regular basis.
A sole proprietor or partner is not required to have workers’ compensation insurance in Georgia, although he or she could elect to have it. Georgia law states that sole proprietors and partners are employers and not employees.
If you fail to carry workers’ comp insurance in Georgia, there could be both civil and criminal penalties. The Georgia State Board of Workers’ Compensation regulates workers’ comp, and its enforcement division will investigate any incidents of noncompliance or allegations of fraud. In cases of noncompliance, employers could face:
Liability: If an employer fails to provide the required workers’ comp coverage, the employer is responsible for compensating an employee for any injuries in the same manner as if there had been workers’ compensation insurance in place. The employer could be held responsible for attorney’s fees, civil penalties, and a 10% increase in compensation to the injured worker if the employer does not secure insurance.
Civil penalties: Any person who violates workers’ comp regulations could face a penalty between $100 and $1,000 per violation. False statements made to the board could carry fines of $1,000 to $10,000 per violation. If an employer fails to provide the required insurance coverage, the civil penalty could be $500 to $5,000 per occurrence of a violation.
Criminal penalties: An employer who refuses or willfully neglects to maintain insurance coverage could be found guilty of a misdemeanor. If convicted, the offense is punishable by a fine of $1,000 to $10,000 or imprisonment up to one year, or both.
Estimated employer costs for workers' compensation in Georgia are $1.08 per $100 covered in payroll. However, the rate an employer pays depends on the risk involved in the employee’s occupation. Workers’ comp class codes quantify risks based on the hazards of a particular job. A company would pay more in workers’ comp insurance costs for roofers than for a receptionist or office staff, for example.
Once an employer becomes aware that an injury has occurred, he or she must immediately file a report with the insurer’s claims office. If the employee must be out of work for seven or more days, the employer must notify the Board of Workers’ Compensation within 21 days.
An employer can choose one of three methods for the insurance company to determine the amount of workers’ compensation to an injured worker:
Panel of physicians. This would consist of at least six non-associated physicians, including an orthopedist. No more than two physicians can be from industrial clinics, and the panel should include one physician who is a minority, where possible.
Conformed panel of physicians. This panel requires a minimum of 10 physicians or professional associations. In addition to the same requirements as the panel of physicians option, this panel must include a general surgeon and chiropractor.
Workers’ compensation managed care organization (MCO). This organization would be certified by the workers’ comp board to coordinate a plan that delivers and manages treatment under the Georgia Workers’ Compensation Act. This organization is also required to include minority providers.
When someone dies on the job, his or her beneficiaries are eligible to receive workers’ compensation death benefits. Georgia laws are designed to provide benefits to individuals who relied on the deceased worker for financial support. The spouse and children of a deceased employee are presumed to be dependents. There are a few conditions:
Workers’ compensation death benefits in Georgia include weekly income benefits, funeral expenses, and the deceased person’s medical bills. These benefits include:
Death benefits to a surviving spouse with no other dependents would be capped at $150,000 and are paid until age 65 or after 400 weeks of payments, based on whichever yields the larger amount of money. Benefits will end if the widowed spouse remarries or cohabitates with another person in a relationship.
Georgia’s State Board of Workers’ Compensation Settlement Division reviews and approves workers’ compensation settlements that include either lump sums or regular payments.
There are two forms of workers’ compensation settlements in Georgia:
Liability settlements resolve the claim, and the insurance company agrees to pay.
Non-liability settlements end a claim even where there is a dispute about benefit eligibility between stakeholders.
Regardless of whether there is a liability or non-liability settlement, once both parties (the employee and the insurance company) arrive at an agreement, the claim is closed. The employee cannot bring any additional claims for that injury.
Often, the Board can approve a settlement based on the following documents:
Lump sum settlements can either be a single payment or a structured settlement, which would mean that the payment is paid out monthly or annually for a specific period of time.
An injured worker is required to file a claim within the workers’ compensation statute of limitations. Georgia law has three separate provisions:
All issues. Generally, the injured person has one year from the date of injury to file a workers’ compensation claim.
Change in condition. If the worker receives benefits for temporary, total, or partial disability, the injured person has two years from the date that the benefits ended to file a claim.
Medical bill / mileage reimbursement. Once medical treatment has happened, the injured person has one year to submit the bill to his or her employer or workers’ compensation insurance company.
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