Every day, employees all over Georgia are injured while performing their day-to-day tasks. Regardless of the job you perform, you may still end up getting hurt. Some workplace injuries may be severe and require long-term treatment and home-based care. Sometimes, employers help employees with their compensation claims. However, there are times when Roswell workers’ compensation disputes arise after work injuries.
Workers’ comp insurance is meant to cover your compensation benefits after a workplace accident. This insurance policy protects workers in Georgia in the event of work-related accidents. Unfortunately, your employer’s insurance company may deny or limit your work injury claim.
If your employer or their insurance company has denied, devalued, or delayed your compensation benefits, you have the right to appeal. Contact our Roswell workers’ compensation lawyers today for expert legal representation. What’s more, we offer free case reviews for work injury dispute cases.
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Causes of Roswell Workers’ Compensation Disputes
After filing a workers’ compensation claim, the insurance company may dispute your claim. They’ll respond to you in writing detailing why they’ve denied your claim. Here are some common causes of workers’ compensation disputes in Roswell, GA:
Employment Status
According to Georgia’s workers’ compensation laws, only employees are eligible to receive compensation benefits after work injuries. Regular part-time workers may also be entitled to these benefits after workplace accidents. Independent contractors and subcontractors cannot file Roswell workers’ compensation claims after work injuries.
Outside Scope of Employment
An insurance company may dispute your claim if your injury is outside the scope of your employment. Your work injury should typically fall within your line of work. For instance, an insurance company may deny your claim if you suffer from black lung disease which is most associated with coal miners while you are a full-time receptionist. Long-term inhalation of coal dust causes pneumoconiosis. They may argue the injury is outside the scope of work.
Lack of Causation
After a work injury, you must prove that your workplace accident caused your injury. If you cannot link your injury to the accident, the insurance company may cite reasons such as pre-existing conditions as the reason for your denial.
Missed Deadline
Workers’ compensation claims have a statute of limitations that all employees and employers must follow. If you fail to report your Roswell work injury claim within 30 days, the insurance company will dispute your claim.
Inadequate Information
After a workplace accident, you’ll be required to submit evidence such as proof of injuries (photographs and medical records) and eyewitnesses. Always cooperate when the insurance company asks for additional information. They may deny your claim on the grounds of inadequate information.
What to Do If Your Workers’ Comp Claim Is Denied in Georgia
An experienced Roswell workers’ compensation lawyer can help you overturn an insurance company’s decision. Our attorneys have a clear understanding of how this process works. We will look into the facts of your case and advise you about your legal options.
Our reliable workers’ compensation law firm in Roswell will also request a hearing with the State Board of Workers’ Compensation (SBWC). We will file a Notice of Claim form (WC-14 form) to ensure you get maximum compensation for your work injury. Workers’ Compensation Lawyers Coalition will also send a copy of the WC-14 form to your employer and the insurance carrier.
Types of Workers’ Compensation Disputes in Roswell
Many issues can result in workers’ compensation disputes in Roswell, GA. Some of the disputes our seasoned workers’ compensation attorneys handle include:
Medical Disputes
According to workers’ compensation laws in Georgia, insurance companies must cover 100% of all medical expenses after work injuries. You may sustain injuries such as bone fractures, back injuries, burns, traumatic brain injuries, or exposure to hazardous or radioactive materials.
Your employer’s insurer should cover all expenses for your drugs, hospital rides, doctor appointments, surgeries, physical therapy, and diagnostic procedures. Unfortunately, the insurance company may refuse to pay these medical bills after a work injury.
Claim Disputes
Your employer and the insurance company may dispute your entire claim, resulting in a claim dispute. These disputes arise from issues such as:
- Average weekly wage computation, payment, and delays
- Work capacity decisions
- Return to work formula
- Retaliatory discharge
If you are facing issues after your work injury, talk to a Roswell work injury attorney. At the Workers’ Compensation Lawyers Coalition, we can help you with your workers’ compensation disputes. We will hold negotiation talks with your employer’s insurance provider to find common ground and resolve your dispute.
Workers’ Compensation Dispute and Appeals Process in Georgia
If your employer and the insurance company dispute your claim, you have the right to appeal their decision. Remember, workers’ compensation should cover all your medical expenses and part of your lost wages. A reliable workers’ compensation lawyer in Roswell, GA can help you throughout the appeals process.
Here’s how it works:
- Completing and filing the Notice of Claim form
- Mediation talks with your employer’s insurance adjusters and attorneys
- Workers’ compensation hearing within 60 days
- Appeals to the appellate division of SBWC if you are unsatisfied with the verdict
- Moving to the Georgia Court of Appeals and then the Georgia Supreme Court as the last resort
Contact Us Now to Discuss Your Roswell Workers’ Compensation Dispute
Work injuries do not only happen in construction sites or manufacturing plants. They can occur in any industry. Even desk job employees can suffer from slips and falls that cause permanent injuries. If your employer has denied your compensation claim, you may still be eligible to receive compensation benefits.
You should reach out to a trusted work injury law firm in Roswell before embarking on your workers’ compensation dispute. Workers’ Compensation Lawyers Coalition can help you with all the legal aspects of your case. Our lawyers will guide you to ensure you don’t ruin your chances of securing maximum compensation benefits.
Call 470-518-5026 now to begin the legal proceedings. Our attorneys will answer any questions that you may have. We also offer free case reviews for all workers’ compensation disputes.