Anytime your workers’ comp benefit check looks too low investigate it. Don’t assume the insurance adjuster calculated the amount. The calculations are complex, and mistakes can cost you thousands in lost benefits. This article provides some background on how benefits are calculated and a case example to show you how it works in real life.
Georgia Workers’ Compensation Benefits Calculation
The unfortunate reality is that your wage benefit check will always be lower than what you are used to getting. That’s because workers’ comp only pays two-thirds of your average weekly wage. This might sound like a simple calculation, but a number of complexities can lead to underpayment. Here’s how.
In Georgia, workers’ comp wage replacement checks are based on your average weekly wage before the injury. Georgia Workers’ Compensation law requires the insurer to calculate the average using your gross earnings for each of the 13 weeks immediately preceding your injury date.
We routinely help clients with disputes where the insurance adjuster has miscalculated the weekly benefit. Some of the most common factors we see leading to underpayment involve failure to consider…
• Overtime pay
• Staffing company wages
• Short-term employment
• Wages from a similar second job
These are just a few examples of factors that can lead result in thousands of dollars in lost benefits. Let’s look at a real case to see how it can happens.
Case Example: Insurer Undercalculated Payment by Ignoring Wages from Temporary Staffing Employment
We recently handled a Georgia workers’ compensation underpayment case involving an employee who suffered a serious back injury doing a physically demanding manufacturing job.
The miscalculation of benefits involved two factors.
- Overtime work.
- Working initially through a staffing company before becoming a direct employee.
The worker in this case had been performing his job through a staffing agency for about three months before being hired directly. About three weeks into full-time employment the worker reported a back injury. He missed some work for treatment, and within another week the pain became so severe that he had to cease work altogether.
How the Undercalculation Happened
The insurance company calculated the weekly workers’ compensation payment based only on the four-week period of permanent employment. This calculation…
- Ignored the three months of pay through the staffing agency, and
- Included a week of reduced earnings during which the worker had to miss time for treatment.
We immediately saw that the calculation was legally incorrect under Georgia Workers’ Compensation law. Our client was being underpaid by a significant amount.
We Successfully Challenged the Insurance Company’s Payment Calculation
Our argument hinged on the following two points:
- The partial injury week should not have been part of the average.
- The worker’s prior staffing company wages should have also been included in the calculation.
This second point above was the most critical. Under Georgia law, the average weekly wage calculation may sometimes include wages earned “whether for the same or another employer” during the 13 weeks preceding the injury if the employee worked in the same type of employment.
In our client’s case, he was performing the exact same job at the same place while employed through the staffing company and after becoming a direct employee. Therefore, we argued that the work performed through the staffing company should be included.
Including earnings through the staffing agency would cause the worker’s average earnings to increase significantly. This period included many 12-hours shifts and overtime pay, so it represented some of the client’s highest earning weeks.
The Court Increased the Weekly Check and Awarded Several Thousand Dollars in Back Pay
Winning the case required a significant work effort. We gained a partial victory at the trial level, but we continued to push. By appealing the case at the Georgia Workers Compensation Appellate Division, we earned a complete win for our client. The Appellate Division awarded our client ongoing weekly checks and back pay using the higher rate (calculated by including gross earnings through the staffing agency). That meant thousands of dollars in additional backpay for our client. To read the published copy of the decision, click here.
If you believe your workers’ compensation check was calculated incorrectly Stow Garvin & Glenn can help you figure it out. We routinely win Georgia workers’ compensation benefit claims involving issues like…
- Incorrect compensation rates
- Overtime disputes
- Staffing company employment
- Gradual onset injuries
- Denied benefits
- Disputed average weekly wage calculations
Initial consultations are always free. And we only get paid if you get paid. Give us a call at (770) 534-5265 or send a confidential contact form to get started.