Workers’ Compensation
The Department of Administrative Services (DOAS) Risk Management Services self-insures the state of Georgia Workers' Compensation Program. The program is administered through a contract with DOAS, the third-party administrator.
The program provides employees monetary supplements for absences from work, as well as medical care through Amerisys Managed Care Organization and other costs associated with job-related injuries.
“Georgia Focus,” a component of the Workers’ Compensation Program, is our three-tiered approach to ensure the safety, care and recovery of employees are a priority of the state.
- Tier 1 proactively addresses the safety of employees through job hazard analysis, education and corrective actions to hazardous conditions.
- Tier 2 is a managed approach to the care of employees in the event of an injury. Timely reporting of injuries by the supervisor ensures injured workers receive prompt care and benefits to which they are entitled. Employees who suffer a job-related injury are provided appropriate and effective medical care.
- Tier 3 is a return-to-work team approach that focuses on an employee's ability as opposed to their disability. This approach enables the employee to return to work sooner and within their medical restrictions.
Related Documents and Forms
Georgia Focus
Created:
This document provides an employee with the tools and resources needed to return to work through the program.
Incident Notice Only
Created:
In the case of incidents that do not result in injuries, the Incident Notice Only form must be used.
Leave Election
Created:
The form must be completed in order to indicate how lost time compensation will be paid to the injured employee.
Mileage Form
Created:
This form is used to request reimbursement for mileage incurred during travel related to a work injury claim.
Reporting Instructions
Created:
Instructions for reporting injuries to a telephonic vendor. Claims cannot be filed by employees themselves.
Supervisor's Accident Investigation
Created:
This document will provide a comprehensive analysis of the accident and help to identify any potential causes of the…
Transitional Employment Plan
Created:
This form is used to document the Transitional Employment Plan as agreed to between supervisor and employee.
Wage Statement
Created:
The Georgia State Board of Workers' Compensation calculates an employee's wage based on the gross wages…
WC/MCO Panel
Created:
Workers' Compensation Panel of Physicians that should be displayed in a conspicuous location to ensure employees…
Witness Statement
Created:
This statement should include a description of the accident, when it happened, any injuries that occurred, and any…
Bill of Rights for the Injured Worker
Created:
WC-BOR WC-BILL of rights Georgia State Board of Workers' Compensation bill of rights for the injured worker.
Bill of Rights for the Injured Worker - Spanish
Created:
Spanish Version WC-BOR WC-BILL of rights Georgia State Board of Workers' Compensation bill of rights for the…
Workers' Comp Handbook
Created:
This handbook is an important resource for all employees of the Georgia State Board of Workers’ Compensation.
Fraud Notice Spanish
Created:
It is important to be aware of the penalties associated with Workers' Compensation fraud in Spanish, as they can…
Fraud Notice
Created:
It is important to be aware of the penalties associated with Workers' Compensation fraud, as they can include…
Employees Report of Injury
Created:
This form should be completed by employees when they report injuries caused by an incident. Filling out this form…
MyMatrixx Quick Reference Guide
Created:
MyMatrixx reference guide is for AmeriSys and the state of Georgia. It identifies the PBM Team and how to submit…
Workers' Compensation Temporary Prescription ID Card
Created:
A temporary prescription ID Card from MyMatrixx that allows injured workers to receive prescription medications and…
WC MCO Panel Espanol - Spanish
Created:
Spanish Workers' Compensation Panel of Physicians that should be displayed in a conspicuous location to ensure…
DOAS Risk Brochure
Created:
The brochure is designed to provide injured workers with detailed information about their rights and benefits under the…
Georgia Activity Analysis
Created:
Workers' compensation activity analysis form.
WC 240a
Created:
Georgia State Board of Workers' Compensation job analysis form. Updated 2018
WC 240
Created:
Notice to employee of offer of suitable employment form. Updated 2021
WC 207
Created:
Authorization and consent to release medical information form. Updated 2024
WC MCO At A Glance
Created:
This document is a one-page overview of Georgia's Workers' Compensation Managed Care Organization. It should…
Injured Worker Emergency Care Card
Created:
This wallet card provides key contacts and information for your claim.
WC MCO Employee Brochure_AmeriSys
Created:
This tri-fold brochure provides a comprehensive overview of the Workers' Compensation program, highlighting its…