3.3 Georgia Workers' Compensation Insurance
Key Takeaways
- Georgia requires workers' compensation for employers REGULARLY employing 3 or more workers (O.C.G.A. § 34-9-2)
- The State Board of Workers' Compensation (SBWC) administers the system; disputes go to Administrative Law Judges, then the Appellate Division, then Superior Court
- Workers' comp is the EXCLUSIVE REMEDY against the employer (O.C.G.A. § 34-9-11) — the no-fault trade-off
- Temporary Total Disability pays 2/3 of the average weekly wage up to a state weekly maximum ($800/week under HB 480 for injuries on/after 7/1/2023, raised for later injury dates — confirm the current SBWC maximum) with a 7-day waiting period
- Coverage may be bought from an admitted insurer, through an approved self-insurance program, or via the Assigned Risk Pool
Who Must Carry Coverage
Under O.C.G.A. § 34-9-2, any employer who regularly employs three (3) or more workers — full-time, part-time, seasonal, or temporary — must carry workers' compensation insurance. The count is by head, not hours; three part-timers trigger the mandate just as three full-timers do.
| Employer / worker type | Coverage status |
|---|---|
| 3 or more regular employees | Mandatory |
| 1–2 employees | Not required (may elect coverage) |
| Corporate officers / LLC members | Counted as employees, but up to 5 may exempt themselves in writing |
| Sole proprietors / partners | Excluded unless they affirmatively opt in |
| Farm laborers, most domestic servants | Statutorily exempt |
| Railroad workers | Covered by federal FELA, not state WC |
| Longshore/maritime workers | Covered by federal LHWCA / Jones Act |
Exam Tip: Memorize 3 or more for Georgia. Officers/LLC members are included in the count, but as many as 5 of them can sign written exemptions out of coverage. Independent contractors are generally excluded — but the Board looks at the right of control, not the label, so misclassified "contractors" who function as employees count.
State Board of Workers' Compensation (SBWC)
The State Board of Workers' Compensation administers the program — not a private insurer and not the insurance Commissioner.
- Adjudication ladder: an injured worker files with the SBWC; a dispute is first heard by an Administrative Law Judge (ALJ), appealed to the Appellate Division of the Board, then to Superior Court, and finally to the appellate courts.
- The Board approves self-insurers, monitors compliance, maintains the injury-reporting database, and can assess civil penalties for failure to insure.
- Employers must post a panel of physicians (a minimum of six listed providers, or a managed-care arrangement) so injured workers know where to seek treatment.
Counting Employees & Penalties for Going Bare
The three-employee count is measured by who is regularly employed, not a single-day snapshot; a business that routinely staffs three positions is covered even if one role is briefly vacant. An employer that fails to insure when required (going bare) faces SBWC civil penalties, may be ordered to pay benefits directly, and can lose the exclusive-remedy shield, exposing the owner to a tort suit and statutory penalties. Officers who sign exemptions still count toward the three-employee trigger even though they collect no benefits.
Exclusive Remedy & Benefit Structure
The No-Fault Bargain
O.C.G.A. § 34-9-11 makes workers' compensation the exclusive remedy against the employer for a job-related injury. The employee gives up the right to sue the employer in tort; in exchange the employer pays defined benefits regardless of fault. Exceptions that let an employee step outside the system: a true intentional tort by the employer, fraudulent concealment, and third-party claims (against a negligent manufacturer, subcontractor, or property owner).
Income Benefits
| Benefit | Rate | Duration / notes |
|---|---|---|
| Temporary Total Disability (TTD) | 2/3 of average weekly wage | Up to the state weekly max ($800/wk under HB 480 for injuries on/after 7/1/2023, raised for later injury dates — confirm the current SBWC maximum); generally 400 weeks for non-catastrophic injuries |
| Temporary Partial Disability (TPD) | 2/3 of the wage difference | Up to a lower state max ($533/wk under HB 480); up to 350 weeks |
| Permanent Partial Disability (PPD) | Scheduled member rating | Paid by the statutory schedule (e.g., arm, leg, hand) × the TTD rate |
| Permanent Total / Catastrophic | TTD rate | Benefits may continue for life for catastrophic designations |
| Death benefits | 2/3 of AWW to dependents | Subject to weekly max and a $10,000 funeral/burial allowance |
Worked example: A worker earning $900/week is totally disabled. TTD = $900 × 2/3 = $600/week (below the ~$800 cap, so paid in full). A worker earning $1,500/week would compute $1,000 but be capped at ~$800/week.
Waiting Period
- A 7-day waiting period applies before income benefits begin.
- If the disability lasts more than 21 consecutive days, the first 7 days are paid retroactively.
- Medical benefits start immediately with no waiting period and no dollar cap for authorized, reasonable treatment.
Obtaining Coverage & Fraud
| Coverage route | Description |
|---|---|
| Admitted insurer | Standard market guaranteed-cost or loss-sensitive policy |
| Self-insurance | Large employers approved by the SBWC (security deposit/excess required) |
| Group self-insurance fund | Similar employers pool risk under Board approval |
| Assigned Risk Pool | Last-resort market for employers declined voluntarily |
Fraud runs three ways: employee fraud (faking or exaggerating a claim), employer fraud (failing to insure or misclassifying employees as contractors to dodge premium), and provider billing fraud. Penalties include criminal prosecution, civil fines, restitution, and Board-assessed penalties for uninsured employers.
Exam Tip: Tie the numbers together — 3+ employees, 2/3 of AWW income rate, 7-day wait (retroactive after 21 days), 400 weeks for ordinary TTD, lifetime for catastrophic.
Medical Treatment & Return-to-Work
Georgia controls medical care through the employer-posted panel of physicians: the injured worker generally must treat with a panel provider but may make one change to another panel doctor without permission. Mileage to authorized treatment is reimbursable. Employers and insurers use light-duty / return-to-work offers (a WC-240 job offer) to shift a worker from TTD to TPD; refusing suitable light duty can suspend income benefits. Claims are commonly resolved by a stipulated or lump-sum settlement that the Board must approve before it is binding.
When is workers' compensation coverage mandatory for a Georgia employer?
How is the Temporary Total Disability (TTD) income benefit calculated in Georgia?
What does the exclusive remedy doctrine (O.C.G.A. § 34-9-11) mean for an injured Georgia worker?
How does Georgia's 7-day waiting period for income benefits work?