Georgia workers’ compensation exists to protect employees and employers. For employees, it reduces your risk of suffering a significant financial burden because of an injury you obtain while performing your work duties. For employers, it reduces the risk of being sued by a worker who is injured on your job.
The workers’ compensation claims process in Sandy Springs, Georgia can be difficult. You must follow the right steps when filing a claim. There are certain scenarios where an injury may be denied or certain aspects of the accident may be disputed. The insurance provider may refuse to pay for a specific medical treatment or argue that your condition is not as severe as you claim.
Attempting to argue your legal rights with a massive insurance company can be a very daunting task. It’s even worse if you’re seriously injured and want to focus on your recovery. But you don’t have to fight against the insurance company alone. Our team of Sandy Springs workers’ compensation lawyers is here to help you during this ordeal.
We take a consistent and aggressive approach to defending our client’s rights. From collecting evidence to representing clients in claim denial hearings, we undertake all of the difficult legal work necessary to win your claim. Call the Workers’ Compensation Lawyers Coalition in Sandy Springs at 770-796-0919 if you want to fight for your right to compensation.
How Can I Know If My Injury Will Be Covered By a Workers’ Comp Claim?
There are a handful of criteria that must be met before an injury can be covered by a workers’ compensation claim. Most of these criteria are outlined clearly in the Workers’ Compensation Act. They include the specific circumstances of the injury as well as some responsibilities of the employee and employer.
You Must Be Covered by a Worker’s Compensation Insurance Policy:
If you work for a business with three or more employees, then they are legally required to have a workers’ comp policy. Your coverage begins your first day of work. You must have an employee-employer relationship with the policyholder. This means that most independent contractors will not be covered.
You can verify an employer’s coverage at the State Board of Workers’ Compensation website.
Your Injury Must Be Caused by Your Work
You must experience an injury or illness that arises “out of and in the course” of your normal employment. This is legal terminology that insurance providers will often use to dispute claims. It means that your injury must have been caused by your normal work duties and must have occurred while performing those duties. If you get into a fight with a coworker or fall down the stairs while taking a break, then it’s highly unlikely that your injury will be covered.
You Must Meet Certain Responsibilities
You must have met and continue to meet certain legal responsibilities. They include following safety guidelines, reporting the incident immediately, filing a claim within the deadline, showing that the accident wasn’t caused by misconduct, agreeing to a drug test, and attempting to perform work that is approved by your treating physician. Failing to meet any of these responsibilities could result in the denial or termination of your claim.
As long as you meet these three criteria, then nearly all forms of injury or illness that are caused by your employment will be covered. There are not strict guidelines regulating specific types of injuries that are prohibited. Common examples of covered injuries include:
- Broken bones
- Loss of sight or hearing
- Amputations or loss of limb functionality
How Long Do You Have to File a Workers’ Comp Claim in Georgia?
You should immediately report your injury to your employer. There is a deadline of 30 days to report a workplace injury. There is also a deadline of 1 year from the time of the injury to file a workers’ compensation claim. If your employer provided you with treatment for an injury, then you have exactly one year from the last date of treatment to file for compensation benefits.
Similarly, with occupational diseases, you have one year from the date that you were diagnosed or became aware of the condition. You may also be limited by one year from the time that you reasonably should have become aware of the link between the disease and your employment. There is a seven-year maximum from the last date of exposure to hazardous chemicals to file a related claim.
How to File a Workers’ Compensation Claim in Sandy Springs, Georgia?
If you properly reported your injury to your employer and they performed their responsibilities, then you should receive a WC-14 form. If you did not receive this form, then you may obtain one for free from the State Board of Workers’ Compensation either through their website or by contacting them via phone or mail. Your claim will then be either approved or denied.
If your claim is denied, then you have the option to appeal and request a hearing. The hearing will include an Administrative Law Judge who will ultimately decide if you should receive benefits and to what extent. There are further options for an appeal if you are likewise denied by the judge.
We advise working with a local workers’ compensation lawyer when you begin the filing process. Working with a lawyer is even more important if you are going to appeal a denial before an Administrative Law Judge. These legal hearings are very similar to court trials. Having expert legal representation on your side will help your case tremendously.
Get Help With the Workers’ Comp Claims Process in Sandy Springs
Nearly all injuries and illnesses can be covered by Georgia’s workers’ comp as long as certain conditions are met. If you suffered an injury at work and while performing your expected duties, then you have a right to receive benefits. Just because an insurance provider tells you that you are denied doesn’t mean they are right.