Employees who suffer on-the job injuries are usually entitled to various benefits under Georgia’s workers’ compensation laws and can file workers’ compensation disputes in Fairburn with full authority. Essentially, workers’ comp benefits are meant to get such employees back on their feet by covering their medical costs and lost wages if their workplace injuries keep them out of work for the statutory amount of time.
For you to be eligible for workers’ comp benefits, you must have suffered an injury due to your work and in the course of employment to file a claim under Workers’ compensation disputes in Fairburn. What’s more, their injuries must be compensable under Georgia’s workers’ compensation laws. If your injury doesn’t check these boxes, your employer or their insurance carrier may have valid grounds to raise dispute and deny your claim.
Speaking to a lawyer can help you evaluate your workplace accident and find viable defenses in the event of unfair denial of claim. If you have been injured while at work in Fairburn, Georgia, it is imperative that you seek the legal counsel of a Fairburn workers’ compensation lawyer to guide you through the injury reporting and claim filing process. Call the law offices of Workers’ Compensation Lawyers Coalition in Fairburn today at 770-796-0919 to schedule a free legal consultation.
Causes of Workers’ Compensation Disputes in Fairburn, GA
Generally, workers’ compensation is a system under state law that provides injured employees with medical and indemnity benefits. The system also protects employers from lawsuits, especially if a workers’ injury was due to their negligence. However, workers’ comp claims are not always as straightforward as they are meant to be, as employers may dispute the validity of an employee’s claim.
Some of the most common disputes that arise in workers’ comp claims include:
To be eligible for workers’ compensation benefits in Fairburn, Georgia, you must be an employee in a business or company that employs 3 or more workers, whether on full-time or part-time basis. Your employer must also carry workers’ compensation as is the legal requirement in Georgia. You may also be entitled to workers’ comp benefits if you are a statutory employee.
Your Fairburn workers’ comp claim may be disputed on grounds of employment status if you work as a:
- Railroad employee
- Independent contractor
- Federal employee
- Farm laborer (with some exceptions)
Outside Scope of Employment
An important factor that is considered before awarding workers’ comp benefits is whether your injury arose directly out of work and whether it occurred in the course of employment. Claims based on injuries that are caused by reasons other than work-related reasons may therefore be disputed.
Some injuries that aren’t covered under Georgia’s workers compensation laws include:
- Injuries due employees’ willful misconduct
- Workplace injuries that occur during lunch and rest breaks
- Injuries that occur on your way to and from work
- Horseplay injuries
- Injuries resulting from workplace fights or aggression
- Strokes and heart attacks, unless there is clear medical evidence showing that these were as a direct result of your work
- PTSD, emotional anguish, or pain and suffering, unless these are direct outcomes of suffering a workplace accident or disability.
Lack of Causation
To be eligible for workers’ compensation benefits, employees must prove that their injury resulted directly from a workplace accident and nothing else. If you had a pre-existing condition at the time of injury, it is imperative that you prove that your work led to the aggravation of this condition for you to receive workers’ compensation benefits. Otherwise, your Workers’ Compensation Disputes in Fairburn, GA may be denied for lack of causation.
There is limited time for every workers’ comp case in Georgia. Employees who get injured while on the job are required to report their injury to their employer immediately but not later than 30 days from the date of injury. If your claim is denied, you should file Form WC-14 with the Georgia’s Workers’ Compensation Board within 1 year of your injury. Failure to observe these deadlines may lead to the loss of your workers’ compensation rights.
Providing scanty information when reporting your workplace could easily lead to the denial of your claim. It is important to provide as much information as possible to help your employer investigate and establish the facts of your injury. It is advisable that you indicate the date and location of the accident, the name of any co-worker who witnessed the workplace accident, the symptoms of the injury, and possibly, photos of the injured part.
What to do if Your Workers’ Comp Claim is Denied in Georgia
If your workers’ compensation has been denied, the most reasonable step to take is to request a hearing before the Workers’ Compensation Board of Georgia. This is one by filing Form WC-14 not later than 1 year from the date of your injury. Speaking to a workers’ compensation attorney also helps with your appeal, as your lawyer will guide you through the claim filing process and presentation of your case before the Administrative Law Judge.
Types of Workers’ Compensation Disputes in Fairburn, GA
While there are various Workers’ Compensation Disputes in Fairburn, GA that may arise in workers’ compensation claims, the most common are medical and claim disputes.
Basically, these are disputes that involve questions over the medical facts of your injury or treatment following your injury. For such disputes, the treating physicians are usually in a better position to provide the facts required in your claim. Such disputes include:
- Denial or refusal of reasonable surgery
- Denial or refusal of physical therapy
- Denial or refusal of in-home care or assisted living arrangements
- Denial or refusal of prescription drugs and medical equipment like braces and crutches.
These are also referred to as indemnity disputes, and usually arise due to legal reasons with which a workers’ compensation attorney can help. Some of the commonest claim disputes include:
- Eligibility for workers’ comp benefits
- Disability, and whether you have lost your income following your injury or occupational illness
- Extent of injury
- Average weekly wage disputes
Workers’ Compensation Disputes in Fairburn and Appeals Process in Georgia
Whenever a dispute arises and puts your workers’ comp claim on hold, it is important that you request a hearing before the Workers’ Compensation Board of Georgia. If you’re not satisfied with the benefits awarded, you can appeal and present your case before an Administrative Law Judge in a contested case hearing. It is important that you get a lawyer to represent you and present testimonies since your employer’s insurance carrier will also have one. Ultimately, the judge will decide whether to award you benefits, and how much.
Workers’ Compensation Disputes in Fairburn, GA are not uncommon, and employees may cite various medical or indemnity reasons to deny your claim. If your claim has been denied or contested, it is important that you speak to a lawyer to guide you on the steps to take. At the Workers’ Compensation Lawyer Coalition, our attorneys are experienced at handling workers’ compensation claims and can help you whenever Workers’ Compensation Disputes in Fairburn arise. Call us today at 770-796-0919 or fill our online form to schedule a meeting with one of our Fairburn workers’ compensation lawyers.