According to Georgia Workers’ Compensation Law, a worker can qualify to receive compensation benefits for a workplace illness or injury. However, there are a few issues that impact the chances of eligibility and recovery of your losses. Most employees fear the benefit claims being denied or lowered by the employer or the insurance carrier. However, the law does give leeway for workplace accident victims facing workers’ compensation disputes in Tucker.
If you are pursuing a workers’ comp case for a sickness or injury you sustained on the job, it is best to consider working with a reputable and experienced lawyer. At the Workers’ Compensation Lawyers Coalition in Tucker, Georgia, we know what it takes to fight for an employee’s rights and interests after being involved in an occupational accident. We are your best bet when it comes to handling worker’ compensation disputes.
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Common Causes of Workers’ Compensation Disputes in Tucker, GA
Georgia’s Workers’ Compensation Act stipulates that the employer and employee must honor some obligations when handing a workers’ compensation claim. The responsibilities play a significant part in determining the benefits the claimant should receive based on if the injury/illness is compensable and the extent of the harm.
Failure to file the claim in time and according to the requirements can be something that your employer and the insurance carrier exploit to dispute your claim. Some of the issues that lead to workers’ compensation disputes include:
Failing a Drug Test
You are likely to undergo some medical examination that includes a drug test after the workplace accident, which is meant to check if you were intoxicated when working. If the tests show you were under the influence of a substance, it will imply that the incident and resulting harm were due to your negligence an and this can be used to deny your workers’ comp claim.
Employment Status Dispute
The claimant’s employment status is a factor that significantly influences the eligibility to receive benefits for an occupational illness or injury. Therefore, it is best to confirm your employment status and your qualification for recovering damages.
After the accident, employees are expected to provide 3concise details of the incident, showing how and why it happened. The information you provide regarding the accident and the resulting harm you suffered will strengthen your claim, and things are better if you have potential witnesses to back up your claim.
The Absence of a Workers’ Compensation Policy
While the law expects employers to carry workers’ compensation insurance if they have two or more employees, you will not receive any benefits if your employer did not provide the coverage.
Rest assured the odds of getting denied are greater if you miss the deadline for filing your workers’ compensation claim. Georgia state laws are very particular about this and lay out stringent requirements that the claimant must honor when pursuing the workers’ comp lawsuit.
Outside Scope of Employment
At times, employers can dispute your claim by suggesting that the accident happened outside your work hours. For example, it can be on your lunch break, but this might not stand if it was during diner or lunch with a business client.
Not Seeking Immediate Medical Attention
Going for a medical checkup later than required, especially with no sound reason for it, can be detrimental to you getting the benefits. Your employer or the insurer can use this to dispute your claim, stating that your injury or illness is not work-related or that they are not severe as you purport.
Prior Workers’ Compensation Records
Insurers are likely to dispute your claim if you have one or more pending workers’ compensation lawsuits, citing that it is a tactic you use to defraud businesses. But such allegations need a strong backing of facts, which your attorney will disclaim and ensure you get what you are rightly owed.
Lack of Causation
It is a strategy in which the victim must prove their sickness or injury and the nature of their work are interrelated. Meaning that the accident is a possible, though not highly expected, occupation hazard.
Failing to Report Your Injury or Accident
Not reporting the occupational accident to the relevant authorities soon after it happened can be a loophole your employer and insurer exploit when disputing your workers’ compensation claim. As such, reporting the accident soon after it occurs improves your chances of recovering the benefits.
You can minimize the chances of a disputed claim by working with an attorney in Tucker, GA, specializing in workers’ compensation lawsuits. At the Workers’ Compensation Lawyers Coalition, we are committed to helping employees fight for their rights and interests when filing a workers’ comp lawsuit.
What Do I Do If My Workers’ Compensation Claim Has Been Denied?
You still can appeal a workers’ compensation claim denial if you believe that you should be awarded the benefits and have enough facts to support your claim. We can help you disclaim any disputes used to deny the claim. However, it is wise for us to point out that appealing the denial has its challenges and will need adequate time and effort.
Your lawyer will help you file a WC-14 form requesting a hearing that will be scheduled to take place 60 days after approval. Moreover, the window for filing the appeal is restricted to under 12 months from when the workers’ comp claim was denied. You also must have your legal counsel present during the appeal, representing the facts that show why you disputed your claim’s denial.
Types of Workers’ Compensation Disputes
Workers’ compensation disputes in Tucker, Georgia are categorized into two types:
- Medical Disputes – which entail disputes associated with medical treatment and care for your occupational sickness or injury. Your attorney can outline issues related to liability disputes, injury management disputes, medical/rehab disputes, or permanent impairment disputes, among others.
- Claim disputes – That cover matters related to the nature of your job. Your lawyer can outline issues such as premium disputes, work capacity decision review disputes, and employment benefits disputes, among others.
What’s The Workers’ Compensation Dispute and Appeals Process in Georgia?
Pursuing a workers’ compensation dispute in Georgia, will see your attorney consider one of the following processes:
- Filling the appeal via the administrative law judge requires you and your lawyer to attend the hearing in the court before the judge.
- Filing the appeal via the State’s Workers’ Compensation Board or the State’s Appeal Court Judge request a review of the previous judgment to review the decision in your favor having considered all the facts your attorney presents that prove you are entitled to getting fair compensation for your occupational injury or illness.
- We are committed to taking the matter to the Supreme Court in Georgia if these options fail.
Let a Dedicated Attorney Handle Your Workers’ Compensation Dispute
Having tried and failed is understandable, but it should not make you despair if you know that the ruling on your workers’ comp lawsuit was unjust more so if you have sufficient proof. What you need is an experienced and committed team of law experts on your side that know how to present the evidence and ensuring you have a winning formula. That is what we at Workers’ Compensation Lawyers Coalition in Tucker, GA offer employees that come to us for help.
Pursuing workers’ compensation disputes can be complex, but you should not burden yourself with such things as you also focus on recovering and resuming work. Let us help you fight for your rights and interests. Call us at 770-796-0919 or fill out our online contact form for a free care review and learn more about how to secure your chances of getting fair compensation.