Georgia workers’ comp claims can range from simple to infuriating and confusing depending on several variables. The nature of the injury, its severity, and any pre-existing conditions will all influence the complexity of the workers’ compensation claims process in Peachtree Corners and the likelihood of denial.
Workers’ compensation laws in Georgia have very specific guidelines that have to be followed when filing a claim. Understanding these guidelines is crucial to ensuring that you stand a chance of receiving the benefits you deserve for your injuries. Our Peachtree Corners workers’ compensation lawyers can guide you through the claims process from start to finish.
Call the Workers’ Compensation Lawyers Coalition at 470-518-5026 for a free consultation today.
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How Can I Know If My Injury Will Be Covered By a Workers’ Comp Claim?
While it can be impossible to predict the approval decisions of an insurance company, there are still some questions you can ask yourself to determine the likelihood of your injury being covered. With the exception of heart attacks and strokes, nearly all types of injuries that can occur at work are covered. And even then, there are still some circumstances where a stroke or heart attack may be covered.
Here are a few questions you can answer to help determine eligibility:
Were You Injured While Acting Within the Scope of Your Employment?
The Georgia Workers’ Compensation Act is very clear in this regard. An injury may only be covered by workers’ comp insurance if it occurs while performing your normal work duties.
This means there are a few work-related scenarios where you might not be covered. For example, if you are injured while on lunch, while on break, or during your commute to work, then you may not be covered. It also means that you may be covered for injuries that occur during mandatory company events.
Was Your Injury Caused by Your Work Activities or Environment?
Simply suffering an injury while at work is not always sufficient to receive a claim approval. This is why heart attacks and strokes are often not covered by Georgia workers’ comp policies. It needs to be shown that your injury was a direct result of your work environment or activities. It is possible for the aggravation of a pre-existing condition to be covered if the source of aggravation can be proven to be your work environment.
Were You Injured Because of Willful Misconduct?
Georgia law provides employers with a willful misconduct defense option. This defense infers that the worker was injured because of a willful failure to follow accepted standards with the understanding that doing so would likely result in an injury. This is not the same gross negligence. It is up to the employer to prove that willful misconduct occurred. They will rely on witness statements and potential footage of the accident.
Were You Under the Influence of Alcohol or Drugs?
Claim denial because of intoxication is fairly common. You are required to submit to a drug test as well as a blood alcohol test within three hours of the incident. If the employer was unable to request the blood alcohol test within the acceptable time frame, then they will rely on secondary evidence sources.
Some insurance providers will attempt to utilize this defense even without adequate evidence to support their claim. Working with a professional workers’ comp attorney will help you win this battle.
Did You Notify Your Employer or Supervisor of the Injury?
You are advised to notify your supervisor of any injury immediately. After notifying them, you can receive a list of approved company physicians and seek medical treatment.
There are some situations where you might be unable to notify your employer immediately because of the circumstances of the accident. You will have up to 30 days to notify your employer or your injury claim will be denied.
How Long Do You Have to File Your Workers’ Comp Claim in Georgia?
There are a handful of deadlines that you need to remember if you do not want your claim to be denied. The first is the 30-day deadline before which you must report your injury to a supervisor or employer. However, even waiting close to this deadline could result in some form of dispute from the insurance company. That’s why we always recommend reporting your injury as soon as you are possible.
Workers’ compensation claims adhere to a statute of limitations similar to personal injury claims. In ideal cases, your employer will begin providing benefits shortly after your injury report. But if this does not occur, then you have up to 1 year from the accident to file a workers’ compensation claim with the Georgia State Board of Workers’ Compensation.
What if your employer pays for some form of medical treatment? That will extend the statute of limitations for filing the claim each time you receive medical treatment. That means you have up to 1 year from your last treatment paid for by the workers’ compensation insurance policy to file your claim. This only applies to treatments paid for by workers’ comp insurance and not treatments you pay for yourself.
What if your employer provides you with some wage loss compensation? This extends the statute of limitations by up to two years. You will have two years from the last weekly benefits check to file your workers’ comp claim with the board.
All of these deadlines are fairly generous and should be avoided when possible. The sooner you file your claim the sooner you can reach a resolution and potential settlement. If you need assistance filing your claim, then contact our local office in Peachtree Corners for assistance.
How to File the Workers’ Comp Claim in Georgia?
Filing a workers’ compensation claim is fairly simple. All that you need to do is print out the WC-14 form from the State Board of Workers’ Compensation website. You then complete the form and mail it to the address supplied on their website. You can work with a workers’ compensation attorney to ensure that you have properly completed and filed the form within the provided time frame.
Get Help With the Workers’ Compensation Claims Process in Peachtree Corners
If you were injured while performing your work duties, were not under the influence of alcohol, and were adhering to normal safety standards; then there are very few reasons why your claim should be denied. An insurance provider may still attempt to deny the claim to avoid payments.
With the help of a professional legal team, you can overturn that denial and receive the benefits that you are legally entitled to. If your Peachtree Corners workers’ comp claim has been denied, then call us immediately at 470-518-5026 for a free case evaluation.
