According to Georgia workers’ compensation laws, any employee (whether part-time or full-time) working for an employer with at least three employees who get injured while on the clock is entitled to workers’ compensation benefits. This should cover their medical treatment, wage loss, and other losses. However, employers and insurance companies are notorious for denying employees’ claims for benefits or suggesting a lower compensation amount than what the employee deserves.
There are many reasons why an employer may dispute your claim, from missed deadlines to the lack of enough evidence. If you find yourself in a Sargent workers’ compensation dispute, call the Workers’ Compensation Lawyers Coalition. We have vast experience dealing with workers’ compensation claims and we can file an appeal if your claim is unfairly denied.
Call our Sargent workers’ compensation lawyers today at 470-518-5026 for the best legal representation and to secure the maximum benefits owed to you.
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Causes of Workers’ Compensation Disputes in Sargent, Georgia
Employers and insurance companies use various tactics to try and justify their reasons for denying your claim. If an employer is able to prove either of the following, then they will have legal grounds to deny your claim:
Employment Status
In the state of Georgia, part-time and full-time employees injured while on the job are entitled to workers’ compensation benefits as long as the employer has at least three employees. It is important to note that independent contractors aren’t entitled to workers’ compensation benefits under Georgia law. As a result, the employer may try to take advantage of this and argue that you are an independent contractor other than a legitimate employee. If this happens, you need to get legal help as soon as possible.
It is also important to note that even if you were injured as an employee of the company but are no longer an employee – perhaps you quit or were fired due to a legitimate reason, then you can’t file for workers’ compensation benefits later. You need to be a current employee of the company.
Outside Scope of Employment
If you were injured while doing something that wasn’t reasonably part of your job duties, then your employer may have grounds to deny your claim. For example, in case you were injured offsite while on a break, then your injuries aren’t compensable under Georgia Workers’ Compensation.
Lack of Causation
For you to be eligible for workers’ compensation benefits, there needs to be a causal link between your job and your injuries. This means that your injuries must have arisen due to the nature of your job or as a result of an unsafe condition at your workplace.
Missed Deadline
If you’ve been injured while on the clock, it is imperative that you report the injury to your employer as soon as possible. under the law, you should do this within 30 days of your injury. If you fail to report your injury within this period then you risk forfeiting your right to seek workers’ compensation benefits and thus, your employer will have a right to deny your claim.
Inadequate Information
When reporting your injury, you need to provide as much information as possible about your accident and injury to prove your claim. You need to provide details about how the accident happened, when it happened, part of the body that was affected, and details of any available witnesses. Failure to provide enough information and the lack of witnesses can lead to your employer denying your claim.
What to Do If Your Workers’ Comp Claim Is Denied in Georgia?
If your claim has been denied for some reason, it doesn’t mean that that’s the end of the road for you. There are still some options available.
Your next step should be to request a hearing before the Georgia State Board of Workers’ Compensation where an administrative law judge will make a determination on your case. To request a hearing, you simply need to complete and submit a WC-14 form. However, note that this should be done within one year of your injury.
Once your claim has been denied it is crucial that you hire an attorney who will help you deal with the appeals process. Your attorney will help ensure that everything is done according to procedure and all deadlines are met. Your attorney will also help you in gathering and presenting all the necessary information to the judge.
Types of Sargent Workers’ Compensation Disputes
There are two main types of workers’ compensation disputes that employees can find themselves dealing with in Sargent, Georiga. The reasons why your claim may be disputed fall under two key categories:
Medical Disputes
These are disputes based on medical grounds. In this case, the employer may claim that you failed to promptly seek medical attention indicating that your injury isn’t as serious as you claim. They may also argue that your injury was pre-existing or wasn’t caused as a result of your job.
Claim Disputes
These are disputes based on errors and technicalities involved in the claims process. For example, your employer may claim that you failed to report your injury on time, the statutes of limitations for filing your claim had lapsed, etc.
Workers’ Compensation Dispute and Appeals Process in Georgia
Here is the process of workers’ compensation disputes and appeals in Georgia
- Filing a Notice of Claim
In the event that your claim is denied, your first step will be to file a WC-14 form and request a hearing before the State Board of Workers’ Compensation.
- Mediation
Before the actual hearing, the two sides involved will try to resolve the claim dispute and negotiate a settlement deal.
- Claim Denial Hearing
In the event that the dispute isn’t resolved during the mediation phase, the two parties will prepare for the hearing. This hearing should be scheduled within 60 days of you filing the Notice of Claim. Evidence will be presented by both sides and a judge will make a ruling.
- Appeal
In case you aren’t satisfied with the judge’s decision, you can appeal your denial all the way up to the Courts of Appeal.
Get Help With Your Sargent Workers’ Compensation Dispute
Suffering a workplace injury can be a very stressful and painful time for anyone. This is only made worse when your Sargent workers’ compensation claim is unfairly denied by your employer or their insurance company. Fortunately, all is not lost. At the Workers’ Compensation Lawyers Coalition, we believe that you deserve your rightful compensation if you are hurt on the job.
This is why we are prepared to fight aggressively for your rights all the way to the end. We will help simplify the daunting appeals process and ensure that you are awarded the full compensation that you deserve. Call us today to get the financial compensation that you deserve.
