September 22, 2019

Revealing the “Return to Work Trap” in Georgia Workers’ Compensation Law

What is the biggest trap that you can face in your Georgia workers’ compensation case?  Without question, issues relating to your return to work after being injured must be handled very carefully.

Let me give you an example.  Earlier this month, I received a call from a potential client.  This young man – I’ll call him "Tom" – had been working with earth moving equipment for a large construction company that was building a dam on a river in north Georgia.  Tom and a co-worker were working late – all of the supervisors and most of the co-workers were gone.  The co-worker pushed a large boulder towards Tom and when Tom tried to control the boulder, it rolled onto his hand, crushing a finger and badly injuring his hand.

Tom’s co-workers took him to the emergency room at a local hospital where his condition was stabalized and a hand surgeon was brought in.  Tom underwent surgery that very night to repair his hand.  Tom was released to go home late that night with a prescription for strong pain medicine and instructions not to use his hand until further notice.

The next morning, a supervisor from Tom’s employer called.   Although the accident had literally happened the night before, the supervisor began pressuring Tom to return to work.  During that first day after the accident, various supervisors from the employer called and emailed Tom repeatedly to demand that he return to work.

Within a few days, Tom received a letter from the employer’s workers’ compensation insurer stating that his claim would be accepted and that his TTD (temporary total disability benefits) would be forthcoming.   At the same time, during this first week, Tom continued to receive calls from his employer requesting that he report back to work.

Tom does not know much about workers’ compensation law, but he sensed that the employer’s actions were not in his best interest.   He found Ginsberg Law Offices on the Internet and he called our office.  When I first spoke with Tom, he advised me that his employer had never posted a panel of physicians, they had not offered him a prescription drug card, nor had anyone from the employer ever explained to him anything at all about how to file a workers’ compensation claim or about any of his rights thereunder.

Where is the "return to work trap?"

The trap arises when an employee returns to work.  Under the Georgia workers’  compensation law, if an injured worker who is receiving his weekly TTD benefits returns to work without a form WC-240, and he cannot perform the assigned job, the TTD benefits stop.  If the employer does not volutarily restart them the employee will have to request a hearing (and wait the two to three months for a hearing date) to try and get them restarted.

However, if that same employee returns to work with a WC-240, and cannot perform the assigned job, his TTD benefits will start again immediately.

What is this special form, the WC-240?

A WC-240 is a State Board from that sets out a specific light duty job description.  The WC-240 includes the start date for the light duty return to work, specific activity limitations as described by an authorized treating physician, the name and contact information for a supervisor and the light duty rate of pay.

If you return to work with a WC-240 and cannot perform the job duties, you notify the contact supervisor, then you return home knowing that your TTD benefits will start again automatically.

In Tom’s case, had he returned to the dam building site without a WC-240 and been unable to resume work in his heavy construction job, there is a good chance that the employer would have cut him off.   At that point, Tom would have no job, no income and no workers’ compensation benefits. 

As you can imagine, Tom’s settlement leverage would be very minimal.

I think it is fairly obvious that Tom’s employer has taken an aggressive, "in-your-face" approach to Tom’s case.  Even the insurance company adjustor confided to me that the employer was not acting properly in what amounts to harassment of Tom.

Sometimes employers understand Georgia law fully and they use this "return to work trap" to squeeze injured employees.  They know that an injured employee who has no money will be more likely to settle for a miminal lump sum out of desparation.

Other employers are not based in Georgia and they don’t know anything about a WC-240, but will take adavantage of the leverage associated with an undocumented return to work.

I think that Tim’s case also illustrates why an injured employee needs legal representation. 

Finally, you should be aware that the WC-240 was appropriate in this case because Tom had already been receiving TTD benefits.  If your employer has controverted the claim and no TTD benefits have commenced, a different strategy might be necessary.

Many of the calls I get from injured workers are triggered by questions about returning to work.  If your doctor has suggested that you are ready to return to work – full duty or light duty, or if your employer is pressuring you to return to work, please do not make any decisions without talking to me or to competent legal counsel.

Temporary Total Disability (TTD) Benefits – What Are They and How Much Can I Receive?

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If you are injured on the job, start to miss work, and your employer accepts your Georgia workers’ compensation claim, you become eligible for temporary total disability benefit payments.  How does TTD work and how much can you receive?  In this video, I discuss the basics about TTD benefits.

Light Duty Return to Work – What Should You Do?

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Have you received a light duty return to work?   What happens if you try to work but the light duty job is too difficult?  What does "light duty" mean anyway?  Will your temporary total disability benefits be restarted?   Returning to work under a light duty release can be very tricky and you can jeopardize your benefits if you do not handle this process correctly.  In this video, I explain how a light duty release is supposed to work and why a WC-240 form is so important.

Should I Return to Work if the Authorized Doctor Releases Me

Jodi, I am receiving TTD (temporary total disability) benefits and the authorized doctor told me that he is releasing me to return back to light duty work.  Should I report to work immediately?

Jodi Ginsberg responds:   No, you should not return to work right away. You should wait until you receive a form in the mail called the WC-240 form.  The WC-240 form is completed by the insurance company and describes specifically a light duty job, the date and time that this light duty job will be available.

The WC-240 protects you, the injured worker.  If you show up at your job site and your employer really does not have a light duty job that corresponds to the limitations on the WC-240, your refusal to try a job outside those limitations will not damage your case.  Further, if you try the light duty job for up to 14 days and cannot perform it, your TTD benefits will resume immediately.

If you return to work without a WC-240, you risk the situation where the light duty job really is not light duty.  If you cannot perform it and/or if your employer terminates you, your TTD will be cut off and, of course, your job is over as well.  You then have to file for a hearing and wait two to three months to ask a judge to reinstate your benefits. 

If you return to work with the WC-240, the burden falls on the employer/insurer to try to stop your benefits. If you return without this form, the burden may fall on you to try to get your benefits restarted.  This is a big distinction and can determine whether you have money coming in every week while you recover.  Further, if you have money coming in you will be less likely to be pressured into a cheap settlement.

Sometimes, an injured employee may be pressured to return to work immediately by his boss or even by a well meaning spouse or co-worker.  Do not be manipulated in this manner.  If you have been receiving benefits and your doctor tells you that he will be issuing a light duty release, wait for your WC-240.

As an aside, part of my job as a claimant’s lawyer is to review the WC-240 to make sure that the light duty description is consistent with the medical records, and to object if it is not.  Further, if it turns out that my client cannot perform the light duty work, I will assert my client’s right to a resumption of TTD benefits.

[tags] WC-240, light duty return to work, georgia workers compensation claim, TTD benefits, temporary total disability [/tags]

When is My First TTD Check Due from the Insurance Company?

I injured my ankle back in August. I have missed work, been place on restricted hours. I finally got sent to a specialist this past thursday. I start rehab on Monday. I had a phone interview with my workers comp. represenative and she told me that i would be reimbursed for time i missed worked and the days that i worked limited hours.

She told me that it would take 13 weeks from today before i would receive any compensation. She also told me that I have to have 13 weeks of time worked prior to the date of the injury and that time worked is a factor of how much i am to receive.

I am hoping that physical therapy will help my ankle so that i can go back to working full time.  Is the workers Comp. rep. trying to get over on me or is the 13 weeks waiting period normal. please let me know as soon as possible. Thank You
–Jason

Jodi Ginsberg replies: Jason, thank you for your inquiry. The answer is "NO." You do not have to wait 13 weeks (91 days) to get payment when an authorized treating doctor gives you a "no work"  form or puts you on light duty and the job has no light duty.

The ins company rep is not telling you the correct information. The law states that when there is an accepted claim, there is a 21 day waiting period from the date of accident and then you can recover TTD (temporary total disability) benefits.  The 13 weeks comes into play when they look at your average weekly gross wage so they can figure how much to pay you in TTD weekly.   There is obviously a big difference between waiting 3 weeks as opposed to 13 weeks.  Again, you only have to wait 21 days (3 weeks) for your first check if the insurance company accepts responsibility for the claim.

Your TTD benefit is an average of the past 13 weeks of gross wages of your salary OR if you were not there for 13 weeks then of a similar employee.  The TTD benefits are 66 2/3 % of average wage and depending upon the year there is a cap paid.  Right now the cap is $450 per week for injuries in 2006.

You are welcome to call me at 770-351-0801 to discuss your case further and rights you have under the law when it comes to benefits, proper medical care, payment, reimbursement and settlement. Please be careful when dealing with the ins company as they may tell you things that are not always correct or that you misinterpreted.

[tags] TTD benefit in Georgia, 21 day waiting period workers comp, 13 weeks and georgia workers compensation, georgia workers comp benefits [/tags]