Frequently Asked Questions

• Will the workers compensation carrier cut off my weekly check if I hire an attorney?

• No. The workers compensation insurer has no legal right to terminate your benefits because you hire an attorney. You have the right to counsel just as the employer and its insurance company does.

• How do I talk to an attorney about workers compensation? Will it cost me anything?

• If you decide to contact Woodall and Pflepsen about your workers compensation claim, the assistant to Mr. Pflepsen will ask you some background questions about your address and so forth, and the nature of your claim and questions. You will be contacted for an appointment with the attorney very soon. You will be told what to bring to the appointment both over the telephone and by letter. Mr. Pflepsen will meet with you to discuss your claim. There is no obligation to hire an attorney. There is no charge to talk to the attorney for a first consultation. Mr. Pflepsen will be happy to discuss whether it would be wise for you to have an attorney involved and what options you have. He will also discuss the Workers Compensation Act in general with you so that you have a basic understanding of your rights, alternatives, and obligations. He will also help you understand the potential long-term consequences of continuing in your case without an attorney to advise you. Mr. Pflepsen hopes that after the meeting you will understand more about how the Workers Compensation system works. He will impress upon you that the insurance company contacts attorneys any time they need them, and you may wish to have someone advise you on your legal rights under the Workers Compensation Act.

• What will it cost me to hire an attorney?

• There is no charge up front. The attorneys fee is 25 percent of the workers compensation benefits. This attorney fees is set forth in the Georgia Workers Compensation Act. Any attorneys fee must be approved by the State Board of Workers Compensation.

  Mr. Pflepsen waits until the case is settled, and collects any attorneys fees at that time. Under his contract, he also has the express right to collect out of pocket expenses. However, he customarily includes the out-of-pocket expenses in the 25 percent of the recovery barring any out of the ordinary expenses. Until then, you will not have to pay an attorneys fee. Also, if no settlement of the case is recovered you will not have to pay an attorneys fee.

  Under the Georgia Rules of Professional Conduct, I am required to provide the following information:

  Contingency Fees and "No fee unless you win" refers only to those fees charged by attorneys for their legal services. Such fees are not permitted in all types of cases. Court costs and other additional expenses of legal action usually must be paid by the client.

• What do I do if I was injured on the job but my Employer refuses to pay me workers compensation?

• The Georgia State Law places the burden of proof on the injured worker to prove that he suffered an injury arising out of and in the course of employment. If the Employer and its Insurance company refuses to pay workers compensation then a injured worker must prepare the case for trial. Employers will refuse to accept a case as valid for a multitude of reasons. For example, if an injured worker aggravated a pre-existing condition, or if the injured worker was on the way to work the case may be denied. If an accident on the job is not witnessed, employers will often deny claims even if they are completely legitimate.

  Other Employers will deny claims asserting that the injured worker was not their employee but only an independent contractor. Sometimes, Employers will not pay benefits because they contend the injured worker has no disability to work. Employers and their insurance companies will also suspend benefits claiming the injured worker is able to work.

  Effective presentation of a successful claim to recover workers compensation benefits to a Judge requires a detailed knowledge of Georgia Workers Compensation Law, the procedures of the State Board of Workers Compensation and extensive trial experience. The State Board of Workers Compensation will conduct a bench trial with an Administrative Law Judge. It would be very ill-advised for an injured worker to go to a bench trial without an experienced attorney in the field of workers compensation.

• Can I see the doctor of my choice when I have a job injury?

• The Employer and its Insurer in the Workers Compensation system has the right to restrict you to treatment with physicians in a validly posted panel of physicians, or a conformed panel, or a Managed Care Organization. Also, Employers and their insurers have the right to compel you to submit to an examination as long as you are claiming benefits under the Workers Compensation Act. If you treat outside of the Employer Insurer's panel, the cost of the treatment shall be borne by the injured worker. However, an injured worker can change physicians within the panel. However, you have the right to request a change of physician to a doctor outside of the Employer Insurer panel of physicians. You also have the right to an independent medical examination, or "second opinion" at the expense of the Employer and its Insurer. Workers Compensation Insurers typically resist attempts to change physicians and a formal motion must be filed with the Trial Division of the State Board of Workers Compensation to secure a change.

• Should I trust the "Company Doctor" or physician that my Employer and its workers compensation insurance company has arranged for me?

• Physicians deserve the benefit of the doubt that they their intentions are good and they strive for the best interests of the patient. One major benefit of the Workers Compensation System is that medical care is provided, unlike a personal injury case such as a car wreck, where the injured party must arrange and pay for their own medical care at least before settlement. Most all physicians are reputable medical professionals and we should rely on their judgment about necessary medical care. However, physicians that regularly provide medical services paid by the worker compensation insurers can sometimes lean in favor of the Employer and its insurance company. In some cases, physicians on the Employers Panel of Physicians may appear more interested in returning the Claimant to work as soon as possible instead of assisting with a full recovery. This concern is addressed with a request for an Independent Medical Examination with the physician of your choice, preferably with one that has a reputation for understanding the severity of the pain and discomfort injuries cause. A "second opinion" often yields additional treatment options for recovery. If the insurance company resists an attempt to change physicians, a motion must be filed with the State Board of Workers Compensation. The assistance of an attorney who is familiar with the Statues, Rules and procedures of the State Board is highly recommended.

• What if the insurance company makes me an offer to settle my case?

• If the insurance company approaches you about settlement, an injured worker must be mindful that the insurance company seeks to resolve the case for as little money as possible. In all frankness, an injured workers is an expense to the insurance company. Workers compensation companies are for-profit corporations, not charities.

  There are many reputable adjusters who handle their files professionally and proficiently. However, it is not the responsibility of the workers compensation adjuster to advise you on what is a fair settlement. The adjuster is paid to control costs.

  Insurance companies often look to offer low settlements early in the case. The economic stress caused by a job injury can often make injured workers vulnerable to making decisions out of desperation instead of their long-term best interest. The insurance adjuster has no responsibility to advise you about dealing with the consequences of long-term disability and other public benefits that may be available such as Social Security Disability.

  An injured worker cannot possibly make a well-informed decision on settlement without an accurate evaluation of the claim. This depends on the future exposure of the insurance company for income benefits and medical benefits and the potential of a catastrophic injury designation. All of this is determined by the application of the Georgia Workers Compensation Act to the particular facts of your case. Injured workers must not be mislead and confused by sensational sounding lawyer television commercials that pertain to injury cases, not workers compensation. You will not doubt hear the boastings of others who have settled claims. The fact is many people exaggerate the amount of money they actually settled for. Mr. Pflepsen has seen many cases where unrepresented injured workers either waste months or years trying to settle for amounts that are unattainable or settle for far too little. In many cases they come to him after the damage is done. A sound settlement decision cannot be made based on the "talk on the street" or compelled by dire circumstances. Settlement should be entered into only with the guidance of a experienced workers compensation attorney.

  Also, most all settlement now involve Medicare Set Aside Accounts. This is an account established in the settlement out of the settlement funds to pay for future medical expenses and avoid the future shifting of medical costs onto Medicare. The involvement of a Medicare Set Asides in a worker's compensation is largely unavoidable. The necessity and operation of a Medicare Set Aside must be explained to an injured worker by an attorney who is familiar with them. Altogether, without the advice of a qualified attorney, an injured worker will likely settle for an unfair amount without knowledge of the legal implications of what they have done and its effect on their future.