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WORKERS’ COMPENSATION HANDBOOK

GEORGIA STATE BOARD OF WORKERS COMPENSATION EMPLOYEE HANDBOOK Please be aware that the Workers COMPENSATION Law, Rules and Regulations are subject to change on July 1st of each year. If you have any questions about the information contained in this HANDBOOK , please contact your employer, adjuster, or the State Board of Workers COMPENSATION . July 2013 Our Pledge to Employees If you are injured on the job, you have certain rights, benefits and responsibilities. Your employer also has obligations and responsibilities regarding all employees.

workers’ compensation claims from the initial injury until the closing of the claim, and to safely return lost-time employees to productive employment. We believe that a healthy, safety conscious and productive company is the result of healthy, safety conscious and cooperative employees.

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NOTICE OF CLAIM - Workers' compensation

sbwc.georgia.gov

Check only REQUEST one: 2NOTICE OF CLAIM ONLY2 HEARING / NOTICE OF CLAIM 2REQUEST FOR MEDIATION / NOTICE OF CLAIM. Complete a new Form WC-14 to add an additional employer, insurer or to add date of injury. If you need additional space, do not alter this form, but instead attach additional sheets. Must be typed or printed in black ink.

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EMPLOYER’S FIRST REPORT OF INJURY OR OCCUPATIONAL …

sbwc.georgia.gov

If Section C is completed, your claim of injury has been denied by the employer/insurer. If you disagree with this denial, you must file a form WC-14, Notice of Claim, within one year of the accident with the State Board of Workers' Compensation, 270 Peachtree Street N.W., Atlanta, Georgia 30303-1299.

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EMPLOYER’S FIRST REPORT OF INJURY OR …

sbwc.georgia.gov

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sbwc.georgia.gov

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GEORGIA STATE BOARD OF WORKERS' COMPENSATION

sbwc.georgia.gov

business address (month) (year) a copy of this form must be filed with your current workers' compensation carrier. if you do not have a carrier, and the business has 3 to 5 corporate officers or limited liability members and no employees, this form must be filed with the state board of workers' compensation at 270 peachtree street, n.w., atlanta, georgia 30303 -1299.

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State Board Form WC-10 Notice of Election or …

sbwc.georgia.gov

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Workers’ Compensation Supervisor’s Manual

sbwc.georgia.gov

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wcd.oregon.gov

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