Under workers' compensation laws in Georgia, an injury to any part of your body which arises out of your employment and while you are engaged in such employment entitles you to workers' compensation coverage, subject to certain defenses which the employer may have. (See, “Drug Use/Horseplay and Other Defenses to Workers' Comp Claims” at page 52). These injuries include both sudden traumatic injuries, such as broken bones or back strains, and repetitive stress injuries such as carpal tunnel syndrome. The injuries need not occur suddenly, but may arise gradually.
Injuries caused only in part by an employee's work accident or work activities are also covered by workers' comp. For instance, an injury to an employee with diabetes may result in a more serious injury. If a diabetic employee stubs their toe at work and because of the diabetes the entire foot must be amputated, the employee would still have coverage for the entire foot injury, even though stubbing the toe played a small part in the amputation.
Aggravations of pre-existing injuries or conditions are covered as well. However, if the employer asks you whether you have any prior injuries or conditions, either verbally or in the employment application and you fail to disclose the condition, or if you take a pre-employment physical and fail to disclose the prior condition under direct questioning from a doctor, you may be barred from recovery of workers' comp benefits for the new injury.
Even heart attacks and strokes may be covered if it can be shown that the heart attack or stroke was due in whole or in part to your work.
Certain diseases, such as asbestosis or black lung disease, are also covered by workers' compensation. However, the laws and rules applicable to these occupational diseases are very complex and different than those applied to accidents.
Psychological injuries, such as “post traumatic stress” or severe depression are covered by workers' compensation, as long as the psychological injury arose with a physical injury.
If you are killed in an accident, or if your work injury or occupational disease causes your death, the employer/insurer will have to pay certain benefits depending on whether you have dependents.
Questions
Q1. I had a prior injury to my lower back, but denied it in my pre-employment physical because I thought I would not be hired. Over the first few months that I was working my back was bothering me and I told my employer that I did have a prior injury. Later, I suffered a severe aggravation of my lower back while working. Am I covered?
Yes. Even though you did not disclose your back condition when you were hired, since your employer knew about your condition before you aggravated the back, your claim is not barred.
Q2. What if the pre-existing condition I did not disclose was to my lower back and I later injured my upper back at work. Does the failure to disclose my pre-existing lower back injury bar my right to coverage for my upper back work injury?
No. In order to be barred from recovery for failure to disclose a pre-existing condition, the pre-existing condition must have played a part in the new injury. If the new injury is in a totally different part of the back you will be covered.
Q3. After working a very repetitive job for about a year, my arms began to bother me. I did not know this condition was work related so my personal doctor treated the arm pain. After several visits the doctor let me know my condition was probably work related. Am I covered?
Yes. Very often people suffer injuries which arise gradually rather than suddenly. If this happens, once you learn your condition may be work related you need to let your employer know.
Q4. I work at a convenience store and the store was robbed. The robber held a gun to my head at one point. As a result, I have nightmares all the time and have found it difficult to work. Am I covered?
As it now stands, a purely psychological injury without any physical injury is not covered under workers' compensation. If, in the course of the robbery, you had been physically injured, such as being struck or shot, both the physical injury and any psychological injuries you suffer would be covered.
Q5. I sustained a severe back injury and have suffered from this now for more than six months. As a result of the pain and not being able to do things like I used to do, I have become very depressed. Is my depression covered by workers' comp?
Yes. If your psychological condition arises at least in part from your work injury, you are entitled to workers' compensation coverage for your psychological care and disability.
Q6. I suffered an injury to my leg and as a result have walked with a bad limp for the last year. My back has begun to bother me and the doctor says that my back has been aggravated by the severe limp. Am I covered for this back condition?
Yes. This is called a “super added injury.” If you have a work injury and it contributes at least in part to another injury, you are entitled to coverage for this “super added injury.”
Q7. My doctor says my carpal tunnel syndrome is work related. When I reported my condition to the employer and asked for coverage, they denied my claim saying it was not work related. Can they do this?
Employers and their insurers will very often deny your condition is related to work, even though you and your doctor know otherwise. Ultimately, if you can demonstrate to the State Board of Workers' Compensation that your condition is related, you will receive coverage. If you choose to pursue a claim that has been denied you should definitely contact an experienced attorney for advice.
Q8. I was injured in my cafeteria at work while at lunch. Another employee was injured while taking a break. Are these injuries covered?
If your lunch or other break is not regularly scheduled, or you are otherwise restricted in what you are permitted to do during your break, any injury which occurs should be covered.
As a general rule, if the lunch break or rest break was regularly scheduled and you are free to do as you wish during the break, any injuries that occur during the break are not covered by workers' comp, even if they occur on your employer's premises. In such circumstances, if the employer or someone else caused the injuries, you may have a personal injury claim not barred by workers' comp laws.
Q9. I had clocked out of work for the day and was walking down a staircase to the building's exit when I fell and broke my leg. Am I covered under workers' comp for this?
Yes. Georgia law gives an employee a reasonable period of time to enter and leave their workplace. If you are injured, even if you are no longer on the clock, your injuries will be covered under workers' comp.
Q10. I was on an out of state sales call for my employer when I was injured. Is this injury covered under workers' comp?
Yes. Out of state accidents are covered in Georgia if the employee is based in Georgia. Therefore, sales people, technical support workers, over the road truck drivers and others whose job requires they leave the state as part of their employment will generally be covered for any accidents that occur out of state, even after normal working hours.
Q11. My job requires that I drive between several different job sites during the day. After finishing at one job site I was on the way to another job site when I was in a car accident and injured. Is this injury covered?
Yes. You do not have to be at the workplace when accidents occur. If you are traveling during the day due to your job requirements and are injured, you will be covered by workers comp.
Q12. What if I was injured going to work or going home?
Injuries which occur going to work or traveling home after you are done for the day are generally not covered by workers' comp. However, while technically not “on the clock,” if you are injured while doing something for your employer's benefit, the injury should be covered. For instance, if you are injured while driving to the post office to drop off mail for your employer on the way home, your injury should be covered.
Q13. I was injured while at a company picnic. Is my injury covered?
In order for an injury which occurs during an employment related social or recreational activity to be covered:
- it must occur at the workplace during a lunch or recreation period as a regular part of your employment, or
- your attendance at the social activity is required by your employer, either expressly or by implication, or
- your employer must derive a substantial benefit from the social activity beyond the improvement in employees' health and morale that is common to all kinds of recreational or social activities.
In your case, unless one of these three conditions is met, your injury will not be covered under workers' compensation. You may instead have a personal injury claim.
If you believe you were engaged in an activity to benefit your employer when you were injured but not “on the clock,” you should consult an attorney. Coverage in these cases often depends on the specific facts and how those facts are presented.
