Under workers’ compensation, the award of benefits to employees who are injured while on the job is supposed to be straightforward. This system covers most workers from compensable work injuries and employers from possible lawsuits, especially if they were at fault for the workplace accident.
Workers’ comp laws make it clear the type of injuries that can be compensated, and these claims are not always as straightforward as you would expect. It is common for Morrow workers’ compensation disputes to arise within the claim process, which can be utterly frustrating to the injured employee. This is why working with a lawyer who specializes in Georgia law is of utmost importance.
At the Workers’ Compensation Lawyers Coalition, our Morrow workers’ compensation lawyers can help you with your claim by investigating your injury and helping you report your injury and file your claim in time. If you have been injured and haven’t reported your injury yet, call us today on 470-518-5026 to schedule a free legal consultation.
Common Causes of Morrow Workers’ Compensation Disputes
Your Georgia workers’ comp claim may be disputed on various grounds, which could lead to the denial of your claim. In most cases, the reasons for disputing your workers’ comp claim will be as follows:
Typically, workers’ compensation covers those who are employed in a company or business with 3 or more employees, whether on a full-time or part-time basis. Some types of workers aren’t covered under workers’ compensation, and their claim may be disputed by their employers if they file one in the event of a work-related injury.
Under Georgia’s workers’ compensation laws, some of the workers that aren’t covered by this system include:
- Federal employees
- Independent contractors
- Railroad workers
- Domestic workers
- Farm laborers, unless an employer carries workers’ comp and notifies the State Board of Workers’ Compensation.
Outside Scope of Employment
Workplace injuries are only compensable if they arise out of and in the course of employment. If your injury occurred due to reasons other than work-related ones, then your employer will most likely dispute your claim. some of the injuries that are considered to be outside the scope of employment include:
- Horseplay injuries
- Injuries that occur due to an employee’s willful wrongdoing
- Injuries that happen on your way to and from work
- Lunch and rest break injuries
- Injuries due to workplace fights
- Heart attacks, strokes, PTSD, or emotional pain, unless there is a clear link between your workplace injury and these conditions backed by medical evidence.
Lack of Causation
If your employer believes that your injury wasn’t a direct cause of the workplace accident you reported, they might dispute your claim citing lack of legal causation. Workers’ compensation only awards benefits to injured employees if their injury was solely as a result of the workplace accident they reported.
It follows that your workers’ comp claim can be disputed by your employer if your injury was due to the aggravation of pre-existing conditions rather than the workplace accident itself.
Georgia workers’ comp laws are clear on the various deadlines that should be observed in reporting and filing a claim. If you have been injured while on the job in Morrow, you are required to report your injury to your employer or supervisor not later than 30 days from the date of the accident.
Your workers’ comp claim should also be filed within 1 year from the date of the workplace accident if you’re to receive your benefits.
The report provided for your workplace injury should be elaborate and with as many details as possible. If you leave out vital details when reporting your injury, your employer may dispute your claim if they establish the facts of the injury after investigation.
Providing truthful and verifiable information about the injury can help prevent a possible claim dispute. When reporting, it helps greatly to indicate where and when the workplace accident happened, the name of a co-worker who witnessed the accident, and the immediate symptoms of your workplace injury.
What to Do If Your Workers’ Comp Claim Is Denied in Georgia?
If your claim is denied by your employer or their insurance carrier, you have 1 year from the date of the accident to request a hearing before the Workers’ Compensation Board of Georgia. A hearing is requested by filing Form WC-14 and awaiting the board’s decision to grant or deny the hearing request.
It is also important that you speak to a workers’ comp lawyer who specializes in Georgia law if your claim has been denied. A lawyer will investigate your workplace accident, establish the facts of your injury, and prepare a case against your employer if they believe that your claim was unfairly disputed.
Types of Workers’ Compensation Disputes
Workers’ compensation disputes can take various forms, but the main ones are medical and claim disputes.
These disputes arise following questions or doubts about the medical facts of your workplace injury. They may also arise if you failed to seek medical treatment from the workers’ compensation physician recommended to you by your employer.
Other disputes that are considered medical disputes include refusal of reasonable medical treatment, including surgery, physical therapy, in-home care, medical equipment, and prescription medication.
Also referred to as indemnity disputes, claim disputes usually stem from legal reasons and a workers’ comp lawyer can help whenever such disputes arise. Some common aspects of claim disputes include:
- Validity of your claim and your eligibility for workers’ comp benefits
- Extent of your workplace injury
- Issues of disability where you are likely to lose your income due to the workplace injury
- Calculation of your average weekly wages and other benefits.
Workers’ Compensation Dispute and Appeals Process in Georgia
In the event of a claim dispute or denial, the reasonable thing to do is request a hearing before the State Board of Workers’ Compensation by filing WC-14 Form. If a hearing date is granted, an Administrative Law Judge will listen to you (or your lawyer) and the employer (of the defense team) and decide whether to award you benefits or not.
Let Us Handle Your Morrow Workers’ Compensation Dispute
Workers’ comp claims are often disputed for various reasons. If your employer has disputed your claim, it is important that you seek the legal counsel of an experienced attorney to ensure that you receive the benefits you’re entitled to.