Workers’ Compensation Claims Process in Decatur, GA

Getting injured on the job can set you back both physically and emotionally. You will have medical bills and may not be able to earn an income while you are recovering from your injury. You may feel under pressure to get back to work as soon as possible to tackle your financial woes or because you fear losing your job. You will also need an experienced attorney who knows the workers’ compensation claims process in Decatur, GA, to represent you.

The state of Georgia provides recourse in allowing you to claim workers’ compensation benefits to cover your medical care and loss of income while you are recovering. These benefits are payable by your employer or their workers’ compensation carrier.

In order to claim workers’ compensation, it is critical to follow the correct process in order to ensure that your claim is approved and paid by your employers’ insurance carrier. You can contact WC Lawyers in Decatur, Georgia in order to find out more about the claims process and for assistance in getting your claim paid as soon as possible.

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Decatur Workers Compensation Claims Process Infographic

How Do I Know If My Injury Is Covered By A Workers’ Comp Claim?

Your employer and their insurance provider don’t want to go to the expense of paying you workers’ compensation benefits while you are not working and will go to great lengths to officially deny your claim. In order for your injury to be covered by a workers’ comp claim, the following requirements must be fulfilled:

  • The injury must have occurred at work and not while you were traveling to and from work or out on a lunch break.
  • The injury must be a result of performing your regular work duties, tasks, or activities that you would normally perform at work.
  • The injury cannot be a result of misconduct or unruly behavior (horseplay) in the workplace.
  • If the injury occurred while you were at an unauthorized gathering at work.
  • The injury or illness may not be the result of a pre-existing health condition.

It may be necessary to prove that your employer was negligent or at fault in order for your claim to be awarded. As such, it is important to keep records and evidence of the incident that caused the injury as well as witness statements and other evidence that will support your case.

How Long Do You Have To File A Workers’ Comp Claim In Georgia?

You have 30 days from the date of your injury to report your injury to your employer. Your employer is then required to inform their insurance carrier within 7 days of your report after which your claim will either be awarded or denied. The injury should be reported to a person of authority within the company or organization such as a supervisor, manager, or boss. It should also be reported to the HR (Human Resources) person or department should the company have one. You may be required to make a written statement describing the injury and incident or to complete a company incident report.

It is however recommended to report the injury immediately after it occurred or as soon as possible rather than waiting. If the deadline expires, you can lose all your medical as well as income benefits.

Man injured on a construction worksite and will need to know the Workers' Compensation Claims Process in Decatur

Understanding the Workers’ Compensation Claims Process in Decatur?

Once you have reported the injury to your employer, they will inform their insurance carrier and start the claims process. You will then be informed whether your claim has been awarded or denied.

If your claim has been denied, you need to complete a WC-19 form and submit it to the State Board of Workers’ Compensation in Georgia. They will provide you with the option of mediation or a hearing.

Mediation is where a third party appointed by the State Board of Workers’ Compensation will attempt to resolve the disputes regarding the claim and to reach a settlement agreement between you and your employer and/or their insurance carrier. If you cannot reach an agreement, then you can appeal the denied claim.

A hearing is like a court trial that will be overseen by an Administrative Law Judge (ALJ) who will hear both sides of the case and then decide what benefits you should receive – if any. You have one year from the date of your injury to request mediation or a hearing. This is another reason why it is so important to report your injury as soon as possible and to submit your WC-19 form soon after your claim has been denied.

If mediation fails or you are not satisfied with the outcome of the hearing, then the next step is Appellate Review of your case by the State Board of Workers’ Compensation. If the decision from the Appellate Review is once again unfavorable, then you have one last course of action and that is to appeal to the Supreme Court in Georgia. You have just 20 days from the date of the Appellate Review decision within which to file your case with the Supreme Court.

However, if the State Board of Workers’ Compensation has denied your claim twice, then it is unlikely that the decision will be overturned in the Supreme Court without good reason. Keep in mind that a court trial takes time and can be a costly process.

When Should I Hire a Lawyer?

It is therefore in your best interest to resolve the matter before it reaches this stage. Hiring a lawyer can help you resolve any disputes about your claim with your employer or their insurance carrier before ever having to request a hearing or seeing the inside of a court.

It is recommended to contact a WC lawyer in Decatur right from the start – before or as soon as possible after you have reported your injury. We will ensure that no deadlines are missed and that your injury is compensable or fulfills the requirements for workers’ compensation benefits.

We will also provide you with expert workers’ compensation legal representation throughout the claims process. Our goal is to have your claim awarded from the start but we will be there for you through mediation, a hearing, or your appeal. We are willing to take your case all the way to the Supreme Court in Georgia if we feel that you are owed benefits from your employer or their insurance provider.

Give us a call today at 770-796-0919 to get the workers’ compensation claims process started or to assist you with getting a denied claim overturned.