If your claim for workers’ compensation has been denied by either your employer or their insurance carrier, it may be as a result of a variety of types of workers compensation disputes in Dallas, GA. In Georgia, you can try to resolve the dispute before taking other action to try to get your workers’ compensation paid.
Dispute resolution can have two outcomes – either in your favor where the claim is paid or against you where you will have to accept that your workers’ compensation benefits have been denied.
For assistance in resolving a dispute with your employer or their insurance carrier that will result in your workers’ comp benefits being paid, contact a workers’ compensation lawyer in Dallas, GA as soon as possible.
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What Are Common Workers Compensation Disputes in Dallas?
A dispute may result for one or more of the following reasons:
Employment Status
Certain types of employees like contractors do not qualify for workers’ compensation benefits even if they are injured within the scope of their job while at work.
Tasks or activities that fall out of the scope of employment
For example, doing a job that you are not qualified, trained, or required to do in your regular duties or partaking in an unauthorized gathering at work.
No proof of the cause of the accident
In other words, there is no evidence that the injury was sustained at work or as a result of working.
Missed Deadlines
You have 30 days within which to report a work-related injury to your employer. If you miss this deadline, you may forfeit your benefits.
Inaccurate or Inadequate Information
You are required by law to provide the correct details of the accident, your employment information, and other facts about the injury and incident that caused the injury. Without this information, your workers’ compensation cannot be paid.
A lawyer can assist you in resolving any of the above reasons for a dispute regarding the payment of workers’ compensation benefits.
What Do You Do If Your Workers’ Comp Claim Is Denied In Dallas?
The first step that you should take after a workers’ comp claim is denied is to call WCL in Dallas. You need to provide all the evidence that you have of the incident and the injury as well as the reason for the claim being denied. Your lawyer will advise as to your next steps and provide legal representation throughout the process.
Types Of Disputes That Can Arise Regarding Compensation
There are certain conditions under which your employer or their insurance carrier can deny workers’ compensation benefits even after a claim has been awarded. These disputes can arise from the following:
Medical Disputes
- If you did not consult or get treated by a doctor authorized by the insurance carrier, your medical expenses will not be covered.
- If you did not follow the instructions from the doctor, then your claim will be dismissed.
- If you had a pre-existing medical condition that contributed to your injury or illness, your claim may be denied.
- If it is found that you intentionally harmed yourself, your claim may be denied.
- If the injury resulted from misconduct or unruly behavior in the workplace, your claim can be denied.
Claim Disputes
- If you were not on the work premises or performing work duties at the time of the injury, your claim may be denied.
- If you did not report your injury within 30 days, your employer or their insurance carrier can deny all benefits.
- If there is any dispute regarding your income preceding the accident, your claim can be denied.
- If you failed to request a hearing 1 year from the date of your accident, your case will not be heard by the State Board of Workers’ Compensation.
- If you did not file your appeal for Appellate Review or to the Supreme Court within 20 days of the State Board of Workers’ Compensation decision, your case will not be heard.
If any of these disputes have resulted in receiving partial or no workers’ compensation benefits, contact WCL in Dallas for assistance in getting the matter resolved.
Workers’ Compensation Dispute And Appeals Process In Georgia
If you feel that the decision by your employer or the insurance carrier to deny your claim is unfair, you can request a hearing before the State Board of Workers’ Compensation in Georgia. You need to complete a WC-19 form in order to request a hearing. An Administrative Law Judge will listen to each side of the case and then decide what benefits you will receive – if any.
Alternatively, you can opt for mediation where a third party will be assigned to resolve the dispute between you and your employer or their insurance carrier. It is highly recommended to have a lawyer represent you at the hearing which is similar to a court trial or at the mediation.
If the Administrative Law Judge does not find it in your favor and you still get no benefits, you can request an Appellate Review from the State Board of Workers’ Compensation. If the decision once again is not favorable, you can appeal to the Georgia Supreme Court. It is unlikely that the Supreme Court will find different than the State Board at the hearing or appeal. However, you can improve your chances of having your workers’ compensation benefits approved if you have a lawyer to represent you.
Contact Our Attorneys Today for Help With All Workers Compensation Disputes in Dallas, GA
There are many reasons why a claim may be denied by an employer or their insurance carrier. While some of these reasons may be legally valid, some of the time a dispute is simply used as an excuse not to pay workers’ compensation benefits. If your benefits have been denied for any reason whatsoever, it is imperative to contact a lawyer as soon as possible to find out whether the dispute is legal and if there is any way to get your claim approved.
Workers’ Compensation Lawyers Coalition Atlanta is here to help you resolve a dispute with an employer as well as provide you with legal representation throughout mediation, a hearing, and the appeals process.
