Ty Wilson Law Podcast

Okay, so, you were in a car wreck in Georgia. You're rear ended by someone who is what is called an "excluded driver". You're likely not gonna find that out at the scene. It's usually whenever you send off a letter of representation to the at fault insurance carrier, They'll say, "Hey!" "Sorry bad news." "We're not going to accept any type of liability on this claim." "And we're going to send you what's called a reservation of rights letter."  Do some research. And then all the sudden, Oh! Turns out the default driver is an excluded driver. What is an excluded driver? Excluded driver, typically, that is when parents have children that they don't feel very safe and they exclude them off their insurance. And they're not supposed to be driving their car. Happens all the time. And they get wrecks all the time. However, that means that unless that child has its own insurance coverage, there is no coverage. So, where do you go from there? You got to look at your underinsured motorist coverage. This is why we always saying, by as much of that as you can get. Stay safe! 

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Everyone we're here today to talk about nine things that are different from personal injury claims to workers compensation claim. We get a lot of questions about what are the differences and there are several different differences. But we're gonna try to point out probably the 9, what we consider the most important or the most obvious differences between a personal injury claim and a work entry claim. So, let's start with No. 1. 

No. 1: When you have a personal injury claim you're entitled to pain and suffering. And pain and suffering is what you feel whenever you're dealing with surgery and you're dealing with just the general pain of being in an injury. Workers Comp. They do not have to pay anything for pain and suffering. And so, that's a big difference. In workers comp, you're looking at medical benefits, you're looking at weekly checks, and possibly something called permanent partial disability. But in personal injury, you're looking at full loss wages, you're looking at economic damages, to include hospital and any type of medical bills, or medical care, prescriptions, etc. And personal injury, those are benefits that you seek to be reimbursed for. In workers comp., they pay for them proactively. Now, not the scope of this video, but they also may get to control your medical care in workers comp. So, we'll talk more about that in another video. So, 

No. 2. In personal injury, for example, a car wreck. you have to prove that the other person was at fault. And was negligent in their actions. In workers comp., it is a no fault system here in the state of Georgia. And all of this is referring to the state of Georgia. And so, there's workers comp is a no fault system. What that means is you don't have to prove that the employer was at fault for causing your injury. You just have to prove that you are employed and not an independent contractor. That you were in the course and scope of your employment. You are not under the influence of alcohol drugs. And you are not horse playing. If you can prove those you prove that you have a claim. And then the employers responsible for the medical cares that relates to your injury. And then if certain conditions are met such as taken out of work completely for more than 7 days. well. then the employer or the insurance company for the employer will have to pay you what is called temporary total disability or temporary partial disability income benefits. Moving on to 

No. 3. In a personal injury claim, the insurance company does not pay for your care as you go. So, you don't go to the doctor and say, "Hey! Insurance company I'm going to the doctor today so make sure you pay them." That's not how it works. Basically, you get all of your medical care in a personal injury case completed and then you seek to get those damages reimbursed along with pain and suffering, etc. Whereas in a workers compensation claim, they do pay for your care as you go. In fact, they have to authorize care before you get to the doctor or the doctor will not see you because the doctor will not get paid. And so, workers comp., they pay as you go. Personal injury, they don't. So, let's go to 

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Alright, everybody. Today, we're gonna talk about five things you should never give an insurance adjuster, if you've been injured in a car wreck in Georgia. Before we get started with that though, let's talk about when you get injured in a car wreck claim you have actually two claims they're associated together. The first one is a Property Damage Claim. And that would be the most logical reason to actually reach out to the insurance company and contact them because you want your car repaired. If your car is in an impound lot, you wanna mitigate your damages. Check out our other video on that, and get it out of there as quickly as possible. But if it's not drivable, certainly, the first thing  you wanna do is contact that at fault insurance company and find out how can I get someone to look at my car. Get it repaired, and get it paid for it.  The second part of the claim,  ou have a property damage claim and most claims are just property damage claims. ,However if you get hurt in the claim,that's where you have a bodily injury claim. And so, bodily injury claim obviously means you've been hurt in the car wreck and now you're getting medical treatment for your injuries. When you discuss the property damage claim for your car you really have no reason to discuss the bodily injury portion. Typically, they're two separate adjusters. However, that's not always the case. So, if they start asking you about your bodily injury it's really not recommended that you speak to them directly about your bodily injury claim. You have two years from the date of the car wreck and that can possibly be told if there's a ticket and for other reasons...

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We got a question the other day. "We have settled the case. What's the process from here?" Well, if you've gone to mediation, or you've just determined the number and both parties agree. And you're gonna settle the case. What needs to happen is the insurance company will usually hire an attorney if there isn't one already on the case to draft what is called a "stipulation settlement agreement". A Stipulation Settlement Agreement; there's one of two ways it can handle, they can handle it. If they've never paid you a weekly check it's called a "No liability step". Meaning they're denying everything. They're asking the board to close this file as being denied. You're gonna sign off on that. Meanwhile they will settle for you whatever the agreed settlement amount is. If it is not, if they paid you weekly checks, then the matter has to be what's called a "Bonafied dispute". And what that usually list out in the stipulation settlement agreement is that will list both parties contentions. The employer contends that the employee is able to return to some form of work. The employee contends they are unable to work in any capacity whatsoever. Something like that. But it lists out the contentions and it basically says, "We're gonna put these contentions aside and settle this case. For whatever the amount is that you're gonna settle." So, once that's drafted, you'll review it. You make sure the numbers are right. You make sure everything looks good. There could be some language in there to protect you if you end up having to file for Social Security disability later depending upon the nature of your injuries. And that's gonna be an important part of your Social Security claim. We put language in our workers compensation claims or should have language in there that basically protects you. If you do have to file for security disability later. Again, always recommended that you have an attorney whenever you're trying to resolve a Georgia workers compensation claim. Make sure you're not shorten yourself somewhere else like so security disability, or anything else, for that matter. So, once the document is completed, you will go over and you will sign it, typically, but not always. The employer will also require what is called a release. Releasing them not from workers comp but from anything else related to the claim. And they're trying to prevent you from suing them in other ways after they've resolved the workers compensation claim...

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We've done some other videos on notice if you're injured on the job in Georgia. Most important things is to provide notice to your employer that you were hurt and that you need medical care. More importantly, when you provide them notice that you are injured, it is head to toe. You need to tell them everything that feels funny. Why do I say that? We got a lot of claims where someone got hurt seriously. Hurt their back. But they also had some sort of tingling funny feeling in their finger. And the reality is the back just hurt worse. Turns out their finger was broken.  Hairline fracture versus a serious back injury. However, if you don't mention it, worker's compensation will fight you to the nail to have that care approved. If it happened because of the same event  and you fail to report it. So, reporting and giving notice is absolutely critical. Everything that feels funny or strange based upon how you hurt yourself. Stay safe!

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Are worker's compensation benefits worth it in the state of Georgia? Well, if you're injured on the job the question is, Do you have the ability to go to another employer, and perform work without the injury bothering you? Maybe you'll make more money going to that employer. However, if your injury is something that really shut you down,  or you might need surgery, or rather serious, workers compensation is something that can keep you afloat while you're getting that medical care you need. Get on your feet. And then move on in life. So, the question is, where are you at with your claim?  So, it could be worth it. It might not be worth it. If it's a minor claim,  very well might not be worth the pain in the tail of it.However, if it's something that knocks you out of your ability to perform your manual task. And it's something you really wanna look at closely. Or at least speak with the workers compensation attorney. Stay safe! 

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How not to return back to work? So, let's say you've been injured on the job in Georgia. The employer has served you what is called a return to work. or WC-240 forms. And you need to show up Monday morning at 8:00, at this location. In order to return back to work. Doctor signed off on it.  All the hurdles have been completely jumped through by the employer. What you don't do is show up. Walk in the door, and say, "I'm here. I can't do this." "See you later. Bye!" That won't work. A lot of times the employers ready for it that either got you on camera. Or they've got multiple witnesses as you're approaching to see if you are actually making good faith effort, to attempt the job that the doctor has already signed off on. Stay safe. Play it smart. Ask questions. 

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What not to do if you are going to a defense medical examination In a workers compensation claim in Georgia? So, if the employer insurer have decided they want you to see one of their doctors. You know what that means. It's a defense medical evaluation. And you have to go there  and the opinion may or may not be written before you even go there. May not be. But you've got to show up and you've got to perform the evaluation. It's a lot like a deposition in the sense that if it's been properly noticed within the right time frame and so forth you need to go forth, you need to show up you need to be cordial to the doctor. Do not argue with that doctor. That doctor can bury you. They probably will anyway. They may not though. We've seen more and more whether or not. And so what you got to do is be cordial. Answer the questions. Don't go into any big history  other than that. Tell them what they ask. Get in and out. Just like a deposition, Stay safe!

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We were asked the other day.  What is the best way to settle your Georgia workers compensation claim? And the reality is... Well, that just kind of depends on where your claim is. Are you getting weekly checks? Is it a medical only claim? Do you still need an extensive amount of care moving forward?  Do you need a surgery? This really depends on where your claim is. So, the best way to settle the claim is to figure out strategically where you are. And where you can live with your care. Because by settling that claim you're giving up those weekly checks. You're giving up future medical benefits. And you're basically saying, "I've got it from here." You're gonna try to negotiate a lump sum of money. You're gonna move on.  A lot of times there's a resignation involved as well. So, you when I say move on, I mean move on to a new employer. New life possibly doing new things. Stay safe! 

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Getting your mileage reimbursed. What's the easiest way to do that? Well, whether you have an attorney or not you need to keep a log of every visit you go to from your house to the doctors from your house to the pharmacist and then of course the return visits. So, from your house to the doctor from the doctor's office back to your house. Look him up on Google Maps. Google Maps will tell you specifically what the mileage is for these particular addresses. You also need a log to provide that to the insurance company. But the Google Maps will help support your position that the mileage is what Google Maps says. They're not gonna believe you if you took the long way, that's on you. You should take the shortest route possible. Then you will run into no problems getting your mileage reimbursed. Check out our other video, as the mileage rates have just increased. Stay safe! 

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