Georgia Form WC-240, “Notice to Employee of Offer of Suitable Employment,” (Revision 7/2021) is the form an employer or insurer files to formally offer an injured worker a light-duty job and, if the worker refuses, to legally stop weekly income (indemnity) benefits. The employer or claims adjuster fills it out, not the injured worker, and it must be served on the worker and the worker’s lawyer at least 10 days before the return-to-work date, as required by O.C.G.A. § 34-9-240 and Board Rule 240.
This one piece of paper carries real money on both sides. A single procedural slip on the WC-240 can cost an employer weeks of extra benefit payments, attorney’s fees, and a failed suspension, which is why claimants’ attorneys watch it so closely. The Georgia State Board of Workers’ Compensation handles tens of thousands of claims each year, and the 240 procedure is one of the most error-prone steps in the entire system.
Here is what you will learn in this guide:
- 📋 What the WC-240 does, who must file it, and the law behind it
- 🖊️ A line-by-line walkthrough of every box, with sample entries
- 👤 Three full filled-out examples using real-world scenarios
- 📨 How to serve and file the form through every channel
- ⚠️ The mistakes that get suspensions thrown out, and how to dodge them
What Form WC-240 Is and Who Must File It
Form WC-240 is the official “offer of suitable employment” notice used in Georgia workers’ compensation claims. The employer or its insurer uses it to tell an injured employee that a light-duty job, approved by the worker’s doctor, is being made available, as stated in the form’s own instructions on the official PDF. The form exists to do one thing: create a legal path to suspend weekly income benefits when a worker who can do modified work refuses to try it.
The filer is almost always a claims adjuster working for the insurer, or sometimes the employer’s HR or risk manager. The injured worker never fills out the WC-240; they only receive it. This matters because the form is part of an adversarial process where the employer is trying to lower its costs and the worker is trying to keep benefits flowing.
The form is required only in a specific situation. Per attorney guidance from Eraclides Gelman, the WC-240 is needed only when both of these are true: (1) the employer needs to suspend indemnity benefits, and (2) the worker has been released to light duty, not full duty. If the worker is released to full duty, the employer files a Form WC-2 with the full-duty release instead. If benefits are not being paid at all, the employer can simply tell the worker to report to modified duty with nothing filed.
The statute behind the form is O.C.G.A. § 34-9-240, and the procedure is spelled out in Board Rule 240. Ignoring these rules has a direct consequence: the suspension fails, the worker’s benefits continue or restart, and the employer can be hit with assessed attorney’s fees. For example, Acme Logistics releases driver Carlos Mendez to light duty and wants to stop his $500-a-week checks; that combination is exactly when the WC-240 comes into play. A common misconception is that any return-to-work letter will do, but Georgia is unique in demanding this exact statutory form and sequence.
Before You Start: Documents and Information You Need
Gather every piece of information before you open the form, because a missing item is the most common reason a 240 suspension collapses. The WC-240 ties together the doctor’s approval, the job offer, the service on the worker, and the filed WC-2, so each input must line up.
Here is the pre-filing checklist:
- Board Claim Number. This is the State Board’s file number for the claim; without it the Board cannot match your form to the right case, and processing stalls.
- Employee’s full legal name and date of injury. These identify the worker and the specific accident; a wrong date can attach your offer to the wrong injury.
- Employee’s current mailing address, email, and phone. You must serve the worker, so an outdated address can void the service step entirely.
- Whether the employee has an attorney, and that attorney’s contact info. You must serve counsel at the same time; skipping this is a fatal error that restarts the clock.
- Authorized Treating Physician (ATP) approval. The doctor must sign and date approval of the specific job within 60 days of examining the worker, or the offer is invalid.
- A completed WC-240a Job Analysis or detailed job description. This is what the doctor reviews and approves; a vague description risks rejection of the suitability claim.
- Job details: title, pay rate, location, hours, and report date/time. These let the worker know exactly where and when to show up; gaps create disputes.
- A planned return-to-work date at least 10 days out. The suspension date cannot be sooner than 10 days after service, so you must count the calendar before you write it.
- The Form WC-2 to file with the Board. The WC-240 is only filed as an attachment to the WC-2 that suspends benefits.
If any item is missing, stop and fix it first. Janet Cole, a Macon adjuster, once filed a WC-240 without confirming the ATP exam was within 60 days, and the entire suspension was thrown out.
Where to Get the Form and How to Access It
The only safe source for the WC-240 is the Georgia State Board of Workers’ Compensation. You can download the current version directly from the State Board’s WC-240 form page, which hosts the official fillable PDF. Always confirm you have Revision 7/2021 printed at the top, because filing an outdated layout can cause the Board or opposing counsel to challenge the form.
Most adjusters complete the form inside their claims software or through the Board’s electronic system. The State Board operates the ICMS portal (Online Claims System) for electronic filing of board forms, including the WC-2 that the WC-240 attaches to. You can also print the PDF, fill it by hand or by typing, and serve and file it the traditional way.
The companion form, the WC-240a Job Analysis, lives on its own WC-240a download page. Pull both at the same time so the job analysis and the offer match word-for-word. A misconception worth clearing up is that a third-party “fill online” website is the official source; those sites are not affiliated with the State Board, and using them risks an outdated form. When in doubt, the agency PDF is the only version that controls.
Step-by-Step: How to Fill Out Form WC-240 Line by Line
The WC-240 is a single page divided into a top header block and three lettered sections: A. Identifying Information, B. Notice to Employee, and C. Certificate of Service. Fill it in order, top to bottom, and remember that fields marked “ER” on the form are completed by the employer/insurer side, while the agency leaves some boxes blank. Below is every field with how to answer it, a sample entry, an edge case, a common mistake, and a misconception.
Header: Board Claim No., Employee Name, M.I., Date of Injury
This top strip ties the form to the exact claim on file with the State Board. You enter the Board Claim Number, the employee’s last name, first name, middle initial, and the date of injury.
Type the Board Claim Number exactly as it appears on prior filings, write the employee’s name in standard order, and enter the date of injury as MM/DD/YYYY. For example, Acme Logistics writes Board Claim No. 2024-012345, last name Mendez, first name Carlos, M.I. R, and Date of Injury 03/14/2024.
An edge case: if the claim has no assigned Board number yet because nothing has been filed, you may need to file the underlying WC-1 first so a number exists. The most common mistake here is transposing digits in the claim number, which causes the Board to misfile the form and delays the suspension. A misconception is that the claim number is optional on a served copy, but a missing or wrong number creates matching problems the moment it reaches the Board.
Section A: Employee Identifying Information
This block asks who the injured worker is and how to reach them. You fill in the county of injury, the employee’s mailing address, email, phone number, city, state, and ZIP code.
Enter the worker’s current mailing address and contact details, matching what is on the latest claim documents. For example, the adjuster writes County of Injury Fulton, Mailing Address 482 Peachtree St NE, City Atlanta, State GA, ZIP 30308, with the worker’s email and phone.
An edge case is a worker who has moved since the injury; always use the newest address on record, and if a P.O. Box is the only mailing address, use it but confirm a physical address for any in-person service. The common mistake is using a stale address, which means the worker never receives the offer and the 10-day clock never legally starts. A misconception is that emailing the worker is enough; the form contemplates proper service, so the mailing address still matters.
Section A: Employer Identifying Information
This block identifies the employer offering the job. You enter the employer’s name, mailing address, email, phone number, city, state, and ZIP code.
Use the legal employer name, not a trade name or parent company, so the offer is tied to the entity that actually employs the worker. For example, the adjuster enters Name Acme Logistics LLC, Mailing Address 1500 Industrial Blvd, City Marietta, State GA, ZIP 30060.
An edge case is a staffing agency placement, where the actual employer of record may differ from the worksite host; list the employer of record and clarify the worksite under the job location later. The common mistake is naming the wrong corporate entity, which lets opposing counsel argue the offer is defective. A misconception is that the employer block is just paperwork; it establishes who is making the binding job offer.
Section B, Line 1: The Job Being Offered
This is the heart of the form. Line 1 states that a specific job is being made available under O.C.G.A. § 34-9-240 and Board Rule 240(b), and it asks for the job Title, Essential Duties, Rate of Pay, Location of Job, Hours/Days to be Worked, and Date/Time to Report for Work.
Describe the job in concrete detail so it matches exactly what the doctor approved. Enter the Title, list Essential Duties (attaching extra pages if needed), and fill the pay, location, hours, and the precise report date and time. For example: Title Light-Duty Dispatch Clerk, Essential Duties answer phones, log deliveries, no lifting over 10 lbs, Rate of Pay $18.00/hr, Location 1500 Industrial Blvd, Marietta, Hours/Days Mon–Fri, 8 a.m.–4 p.m., Date/Time to Report 06/15/2026 at 8:00 a.m.
An edge case is a job with rotating duties; spell out the lightest realistic version and make sure no listed task exceeds the doctor’s restrictions. The common mistake is describing duties that go beyond what the ATP approved, which makes the offer “unsuitable” and kills the suspension. A misconception is that a vague title like “light duty” is enough; the duties must be specific enough for a doctor and a judge to evaluate.
Section B, Line 2: Physician Approval Attachment
Line 2 states that the report of the authorized treating physician(s) approving the job as suitable is attached. You confirm the doctor’s signed approval is physically attached to the form.
Attach the ATP’s signed and dated approval, ideally the WC-240a Job Analysis the doctor signed, or the detailed job description with the doctor’s signature. For example, Acme attaches Dr. Patel’s WC-240a, signed 05/30/2026, approving the dispatch clerk duties.
An edge case is when care has drifted to a referral physician; the approval must come from the actual ATP, not a referral doctor who never formally became the ATP. The common mistake is attaching an approval older than 60 days from the exam, which the form’s certificate specifically prohibits, voiding the offer. A misconception is that a verbal “okay” from the doctor counts; the approval must be signed and dated in writing.
Section B, Line 3: Suspension and Reinstatement Warning
Line 3 is pre-printed boilerplate that warns the worker of the consequences. It explains that an unjustified refusal, or an attempt of less than eight cumulative hours or one scheduled workday (whichever is greater), lets the employer suspend benefits effective the report date, and that benefits restart immediately if the worker tries but stops within 15 scheduled workdays.
You do not write anything here, but you must understand it because it drives your strategy. As summarized by Eraclides Gelman, if the worker never shows or quits before the 8-hour/one-day mark, the suspension stands; if the worker works past that mark but quits before 15 scheduled workdays, you must reinstate benefits at once.
An edge case is a worker who works exactly the threshold and then stops; track the hours precisely because the 8-hour-versus-one-day “whichever is greater” rule decides the outcome. The common mistake is failing to immediately reinstate benefits when a worker quits within 15 days, which waives the employer’s defense that the refusal was unjustified. A misconception is that the 15-day rule lets the worker keep benefits forever; after 15 scheduled workdays, the employer is not required to reinstate without a Board order.
Section B, Line 4: Employer Contact for Questions
Line 4 gives the worker a contact for questions about the job being offered. You enter the name and contact point the worker can call.
Provide a real person and a working phone number or email so the worker can ask about the assignment. For example, Acme writes HR Manager Dana Reed, (770) 555-0142.
An edge case is a represented worker; even with a contact listed, expect the worker to route questions through their attorney. The common mistake is leaving this blank or listing a disconnected line, which lets opposing counsel argue the offer was not made in good faith. A misconception is that this contact replaces serving the attorney; it does not, and the attorney must still be served.
Section C: Certificate of Service
Section C is the sworn certification that the offer is legitimate and properly served. You check the box certifying the job is available, that the ATP examined the worker within 60 days of the attached approval, that the offer is in good faith no later than 10 days before the report date, and that a copy was sent to the employee and counsel. Then you print your name and title, email, mailing address, sign, date, and add city, state, and ZIP.
Complete this only after every other field is correct, because you are certifying the truth of the whole form. For example, Janet Cole, Senior Claims Adjuster prints her name and title, lists her email and mailing address, signs, and dates it 06/02/2026, certifying she served Carlos and his attorney that day.
An edge case is an unrepresented worker; you still certify service on the employee, and the “counsel” portion simply does not apply. The common mistake is signing before serving, or back-dating the certificate, which is a false statement; the form warns that willfully making a false statement carries penalties up to $10,000 per violation under O.C.G.A. §§ 34-9-18 and 34-9-19. A misconception is that the certificate is a formality; it is the proof that triggers the legal 10-day clock and the suspension.
The Companion Forms: WC-240a and WC-2
The WC-240 rarely travels alone. The WC-240a Job Analysis is the preferred attachment the doctor reviews; it breaks the proposed job into physical demands so the ATP can approve or reject each duty. Filing it as an attachment to the WC-240 gives the cleanest record that the job matches the restrictions.
The Form WC-2, Notice of Payment or Suspension of Benefits, is how the suspension is actually filed with the Board. The WC-240, with all attachments, “should only be filed with the Board as an attachment to a Form WC-2,” per the form’s own instructions. So the sequence is: doctor approves the WC-240a, you serve the WC-240 with attachments, then on the suspension date you file the WC-2 with the WC-240 attached. Skipping the WC-2 means there is no filed suspension, and benefits legally keep running.
Three Filled-Out Examples Using Real Scenarios
Below are three common fact patterns, each following one filer through the form. Sample entries are shown as they would appear on the page.
Scenario 1 — Represented worker, back injury, light-duty desk job. Carlos Mendez, a delivery driver for Acme Logistics, hurt his back and was released to light duty with a 10-pound lifting limit. His adjuster, Janet Cole, must suspend his $500/week benefits if he refuses a dispatch desk job.
| Form Section | What Janet Enters for Carlos |
|---|---|
| Board Claim No. | 2024-012345 |
| Employee Name / DOI | Mendez, Carlos R / 03/14/2024 |
| Section A – Employee Address | 482 Peachtree St NE, Atlanta, GA 30308 |
| Section A – Employer | Acme Logistics LLC, Marietta, GA |
| B-1 Job Title / Duties | Light-Duty Dispatch Clerk / phones, logging, no lifting over 10 lbs |
| B-1 Pay / Hours / Report | $18.00/hr / Mon–Fri 8a–4p / 06/15/2026 8:00 a.m. |
| B-2 Attachment | Dr. Patel WC-240a, signed 05/30/2026 |
| C – Certificate of Service | Janet Cole, Sr. Adjuster — served Carlos AND his attorney 06/02/2026 |
Scenario 2 — Unrepresented worker, shoulder injury, modified warehouse role. Aisha Brown, a warehouse picker at Northside Distributors, has no attorney. Her ATP approved a light-duty scanning role with no overhead reaching.
| Form Section | What the Adjuster Enters for Aisha |
|---|---|
| Board Claim No. | 2025-004321 |
| Employee Name / DOI | Brown, Aisha M / 01/10/2025 |
| Section A – Employee Address | 77 Glenwood Ave, Decatur, GA 30030 |
| Section A – Employer | Northside Distributors Inc, Norcross, GA |
| B-1 Job Title / Duties | Light-Duty Scanner / handheld scanning, no overhead reach |
| B-1 Pay / Hours / Report | $16.50/hr / Tue–Sat 7a–3p / 06/20/2026 7:00 a.m. |
| B-2 Attachment | Dr. Nguyen signed job analysis, 06/05/2026 |
| C – Certificate of Service | Adjuster certifies service on employee only (no counsel) |
Scenario 3 — Staffing-agency worker, hand injury, host-site clerical job. Marcus Lee was placed by Reliable Staffing at a host factory and injured his hand. The employer of record is the staffing agency, while the worksite is the host’s office.
| Form Section | What the Adjuster Enters for Marcus |
|---|---|
| Board Claim No. | 2025-009876 |
| Employee Name / DOI | Lee, Marcus T / 02/22/2025 |
| Section A – Employee Address | 15 Oak Hill Dr, Augusta, GA 30901 |
| Section A – Employer (of record) | Reliable Staffing LLC, Augusta, GA |
| B-1 Job Title / Duties | Light-Duty Clerk / filing, data entry, one-handed tasks |
| B-1 Location / Report | Host site: 900 Mill Rd, Augusta / 06/25/2026 9:00 a.m. |
| B-2 Attachment | ATP Dr. Howard approval, 06/10/2026 |
| C – Certificate of Service | Adjuster serves Marcus and his attorney same day, 06/12/2026 |
How to File the Completed Form
Filing the WC-240 has two distinct steps: serving the worker and counsel, and later filing the suspension with the Board. Get both right, in order.
Serving the worker and attorney. You must provide the WC-240 with all attachments to the employee and the employee’s counsel at least 10 days before the return-to-work date, served in the same manner to both. Acceptable channels include U.S. mail (keep the certificate of service and proof of mailing), email if used consistently for both recipients, and hand delivery. Keep proof of the date and method, because the 10-day clock and your certificate depend on it.
Filing with the State Board. The WC-240 itself is filed only as an attachment to a Form WC-2. Most insurers file the WC-2 electronically through the ICMS Online Claims System, which is free and gives an electronic confirmation; you can also mail it to the State Board at 270 Peachtree Street NW, Atlanta, GA 30303-1299, or call the Board at 404-656-3818 or 1-800-533-0682 with questions, as listed on the form. There is no filing fee for board forms. Keep the ICMS confirmation or certified-mail receipt as your proof of filing.
The timing is strict: serve first, wait the full 10 days, then file the WC-2 with the WC-240 attached effective on the return date. Filing the suspension before the 10 days run is a defect that can restart the process.
What Happens After You File
Once the worker is served, the ball is in the worker’s court on the report date. If the worker reports and works, benefits are suspended as of that date and the file moves toward closure of the indemnity exposure. If the worker never shows or quits before working eight cumulative hours or one scheduled workday, the employer may proceed with the suspension.
If the worker tries the job but stops within 15 scheduled workdays, the employer must immediately reinstate income benefits, then may request a hearing to prove the job was suitable and seek reimbursement, as explained by Eraclides Gelman. After 15 scheduled workdays, the employer is not required to reinstate without a Board order.
Expect possible pushback from the worker’s attorney, who may file a Form WC-14 to request a hearing and challenge the suitability of the job or a defect in the 240 procedure. The Board may then set a hearing before an Administrative Law Judge. Keeping clean proof of service, the ATP approval date, and the filed WC-2 is what wins these disputes.
Mistakes to Avoid When Filling Out the Form
- Serving the worker but not the attorney. The suspension is invalid because counsel must be served at the same time and manner.
- Using an ATP approval older than 60 days from the exam. The offer is void, and benefits cannot be suspended.
- Getting approval from a referral doctor, not the actual ATP. The approval does not count, and the offer fails.
- Listing job duties beyond the doctor’s restrictions. The job is “unsuitable,” so the refusal is justified and benefits continue.
- Setting the report date fewer than 10 days after service. The notice is defective and the clock must restart.
- Filing the WC-240 alone, without a WC-2. No suspension is actually on file, so benefits keep running.
- Failing to reinstate benefits when a worker quits within 15 days. This waives the employer’s “unjustified refusal” defense entirely.
- Using a stale employee mailing address. Service fails, so the 10-day clock never legally begins.
- Naming the wrong corporate entity as employer. Opposing counsel can argue the offer is defective.
- Back-dating or signing the certificate before serving. This is a false statement carrying penalties up to $10,000 per violation.
- Leaving the Board Claim Number blank or wrong. The Board misfiles the form and the suspension is delayed.
- Confusing full-duty and light-duty releases. A full-duty release needs only a WC-2, not the WC-240 process.
Do’s and Don’ts
Do: – Do confirm the worker has both an indemnity-suspension need and a light-duty release before starting, because the form is required only then. – Do use the WC-240a so the doctor approves the exact duties, which strengthens your suitability proof. – Do serve the worker and counsel in the same manner on the same day, since simultaneous service is mandatory. – Do count 10 full days from service before setting the report date, to keep the notice valid. – Do keep dated proof of service and the ATP exam date, because these win hearings. – Do file the WC-240 as an attachment to the WC-2, as the form’s instructions require.
Don’t: – Don’t describe duties the doctor never approved, or the offer becomes unsuitable. – Don’t rely on a verbal physician okay, because approval must be signed and dated. – Don’t forget to reinstate benefits if the worker quits within 15 scheduled workdays, to avoid waiving your defense. – Don’t use a third-party “fill online” site as the source, because it may be outdated. – Don’t file the suspension before the 10 days run, since that defect restarts the process. – Don’t treat a referral physician as the ATP, because only the actual ATP’s approval counts.
Pros and Cons of Handling the WC-240 Yourself vs. With Counsel
For employers and adjusters, the choice is usually whether to run the 240 in-house or loop in defense counsel.
| Filing In-House (Pro/Con) | Using Defense Counsel (Pro/Con) |
|---|---|
| Pro: Faster and cheaper for routine, unrepresented claims | Pro: Lawyer catches the 60-day and 10-day traps that void suspensions |
| Pro: Adjuster controls timing and the file directly | Pro: Stronger position if the worker is represented and likely to fight |
| Pro: No added legal fees on simple offers | Pro: Counsel handles the WC-14 hearing if suitability is challenged |
| Con: High risk of a procedural slip that costs weeks of benefits | Con: Adds legal cost to every offer |
| Con: Adjuster may miss the simultaneous-service rule | Con: Can slow down a straightforward, low-risk suspension |
For the injured worker who receives a WC-240, the parallel choice is whether to hire a claimant’s attorney; a lawyer can spot a defective offer and protect benefits, but takes a fee, while going it alone is free but risks missing a fatal flaw in the employer’s paperwork.
FAQs
Who fills out the WC-240, the employer or the worker? No worker fills it out. The employer or insurer completes and serves it; the injured employee only receives the offer and decides whether to report to the job.
Do I have to serve the worker’s attorney too? Yes. You must serve counsel at the same time and in the same manner as the worker. Skipping the attorney invalidates the offer and the suspension.
How many days before the return date must I serve the form? Yes, at least 10 days. The return-to-work and suspension date can be no sooner than 10 days after the worker and counsel are served with the form and attachments.
Does the doctor’s approval expire? Yes. The ATP must have examined the worker within 60 days of the attached approval. An older exam voids the offer and blocks the suspension.
Can I file the WC-240 by itself with the Board? No. The form is filed with the Board only as an attachment to a Form WC-2. Filed alone, it does not suspend any benefits.
In Section B-1, do I list the full job or just light-duty tasks? No full-duty tasks belong there. List only the specific light-duty duties the ATP approved; any extra task can make the job “unsuitable.”
What do I attach for Line 2’s physician approval? Yes, attach the signed WC-240a Job Analysis or a doctor-signed job description. A verbal okay does not satisfy Line 2.
Do I sign the Certificate of Service before or after serving? No, never before. You certify service the day you actually send copies; signing early or back-dating is a false statement with penalties up to $10,000.
What if the worker quits the job after a week? Yes, you must reinstate benefits immediately if the worker stops within 15 scheduled workdays. You may then request a hearing to prove the job was suitable.
What if the worker never shows up at all? Yes, you can proceed with the suspension. A no-show or working less than eight cumulative hours or one scheduled workday lets the employer suspend benefits.
Do I need the WC-240 if the worker is released to full duty? No. A full-duty release needs only a WC-2 with the release attached. The WC-240 applies only to light-duty offers.
Is the form on third-party “fill online” sites the official one? No. Use only the State Board’s official PDF. Third-party sites are not affiliated with the agency and may host an outdated version.
What happens if I get the Board Claim Number wrong in the header? No good comes of it. A wrong or missing number causes the Board to misfile the form, delaying the suspension and inviting a challenge.
Can the worker challenge the offer after I file? Yes. The worker can file a WC-14 to request a hearing, where an Administrative Law Judge reviews whether the job was suitable and the procedure was followed.
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