Georgia Form WC-243 is the “Credit” form that an employer or insurer files with the State Board of Workers’ Compensation to claim a dollar-for-dollar credit for certain payments already made to an injured worker. The form lets the employer/insurer recover money it paid through unemployment compensation, a wage continuation plan, a disability plan, or a disability insurance policy under O.C.G.A. § 34-9-243.
The current version is WC-243, Revision 7/2021, so check the bottom corner of your form before you start. File it wrong, miss the 10-day deadline, or fudge the contribution math, and the Board can deny your credit, force you to keep paying full benefits, or hit you with a penalty of up to $10,000 per violation for a willful false statement. Georgia processes tens of thousands of workers’ comp claims each year, and credit disputes are one of the most common reasons adjusters and injured workers end up in front of an administrative law judge.
Here is what you will learn in this guide:
- 📋 What WC-243 actually does and who is allowed to file it
- 🧮 How to fill out every box, including the tricky contribution-ratio math in Section B
- 🧑💼 Three full filled-out examples using real-world scenarios
- 📤 How and where to file the form and serve every other party
- ⚠️ The mistakes that get credits denied and how to dodge each one
What the Form Is and Who Must File It
Form WC-243 is the official “Credit” request used in Georgia workers’ compensation claims. The employer or its insurer uses it to tell the Board, the injured worker, and any lawyers in the case that it has already paid the worker money from another source and now wants credit for those dollars against the weekly income benefits it owes. The whole point is to stop “double-dipping,” where a worker collects both regular workers’ comp checks and another employer-funded benefit for the same time off.
The filer is almost always the employer, the insurer, the self-insurer, or the third-party claims administrator (TPA) — or the defense attorney working for them. The injured worker (the claimant) does not file this form. Workers and their lawyers receive a copy so they can review the credit, agree to it, or fight it at a hearing. So while the instructions below speak mainly to the adjuster or employer filling it out, injured workers reading this will see exactly what the credit means for their checks.
The form ties together five things: the form’s purpose (claiming a credit), the agency that receives it (the State Board of Workers’ Compensation), the statute that allows it (O.C.G.A. § 34-9-243), the deadline that controls it (no later than 10 days before a hearing), and the penalty that follows a false statement (up to $10,000 per violation). Each piece depends on the others. Miss the deadline and the statute will not protect your credit. Get the math wrong and the Board may toss the whole request.
A common misconception is that filing WC-243 lets you stop paying the worker right away. It does not. The form claims a credit; it does not by itself suspend benefits. Suspension and recommencement of income benefits run through Form WC-2, and the credit only reduces what you owe up to the amount of income benefits actually due.
Before You Start: Documents and Information You Need
Filling out WC-243 goes fast when you have your file in order first. The form is short, but the numbers behind it must be exact, because the Board and the claimant’s lawyer will check your math. Gather these items before you open the form, and know why each one matters.
- Board Claim Number — the Board’s case ID; without it the form may not attach to the right claim and could be rejected or lost.
- Employee’s full legal name and date of injury — these must match the Board’s records, or the filing will not link to the existing claim.
- The plan or policy document — the unemployment, wage continuation, disability plan, or disability insurance contract that shows what was paid and who funded it.
- Proof of the employer’s contribution share — payroll records or the plan summary that prove the exact percentage the employer paid, since the credit only covers the employer-funded part.
- Payment ledger with exact dates — the start and end dates and weekly amount paid, because the form asks for the period “from” and “through” and the weekly benefit figure.
- SBWC Insurer/Claims Office ID number (five digits) — the Board identifies the insurer by this number, and a wrong one routes the form to the wrong file.
- Current addresses and emails for all parties — the employee, employer, insurer, and claims office, so service is valid.
- Names and addresses of all counsel and unrepresented parties — you must serve every one of them the same day you file, or the credit can be challenged.
- A signer with knowledge of the facts — the certificate of service must be signed by someone who can truthfully swear the figures are correct.
If any item is missing, stop and find it. A missing contribution percentage means you cannot complete Section B, and a missing service list means your certificate of service is false.
Where to Get the Form and How to Access It
You can get the official WC-243 only from the State Board of Workers’ Compensation forms page, where it sits in the board forms list dated 2021. Download the PDF directly from the WC-243 form link so you know you have the Revision 7/2021 version and not an old copy floating around online. Using an outdated form is a quick way to have a filing kicked back.
Most professional filers complete and submit the form through the Board’s electronic system, the Integrated Claims Management System (ICMS), which lets insurers and TPAs file and serve documents online. If you are not set up for ICMS, you can also fill out the PDF by hand or by typing into the fields, then file by mail. Paper copies are free; you can request them by calling the Board at (404) 656-3870.
A nuance worth knowing: the form itself is a PDF you can type into, but the math in Section B is not auto-calculated. You must run the multiplication yourself and enter the result. A misconception is that ICMS “checks” your numbers — it does not. ICMS routes the form; it does not audit your credit math, so the burden of accuracy stays on you.
Step-by-Step: How to Fill Out Form WC-243 Line by Line
The form has a short header block, then three lettered sections: A. Identifying Information, B. Credit Requested, and C. Certificate of Service. Fill them in the order they appear. Use the exact box names printed on the form, type in clear block text, and double-check every date and dollar figure before you sign.
Header: Board Claim No., Employee Name, M.I., and Date of Injury
The top strip asks for the Board Claim No., Employee Last Name, Employee First Name, M.I. (middle initial), and Date of Injury. In plain English, this is the box that tells the Board which case and which worker the credit belongs to.
To answer it, copy the Board Claim Number exactly as it appears on prior filings, write the employee’s legal name last-name-first, add the middle initial, and enter the date of injury as MM/DD/YYYY. For example, adjuster Dana Pierce enters Board Claim No. 2024-031847, Last Name “Ramirez,” First Name “Hector,” M.I. “L,” and Date of Injury 04/12/2024.
A common edge case is a worker with two last names or a recent name change; use the name on the existing Board record, not a new one. The most common mistake here is transposing digits in the claim number, which causes the form to attach to the wrong file or no file at all, delaying your credit for weeks. A misconception is that the date of injury is the date you learned about it — it is the actual accident date already on the claim.
Section A: Employee Identifying Information
This part asks for the employee’s Mailing Address, Employee E-mail, City, State, Zip Code, and the County of Injury. In plain terms, it is where the Board and parties can reach the injured worker and where the injury legally occurred.
Enter the worker’s current mailing address in all caps for clean reading, add the email if you have it, and fill the county where the accident happened, not where the worker lives. For example, Dana enters 1420 PINE HOLLOW DR, MARIETTA, GA 30062, with County of Injury “Cobb.”
If the worker uses a P.O. Box, enter it, but try to also confirm a physical contact so service is reliable. The common mistake is leaving the county blank or guessing it, which matters because venue and jurisdiction can hinge on the county of injury. A misconception is that the employee’s home county and the county of injury are the same — they often are not, especially for traveling workers.
Section A: Employer Identifying Information
Here you list the Employer Name, Mailing Address, City, State, Zip, Employer E-mail, and Phone Number. This block tells everyone which business employed the worker on the date of injury.
Write the employer’s full legal business name, not a nickname or “doing business as” unless that is the legal name on the claim, and complete the full address and contact fields. For example, Dana enters Employer Name “Summit Logistics, Inc.,” 88 WAREHOUSE PKWY, AUSTELL, GA 30168, phone (770) 555-0142.
If the company has several locations, use the address tied to the claim, not corporate headquarters, unless that is where claim notices go. A common mistake is using a trade name that does not match the Board’s record, which can cause confusion about who is actually seeking the credit. A misconception is that the employer info is optional because the insurer is filing — it is required, because the credit belongs to the employer/insurer jointly.
Section A: Insurer / Self-Insurer and Claims Office Information
This block asks for the Insurer/Self-Insurer Name, the Claims Office Name, the SBWC ID# (five digit no), the claims office E-mail, and the Mailing Address, City, State, Zip. These boxes identify who actually pays the claim and who handles the file day to day.
Enter the insurance carrier or self-insured entity, the TPA or in-house claims office name, and the all-important five-digit SBWC ID number that the Board uses to track the insurer. For example, Dana enters Insurer “Peachtree Mutual Insurance Co.,” Claims Office “Pierce Claims Services,” SBWC ID# 41827, email claims@pierceclaims.com.
If the employer is self-insured, list the company as both employer and self-insurer and use its self-insurance SBWC ID. The most common mistake is entering the wrong five-digit SBWC ID, which misroutes the form inside the Board’s system. A misconception is that this number is the policy number — it is not; it is the Board’s own insurer identifier.
Section B, Item 1: Type of Credit Requested
Item 1 states that a credit is requested under O.C.G.A. § 34-9-243 for benefits paid under the “Employment Security Law” or employer-funded portions of payments, and gives four checkboxes: Unemployment compensation payments, Wage continuation plan, Disability plan, and Disability insurance policy. In plain English, this is where you tell the Board which kind of payment you want credit for.
Check the one box that matches the source of the money the worker received. For example, Dana checks “Unemployment compensation payments” because Hector drew state unemployment while out of work.
The edge case is a worker who received money from two sources, such as unemployment and a disability plan; many practitioners file a separate WC-243 for each credit type to keep the math clean, though you may address both if documented. The common mistake is checking “Disability insurance policy” when the plan was actually a self-funded “Disability plan,” because the credit rules differ. A misconception is that any benefit the worker received qualifies — only the four listed, employer-funded categories do, and a credit for unemployment is dollar-for-dollar while plan and policy credits are limited to the employer-funded share.
Section B, Item 2: Amount and Dates of Payments
Item 2 reads: “The employee has been paid weekly benefits of $_, from the date of _// through //, for which credit is sought.” This box pins down how much was paid and over what exact window.
Enter the weekly dollar amount the worker actually received and the precise first and last dates of that payment period in MM/DD/YYYY format. For example, Dana enters weekly benefits of $330.00, from 05/01/2024 through 07/24/2024.
A common edge case is a payment amount that changed mid-period; if the weekly figure varied, list the periods separately or attach a payment ledger so the math is clear. The biggest mistake here is overstating the period or amount, which inflates the credit and invites a challenge — and an inflated figure made knowingly can be a false statement under O.C.G.A. § 34-9-18 and § 34-9-19. A misconception is that you can claim credit for future weeks you expect to pay; the credit covers benefits already paid, not money you plan to pay later.
Section B, Item 3: The Contribution Ratio and Credit Calculation
Item 3 is the heart of the form. It states: “The ratio of the employer’s contributions to the total contributions of the plan or policy is ____%,” then gives the formula: $_ (weekly disability benefit per plan or policy) X _% (ratio of contributions) = $____ (to be credited against TTD or TPD benefits due). In plain English, this box figures out how much weekly credit you actually get, because you only get credit for the share the employer funded.
To answer it, find the percentage of the plan or policy the employer paid, multiply the weekly benefit by that percentage, and write the result in the third box. For example, for an employer-funded short-term disability plan, Dana enters a weekly benefit of $400.00, a contribution ratio of 60%, and a credit of $400.00 X 60% = $240.00 per week. For pure unemployment compensation, the ratio is 100% and the credit equals the full weekly amount.
The edge case that trips people up is a plan funded partly by employee payroll deductions; if the worker paid 40% of the premium, the employer only gets credit for the other 60%. The most common and costly mistake on the entire form is claiming 100% credit on a jointly funded plan, which the claimant’s attorney will challenge and the judge will likely reduce or deny. A key misconception is that the credit can wipe out a week’s check entirely no matter how big it is — the form states plainly that the credit shall not exceed the amount of income benefits due the employee, so a $300 weekly TTD benefit can never be reduced by more than $300.
Section C: Certificate of Service and Signature
Section C is the certificate of service. It contains a checkbox stating, “I hereby certify that the above information is true and correct to the best of my knowledge and a copy of this form has been sent to the Board, to counsel, and to all unrepresented parties in this claim,” followed by Print Name Here, Signature, Date, Phone, and E-mail. In plain English, this is your sworn promise that the numbers are accurate and that you served everyone.
Check the box, print and sign the name of the person with knowledge of the facts, and enter the date you actually file and serve, plus a working phone and email. For example, Dana checks the box, prints “Dana Pierce,” signs, dates it 07/26/2024, and lists (770) 555-0142 and dpierce@pierceclaims.com.
The edge case is a defense attorney signing on behalf of the insurer; that is allowed, but the signer still vouches for accuracy. The most serious mistake on the whole form is signing the certificate when you have not yet served all parties, because that makes the certification false and can support a penalty of up to $10,000 per violation. A misconception is that emailing the Board alone counts as service — you must serve the Board, all counsel, and every unrepresented party at the same time you file.
Three Filled-Out Examples Using Real Scenarios
These three scenarios walk named filers through the most common WC-243 situations. Each table shows what the filer enters in the key boxes.
Scenario 1 — Unemployment compensation credit (dollar-for-dollar). Adjuster Dana Pierce seeks credit for state unemployment that Hector Ramirez drew while his claim was disputed.
| Form Section | What Dana Enters |
|---|---|
| Board Claim No. | 2024-031847 |
| Employee Name / Date of Injury | Ramirez, Hector L. — 04/12/2024 |
| County of Injury | Cobb |
| Insurer / SBWC ID# | Peachtree Mutual Insurance Co. / 41827 |
| Item 1 — Credit type | ☑ Unemployment compensation payments |
| Item 2 — Weekly amount and dates | $330.00, 05/01/2024 through 07/24/2024 |
| Item 3 — Ratio and credit | $330.00 X 100% = $330.00 per week |
| Certificate of Service | Signed Dana Pierce, 07/26/2024 |
Scenario 2 — Employer-funded short-term disability plan with a partial ratio. Claims handler Marcus Webb files for credit on an STD plan that employer Brightway Manufacturing funded 60% and the worker, Aisha Bello, funded 40%.
| Form Section | What Marcus Enters |
|---|---|
| Board Claim No. | 2025-009922 |
| Employee Name / Date of Injury | Bello, Aisha N. — 01/08/2025 |
| Employer Name | Brightway Manufacturing, LLC |
| Item 1 — Credit type | ☑ Disability plan |
| Item 2 — Weekly amount and dates | $400.00, 01/20/2025 through 03/31/2025 |
| Item 3 — Ratio and credit | $400.00 X 60% = $240.00 per week |
| Note on cap | Credit not to exceed TTD due of $725.00/wk |
| Certificate of Service | Signed Marcus Webb, 04/02/2025 |
Scenario 3 — Wage continuation / severance credit. Defense attorney Janet Cole files for credit on salary continuation that employer Coastal Freight paid to Leon Carter after his injury.
| Form Section | What Janet Enters |
|---|---|
| Board Claim No. | 2025-014530 |
| Employee Name / Date of Injury | Carter, Leon R. — 02/15/2025 |
| Employer Name | Coastal Freight Co. |
| Item 1 — Credit type | ☑ Wage continuation plan |
| Item 2 — Weekly amount and dates | $650.00, 02/22/2025 through 04/19/2025 |
| Item 3 — Ratio and credit | $650.00 X 100% = $650.00 (capped at benefits due) |
| Certificate of Service | Signed Janet Cole, attorney, 04/21/2025 |
A nuance across all three: when the employer fully funds the benefit, the ratio is 100%, but the credit is still capped at the income benefits due. Severance treated as wage continuation can support a credit, but only when the form documents it as such.
How to File the Completed Form
You can file WC-243 through three channels, and you must serve all other parties at the same moment you file. Whichever channel you use, the statute and Board Rule 243 require service on the Board, all counsel, and all unrepresented parties no later than 10 days before a hearing.
- Online (ICMS portal): Insurers, self-insurers, and TPAs file electronically through the Board’s Integrated Claims Management System at the SBWC forms and filing pages. There is no filing fee. Keep the ICMS confirmation receipt as your proof of filing, and serve the other parties by email or mail the same day.
- By mail: Send the completed PDF to the State Board of Workers’ Compensation, 270 Peachtree Street NW, Atlanta, GA 30303-1299. There is no fee. Use certified mail with return receipt so you have proof of filing and the date.
- In person / by phone request for forms: You can request free paper forms by calling the Board at (404) 656-3870, then file the completed form by mail or ICMS.
For general questions while filing, the form lists the Board’s help line at (404) 656-3818 or 1-800-533-0682. No matter the channel, save a date-stamped copy and your proof of service for every party — that record is what protects your credit if the worker disputes it later.
What Happens After You File
Once WC-243 is filed and served, the Board dockets it to the claim and the other parties get their chance to review the credit. The injured worker or their attorney can accept the credit, ask for backup documents, or object and set the issue for a hearing. The form by itself does not change the worker’s check; it puts the credit on the record so it can be applied to income benefits due.
If no one objects and the math is correct, the employer/insurer applies the weekly credit against the temporary total disability (TTD) or temporary partial disability (TPD) benefits owed, never reducing a week’s payment below zero and never exceeding the benefits due that week. If the worker objects, an administrative law judge decides whether the credit is valid and how much applies, often turning on the contribution ratio and whether you served the form on time. A late or unserved WC-243 is the fastest way to lose a credit you were otherwise entitled to.
Keep in mind that suspending or restarting the actual benefit checks is handled on Form WC-2, not WC-243. The credit form sets up the offset; the WC-2 reflects the changed payment. Treating the two as interchangeable is a frequent source of error in Georgia claims.
Mistakes to Avoid When Filling Out the Form
Each error below has stopped a credit cold. Read the mistake, then the consequence.
- Missing the 10-day deadline — the Board can refuse to consider the credit at the hearing entirely.
- Wrong Board Claim Number — the form attaches to no claim and your credit sits unprocessed.
- Claiming 100% on a jointly funded plan — the judge cuts your credit to the employer’s true share or denies it.
- Overstating the weekly amount — invites a challenge and risks a false-statement penalty up to $10,000.
- Leaving the contribution ratio blank — the Board cannot verify the credit and may reject Section B.
- Forgetting to serve all parties — your certificate of service becomes false and the credit is vulnerable.
- Wrong five-digit SBWC ID — the form misroutes inside the Board’s system and stalls.
- Checking the wrong credit-type box — applies the wrong legal standard and undercuts the request.
- Claiming credit for future, unpaid weeks — the statute only allows credit for benefits already paid.
- Exceeding income benefits due — any credit above the weekly benefit owed is invalid on its face.
- Using an outdated form — a pre-2021 version may be kicked back, costing you the deadline.
- Unsigned certificate of service — an uncertified form is incomplete and will not be honored.
Do’s and Don’ts
Do’s
- Do confirm you have the Revision 7/2021 form, because old versions get rejected.
- Do attach payment ledgers, since proof speeds Board acceptance of your numbers.
- Do serve every party the same day you file, because the rule requires simultaneous service.
- Do calculate the contribution ratio from real payroll or plan records, since guesses lose at hearing.
- Do keep your proof of filing and service, because it defends the credit if challenged.
- Do file a separate WC-243 for each distinct credit type, since it keeps the math and record clean.
Don’ts
- Don’t assume the form suspends benefits, because that takes a WC-2.
- Don’t claim more than the income benefits due, since the cap is built into the form.
- Don’t round the contribution percentage up in your favor, because it reads as overreaching.
- Don’t sign before service is done, since that makes your certification false.
- Don’t use a trade name that mismatches the claim, because it confuses who seeks the credit.
- Don’t wait until the hearing to file, since the 10-day rule bars late credits.
Filing on Your Own vs. With Help
Most WC-243 filings are handled by adjusters in-house, but complex credits often go to defense counsel. Here is how the two paths compare.
| Filing It Yourself (Adjuster/Employer) | Filing With Defense Counsel |
|---|---|
| Pro: No legal fees and faster turnaround | Pro: Attorney spots disputed ratios before filing |
| Pro: You know the payment ledger best | Pro: Stronger position if the worker objects |
| Pro: Simple unemployment credits are easy | Pro: Handles hearings if the credit is contested |
| Con: Easy to miscalculate the ratio | Con: Adds legal cost to the claim |
| Con: Risk of missing the 10-day rule | Con: Slower if counsel is juggling many files |
| Con: A false figure exposes you to penalties | Con: May be overkill for a clear 100% credit |
For a clean, fully employer-funded unemployment credit, a careful adjuster can usually file alone. For a partly employee-funded disability plan or a severance dispute, counsel is worth the cost because the contribution ratio and characterization of the payment are exactly what gets litigated.
Related Forms and Agencies
Several Board forms interact with WC-243. Form WC-2 is the Notice of Payment, Suspension, or Recommencement of income benefits — it actually changes the worker’s checks, while WC-243 only claims the credit. Form WC-240 handles a bona fide return-to-work offer, which can affect what benefits are due in the first place. Form WC-244 is a separate Board form used in the same claims family. The agency receiving all of them is the State Board of Workers’ Compensation, and the controlling statute is O.C.G.A. § 34-9-243, fleshed out by Board Rule 243. For unemployment-based credits, the underlying payments come through Georgia’s “Employment Security Law,” which is why the form lists unemployment compensation as its own checkbox.
FAQs
Who files Form WC-243, the worker or the employer?
No. The injured worker does not file it. The employer, insurer, self-insurer, or their attorney files WC-243 to claim a credit, and the worker only receives a served copy.
Does filing WC-243 stop my workers’ comp checks?
No. WC-243 only claims a credit. Suspending or changing payments is done on Form WC-2, and any credit is capped at the income benefits due that week.
What is the deadline to file WC-243?
Yes, there is one. You must file and serve it no later than 10 days before a hearing, and serve all parties at the same time you file with the Board.
Do I check more than one box in Section B, Item 1?
No, usually. Check the single box matching the payment source, and file a separate WC-243 for each distinct credit type to keep the calculations clean.
What percentage do I write in the Item 3 ratio box?
Yes, it must be the employer’s share. Enter the percentage of the plan or policy the employer funded; for full unemployment compensation it is 100%, for a jointly funded plan it is the employer’s portion only.
Can the credit reduce my weekly check to zero?
No. The form states the credit shall not exceed the income benefits due, so the credit can never reduce a week’s benefit below zero.
Do I get credit for a disability plan the worker partly paid for?
Yes, but only for the employer-funded share. If the worker paid 40% of the premiums, the employer’s credit is limited to the remaining 60%.
Is the date of injury box the date I learned of the claim?
No. It is the actual accident date already on the Board’s claim record, entered as MM/DD/YYYY, not the date the claim was reported to you.
What goes in the SBWC ID# box?
Yes, a five-digit number. It is the Board’s identifier for the insurer or self-insurer, not the insurance policy number, and a wrong entry misroutes the form.
Can I claim credit for weeks I have not paid yet?
No. The credit covers benefits already paid to the worker, with exact start and end dates in Item 2, not future payments you expect to make.
Does emailing the Board count as serving the other parties?
No. You must separately serve the Board, all counsel, and every unrepresented party at the same time, then certify that service in Section C.
What happens if I claim 100% credit on a jointly funded plan?
No good outcome. The worker’s attorney can object, and the judge will likely reduce the credit to the employer’s true share or deny it.
Is there a penalty for putting wrong numbers on the form?
Yes. Willfully making a false statement to obtain or deny benefits is a crime carrying penalties of up to $10,000 per violation under O.C.G.A. § 34-9-18 and § 34-9-19.
Where do I get the official WC-243 form?
Yes, from the Board. Download the Revision 7/2021 PDF from the State Board of Workers’ Compensation forms page, or request a free paper copy by calling (404) 656-3870.
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