If you have been injured on the job, your most immediate concern may be dealing with your loss of income. Medical treatment matters, of course, but the question that keeps my clients up at night is simple:
“How am I going to pay my bills if I can’t work?”
Georgia’s workers’ compensation system does provide wage-replacement benefits, but those benefits are not automatic and they do not fully replace your pre-accident earnings. Understanding how and when an insurance company decides whether to “pick up” a claim can reduce uncertainty and help you know what to expect.
What Does It Mean When an Insurance Company “Picks Up” a Claim?
In workers’ compensation terms, an insurance company (or self-insured employer) “picks up” a claim when it accepts the injury as compensable and begins paying benefits voluntarily.
This usually means:
- The insurer accepts that the injury arose out of and in the course of employment, and
- The insurer agrees that the injury is causing lost time from work.
If your employer and their insurance company decide to pick up your claim they are supposed to send you a form called a WC-2. This form will show that benefits have been commenced, the date of the first check and whether a late payment penalty is included.
The WC-2 form will also include the weekly payment rate and the “average weekly wage” number used for this calculation.
What constitutes your “average weekly wage” is a topic for another article but in general, your employer must look at your gross (before tax) earnings from the 13 weeks immediately preceding your injury. If you have not worked for 13 weeks prior to your injury or if you have worked for multiple employers then a different calculation is used.
Under Georgia workers compensation law you are entitled to 2/3 of your average weekly wage with a maximum of $800 per week. This maximum applies to work accidents that occured after July 1, 2023. If your date of injury is before July 1, 2023 the maximum weekly wage benefit will be lower. Hopefully the Georgia legislature will see fit to increase this maximum TTD (temporary total disability) benefit in years to come. [Continue reading] about When Will I Receive my First Lost Wage Check from the Insurance Company?
