Have you been injured while at work? Have you sustained job-related illnesses? That is because you are entitled to receive worker’s compensation benefits. However, in some cases, the employer’s insurance carrier is going to either deny your benefits or try to suggest a lower amount than the loss itself.
Our Carrollton worker’s compensation lawyers can help fight and protect your legal rights. At the Workers Compensation Lawyers (WCL) Coalition, we take all the necessary steps to aggressively represent our clients in workers’ compensation disputes in Carrollton, GA.
This is why we offer personalized client support and services. Speak to us today at 470-518-5026 to schedule a free consultation, and let us work for you.
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Causes of Workers’ Compensation Disputes in Carrollton, GA
After a work-related injury, both parties (the employer and the employee) must fulfill certain responsibilities. These are responsibilities play a huge role in determining the benefits you are owed, the extend of your injuries, and so on. Failure to abide by these responsibilities will jeopardize your claim.
A good example of such responsibilities for an employee involves getting immediate medical attention. Here are some of the most common reasons why your worker’s compensation benefit might be denied in Georgia.
Employee’s Employment Status
Every state in America has its own laws that govern worker’s compensation insurance claims. As such, in Georgia, an employee’s employment status does affect the benefits they are likely to receive or denied. Factors such as the duration you have been working, temporary/casual employment, and others will play a role.
Failure to Seek Immediate Medical Attention
Having not sought immediate medical attention may be interpreted in another way (maybe you were not injured, your injuries are not serious, you sustained the injuries out of work, etc.) To avoid this, it is wise to seek immediate medical attention.
Failure to Report the Accident or Injury
If you do not report the injuries to the employer, you will definitely experience a difficult time seeking and being awarded compensation for it. In Georgia, you must report a workplace accident to your employer within 30 days.
Inadequate Information
Of course, when an employee gets injured while at work, they will have to provide adequate information regarding the incident. This will include providing witnesses, proof of injuries, the cause of the injury, and more.
Failure to Pass a Drug Test
If you fail a drug test, you are not going to receive worker’s compensation benefits. This means that if the incident happens when you were under the influence of a substance, you will not qualify for compensation.
Outside Scope of Employment
This means any act that does not fall anywhere under the job description of the employee, and is completely unanticipated from the employer’s point of view. For example, an electrical technician or worker from a specific company is not expected to get miner’s diseases like silicosis, pneumoconiosis, and others.
A Lack of Causation
This is a legal term that refers to the relationship between factor A to factor B. In other words, an employee must show or link the injury to a work-related activity or accident. Showing this will eliminate arguments like pre-existing conditions or injury.
Missed Deadlines
All personal injury claims have a statute of limitation, and this also applies to workers comp. If therefore, an employee misses a deadline, their claim will be denied. Often, employers use delay tactics so that you can be denied compensation.
Prior Workers Compensation Claim Records
If today you file a claim that is similar to another you filed some years back, chances are you will be denied. This can be a good reason to cast doubt on your incident.
No Workers Compensation Policy
If your employer does not have a worker’s compensation insurance policy, then you will not receive the benefits. Employers with three or more regular workers must have workers’ comp insurance in Georgia.
To avoid all these problems, we advise that you find a skilled workers comp lawyer before you begin the process of filing a claim. This is why consulting a lawyer is a wise move. At the Workers Compensation Lawyers Coalition, we are ready to listen to you and offer the best legal advice based on your case.
What to Do If Your Workers Comp Claim Is Denied in Georgia?
If your claim is denied, it can be extremely difficult to obtain a reversal of that decision without the help of a seasoned lawyer. Nevertheless, you must have a clear understanding or knowledge of why it was denied.
After this, file or request a hearing before the industrial commission. This is done by submitting the WC-14 form and the hearing takes place after 60 days, starting from the date of the submission. Remember, a worker’s compensation denied appeal must be filed within a year starting from the date of the accident.
Although it is not a requirement to have a lawyer present (by your side), it is a wise decision to have one. That is because a lawyer will make the process less stressful for you by presenting facts to the judge.
Types of Workers’ Compensation Disputes
Worker’s compensation disputes can be divided into two primary categories. These are:
Medical Disputes
This covers any dispute related to treatment and anything related. This type of disputes covers:
• Liability disputes
• Medical, hospital, and rehabilitation disputes
• Permanent impairment disputes
• Injury management dispute
Claim Disputes
This covers anything related to the worker’s comp itself. As such, it includes disputes like:
• Premium disputes
• Work capacity decision reviews disputes
Workers Compensation Dispute and Appeals Process in Georgia?
It is important to note that worker’s compensation benefit disputes and appeals can take two forms/ways in Georgia. These are:
1. Administrative Law Judge – In this form, the process involved going or filing for a hearing before an administrative law judge.
2. State Board and Courts – This process involve filing for an appeal decision by the administrative law judge to the full board of worker’s compensation board or a superior court judge (the court of appeal). It could then possibly go to Georgia’s supreme court.
NOTE: Worker’s compensation claims vary from state to state. For this reason, there is no federal jurisdiction, and therefore, appeals cannot go to the federal or U.S. supreme courts.
The best process to follow in case of a dispute or appeal differs from one case to another; although some may pass through similar channels. Nevertheless, speak to our worker’s compensation dispute lawyers to know the best legal action to take.
Get the Best Lawyers for Workers’ Compensation Disputes in Carrollton
Before starting your worker’s compensation dispute process, it is important to reach out to our experienced Carrollton worker’s compensation lawyers. We will guide you through the whole dispute process and help you avoid common drawbacks that may affect your claim process.
At Worker’s Compensation Lawyers Coalition, we will ensure your rights are protected and received the benefit you are legally owed. Call us today at 470-518-5026 or contact us online and schedule your free case review and consultation to know more.
