If you get injured in a workplace accident, you may be eligible to receive workers’ compensation benefits. However, it is not easy to receive the maximum benefits since your employer and insurance company may try to lower the amount or even deny your claim.
It is better to hire a Covington worker’ compensation lawyer to save you time, reduce your stress, and get you the full benefits you are owed. If your injuries are very severe, you may never have the time and energy to focus on your case. Hiring a credible attorney gives you time to recuperate. You can trust your lawyer to protect your rights.
If you are looking for reliable and knowledgeable lawyers in Covington, GA, then contact the Workers’ Compensation Lawyers Coalition to talk to their workers’ compensation lawyers. Our lawyers have extensive experience representing injured employees in Covington workers’ compensation disputes.
Let us deal with the insurance company on your behalf. Call us today at 470-518-5026 for a free case evaluation.
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Causes of Workers’ Compensation Disputes
Your workers’ comp claim could be denied or disputed for several reasons. Common causes of Covington workers’ compensation disputes include:
Employment Status
Georgia law requires employers with three or more employees to have workers’ compensation coverage. However, if an employer does not want to pay an injury claim, they can challenge the employment status of the employee. If they can prove that the employee was an independent contractor, they can avoid paying a claim.
Outside Scope of Employment
If the employee injures themselves intentionally or if they were injured while intoxicated or impaired, then the insurance company can deny a claim for benefits since the injury happened outside the scope of employment. You can appeal these determinations of the insurance company and your employer.
Lack of Causation
If there is no valid connection between the work-related accident and the employee’s injury, then the insurance company can deny a claim. If you do not want the insurance to deny your claim, you need to seek a second medical opinion and submit the medical records to clarify the nature of your injury.
Missed Deadline
If you get injured in a work-related accident, the law requires you to report the accident to your employer within 30 days. Especially if you are planning to seek workers’ compensation benefits. If you do not report the accident within the specific period, the insurance company will dispute your workers’ comp benefits.
Inadequate Information
If your workers’ compensation claim is incomplete or if you fail to submit the medical record proving your workplace injury, then the insurance company may deny your claim. It is much better to hire a knowledgeable workers’ compensation lawyer to make sure you do not miss anything.
What to Do If Your Workers’ Comp Claim Is Denied in Georgia?
If your employer and/or their insurance company deny your workers’ compensation claim in Georgia, you can consult an experienced and knowledgeable workers’ compensation lawyer to know your legal rights.
Here are some of the things you can do if your workers’ compensation claim is denied in Georgia:
Request Hearing Before the Industrial Commission
If you decide to appeal your denied workers’ compensation claim, you need to file a Notice of Claim WC-14 form and request a hearing before the State Board of Workers’ Compensation. An administrative law judge will hear your case and review all evidence before making a final decision. The judge will provide a written report supporting overturning the decision of the insurer or denying your claim.
Contact an Attorney
Even though you may have a valid workers’ compensation claim, your employer and/or their insurer can deny your claim. It takes time and lots of effort to overturn a denied workers’ compensation claim in Georgia. That is why you will need to contact a workers’ compensation attorney. Your attorney will gather evidence to support your claim. You can trust your attorney to guide you through the complex workers’ compensation process.
Types of Covington Workers’ Compensation Disputes
There are two main types of workers’ compensation disputes you may face in Covington, Georgia.
Medical Disputes
Medical disputes involve the medical facts related to your medical treatments. It usually takes time to resolve medical disputes. Hiring an attorney can speed up the process since the attorney can talk to the doctor. It is much easier for an experienced attorney to ask a doctor to cooperate. Here are some of the medical disputes:
- Denied surgery
- Denied therapy
- Denial of services, including assisted living arrangements and home-based healthcare
- Denial of medical supplies or products, including braces, and more.
Claim Disputes
A lot of disputes related to your workers’ comp claim can arise as you work on your normal workers’ comp claim. Here are some of the claim disputes:
- Average Weekly Wage: They arise if the injured employee disagrees on how much they should get as workers’ compensation.
- The Extent of Injury: They arise if the work-related injuries should include other body parts or health systems or not. For example, if the worker injuries their shoulder and back, the insurance company can agree to cover the back only.
- Disability: They arise if it is hard to know if the injured worker lost their wages as a direct result of the work-related injury or disease or not.
- Compensability: They arise if it is difficult to determine if the injury or illness suffered is eligible for workers’ compensation benefits.
Workers’ Compensation Dispute and Appeals Process in Georgia
Here is the workers’ compensation dispute and appeals process in Georgia:
You will need to complete an Issues form and submit it to the Commission and your employer or their insurer. The Commission will select the relevant issues on the form. Then, the Commission will listen to your side and the side of your employer.
The Commission will decide if you are eligible for compensation benefits or not. If you are not satisfied with the decision, you can make a written request for another hearing.
If the Commission does not accept your request for another hearing, you can file an appeal with the Courts of Appeal of Georgia. The Court may agree or disagree with the decision of the Commission.
Speak to a Covington Workers’ Compensation Lawyer for Free
It is easy for most people to avoid appealing the workers’ compensation disputes. Many employees do not appeal because they are afraid of offending their employers. Georgia law protects you from wrongful termination. So, do not let the fear of losing your job stop you from seeking the compensation benefits you are entitled to.
You will need an experienced workers’ compensation lawyer to help you with workers’ compensation disputes. If you are seeking compensation for the first time, you are more likely to make lots of mistakes. Hiring trustworthy lawyers increase the chance of success since your lawyer will fight for you.
Out workers’ compensation lawyers, at the Workers’ Compensation Lawyers Coalition, have several years of experience handling workers’ compensation appeals in Georgia. We will handle the communications with the insurance company on your behalf. We will use our experience and knowledge to get you the benefits you are owed. Contact us today at 470-518-5026 for a free case review.
