Disability Law

How, When and To Whom Do I Give Notice of my On-the-Job Injury?

By Jodi Ginsberg

Several times a year, I get a call from an injured worker who is facing a denial from the insurance company on the grounds that no timely notice of a claim was filed.  The Georgia workers' compensation statute contains two separate notice provisions, both of which must be met:

Notice to Employer

The Georgia Code says that an injured worker must give notice to his employer within thirty (30) days after his on-the-job injury.   We advise our clients to give notice, preferably in writing, to a direct supervisor.  The the sooner you give this notice the better.   When giving notice to your supervisor you should be as clear as possible about the exact date and time you were injured and about exactly what happened.    The more specific the better as we find that employers tend to question vague and uncertain reports about a work injury.

Remember that workers' compensation covers injuries "arising out of and in the course of " your employment.  This means that an injury incurred while you are on break, or coming or going from work may be challenged.  Be suspicious if your employer's workers' comp rep tries to put words in your mouth about when or how your injury happened.  A quick word about the phrase "arising out of and in the course of employment."  The Georgia State Board of Workers' Compensation spends a lot of its time listening to lawyers argue about what this phrase means.  What you tell your employer about your injury, and what you tell your doctor can make a huge difference.  For this reason, we encourage injured workers to seek legal counsel sooner rather than later.

Once you report an on-the-job injury, your employer is supposed to write up a "first report of injury" and send it to both the State Board of Workers' Compensation and to its insurance carrier.   Not surprisingly, this does not always occur as employers try to avoid filing claims with their workers' comp. carriers.   Your employer may delay filing the required paperwork and may tell you to file with your group health insurer.  They may suggest you file under short or long term disability for lost time from work.   Do not let this happen as group health and/or STD/LTD carriers will not pay for either lost wages or medical costs related to a work related injuries, as workers' compensation insurance is considered "primary" coverage.  We have seen some situations in which the group health carrier initially accepts the claim, but later rejects it once the file is audited.  This could leave you stuck with a medical bill that otherwise should be covered.

Notice to State Board of Workers Compensation

In theory, once you give your employer notice of your injury, the employer will file a notice of claim with the State Board of Workers' Compensation.  A better course of action would be for you to file that notice directly.  You file notice using a form called a WC-14, and this form must be filed within one (1) year from the date of your accident.  Our office regularly completes and files WC-14 forms for our client.  If you are not sure how to fill out this form, you should speak to an experienced attorney as filling out this form improperly can negatively impact your case later on.

Case Study - Injured Employee Files WC-14 Two Weeks too Late

Our office, like many workers compensation firms, subscribes to a service that reports about recent Georgia court decisions involving workers' compensation.   A recent case decided by the Court of Appeals illustrates why it is so important to carefully complete your notice forms and to be extremely clear as to when and where your accident happened.

In this particular case, an individual was injured on the job but he claimed that he could not remember the exact date of his injury.  He did not file his WC-14 until a year and two weeks after his accident.   The employer denied receiving notice so the court was left with the WC-14 date only.  Because the WC-14 was dated more than a year after the accident, the court found that this claimant was barred from filing a claim because he filed his notice too late.

Unfortunately it is not at all unusual for witnesses supporting the employer to "not remember" a conversation when a claimant gives notice.  In tough economic times your co-workers and supervisors do not want to do anything to jeopardize their jobs.  You must be an advocate for yourself and if this means hiring a lawyer to pursue your rights you should take that step.

Full post as published by Georgia Workers Compensation blog on December 04, 2008 (boomark / email).