Have you experienced workers’ compensation disputes in Decatur, GA? If you believe you’re entitled to benefits, you shouldn’t stop fighting for the funds that you’re owed. Georgia law gives you the right to file an appeal, and our Decatur workers’ comp lawyers at the Workers’ Compensation Lawyers Coalition can assist you during the appeals process.
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Causes of Workers’ Compensation Disputes
Workers’ compensation claims can be delayed or denied for a number of reasons. One of the most common causes of disputes is employment status. As an example, many workers in Georgia are independent contractors. Even if you are not a standard W2 employee, you may qualify for workers’ comp benefits.
Insurance providers may also argue that the injury is outside the scope of employment. Injuries do not necessarily need to happen on the job to be covered. For example, injuries that happen at work-sponsored activities, like injuries at company picnics, should be covered. However, if you are injured on your lunch break or during your commute, you will not have access to benefits.
Having drugs or alcohol in your system at the time of your injury can lead to disputes, but it won’t always lead to your claim being denied. An attorney can make a lack of causation defense and argue that drugs or alcohol had no bearing on the injury that you sustained.
Georgia law states that employees must report injuries within 30 days. Furthermore, workers’ compensation claims must be filed within one year of the date the injury occurred. The Georgia State Board of Workers’ Compensation Board can excuse late notice of work-related injuries. If a claim is not filed on time, however, it may be barred by the Statute of Limitations.
Claims may also be disputed or denied if you provide inadequate information or documentation to support your claim. For these reasons and others, you should consider working with a skilled attorney. Our lawyers can make sure that your claim is fully completed and filed on time, and we can protect your rights if your claim is unfairly denied.
What to Do If Your Workers’ Comp Claim Is Denied In Georgia?
If your claim has been denied, you have the right to request a hearing before the State Board of Workers’ Compensation. While you can represent yourself during this hearing, you’re more likely to see a favorable outcome if you hire an experienced Decatur worker’s comp lawyer.
Your attorney can ensure that all necessary paperwork is completed ahead of your pre-trial hearing. A lawyer can prepare you for the compensation hearing and can build a strong case for the presiding judge. Contact the Workers’ Compensation Lawyers Coalition in Decatur, GA right away to improve your chances of a successful appeal.
Types of Workers’ Compensation Disputes
There are two main types of workers’ compensation disputes: medical disputes and claim disputes. Medical disputes occur when an employer denies medical treatment or payment for medical care. Your appeal will give you the opportunity to argue that treatment is necessary or compensable.
Denials are a type of claim dispute, but this type of dispute also includes cases in which an employer downplays the severity of an injury in order to limit benefits. If you choose to appeal your employer’s decision, a judge will examine evidence and review medical records to assess your entitlement to benefits.
Workers’ Compensation Dispute and Appeals Process In Georgia
Claim denials, benefits disputes, and medical disputes can all be reviewed by the Georgia Board of Workers’ Compensation at your request. If your claim is denied by the board, you have the option of having your filing an appeal in the Georgia court system.
In order to begin the appeals process, you will need to file a notice of claim. You can find this notice on state Form WC-14. This form must be submitted to the Georgia State Board of Workers’ Compensation within one year of the date of your injury. Copies should also be sent to your employer and their insurance provider.
Although you have a year to file an appeal, acting quickly can strengthen your case. The Georgia workers’ comp appeal process can be lengthy. Filing quickly will allow you to access benefits more quickly if your appeal is successful. Fast action also allows important evidence to be protected.
After filing a claim, your case will be heard by an Administrative Law Judge (ALJ). In most cases, this hearing will be scheduled within 60 days of the date when your claim form was filed. During your hearing, you will have the opportunity to present evidence in support of your claim, and your employer will be able to present their grounds for denial.
As soon as all evidence has been heard, the ALJ will use applicable laws and the evidence to make a decision on your case. The decision will not be presented to you on the date of your hearing. Instead, the decision will be mailed to you within 30 days.
You can also request mediation between you and your employer’s insurance provider. The option to request mediation can be found on Form WC-14. If your request is approved by the board, the date, and location for mediation will be set. During mediation, you will be able to present evidence and negotiate with the insurance company.
If you are not satisfied with the decision from the ALJ, you have the right to appeal this decision with the Appellate Division of the State Board. No new evidence can be heard during the appeals process. Instead, both you and the insurance provider will file a brief and make a five-minute in-person argument. Your appeal will be denied unless a mistake was made when your case was decided. You may also choose to have your appeal heard by the Superior Court.
The appeals process in Georgia is extremely complicated, which is why you’ll want to have a qualified attorney representing you throughout this process. Workers’ Compensation Lawyers Coalition can evaluate your claim and determine if it was wrongfully disputed or denied. Contact us today at 470-518-5026 for a free case evaluation.