Thanks to workers’ compensation insurance, anyone who works for a company with three or more employees in Georgia qualifies to receive benefits for any injuries sustained in the workplace. However, while workers’ comp is there to protect workers’ rights to receive medical care and benefits, there are a few issues that might affect your chances of getting the benefits you deserve for your damages.
Many injured workers fear that their compensation claim might be denied, or the compensation amount lowered. As someone who sustained injuries while working, there is a chance that this could happen to you, especially if your employer and the insurance provider decide to dispute your claim. Fortunately, however, there are laws in place that are designed to ensure that parties with an interest in your claim don’t take advantage of your situation to deny you benefits.
If you’ve been injured at work and believe that your employer is trying to deny your claim by disputing your injuries, then consider getting in touch with us at the Workers’ Compensation Lawyers Coalition today for help. Our workers’ comp attorneys have years of experience in workers’ compensation disputes in Vidalia and can help protect you against your employer’s or their insurer’s ploys to deny you benefits.
Call 470-518-5026 now to book a meeting with our attorneys for legal counsel and a chance to have your case reviewed for free.
Table of Contents
Common Causes of Workers’ Compensation Disputes in Vidalia, Georgia
According to Georgia’s workers’ compensation act, there are obligations that both the employee and employer must honor when handling a workers’ comp claim. These responsibilities play a vital role in determining what benefits the injured worker should receive based on the injuries they’ve sustained and if they are compensable.
As an injured worker, failing to file a claim within the stipulated time by set laws is something that insurance companies and employers often exploit when disputing a claim. Other issues that might lead to workers’ compensation disputes in Vidalia, Georgia, include:
Failing a Drug Test
After or when receiving treatment for your injuries, chances are you will be subjected to a drug test to find out if you were under the influence of a drug or alcohol when the incident happened. If it’s found out that you were either drunk or high when the accident happened, then chances are your compensation claim will be denied on negligence grounds.
Employment Status Disputes
Employers will sometimes dispute the fact that an injured worker was not their employee when the incident happened. As a worker, make sure that you know your employment status and if you qualify for workers’ compensation to avoid complications when pursuing a claim.
Insufficient Information
After getting injured at work, you are expected to provide accurate details of what happened and the injuries sustained. If it’s discovered that the information you provided is inaccurate or falsified, you could end up having your claim denied. Apart from that, you risk prosecution for providing false information.
Absence of a Workers’ Comp Policy
While Georgia’s workers’ comp laws expect people who employ at least three workers to carry workers’ comp insurance, you won’t get compensation if your employer doesn’t have coverage.
Missed Deadlines
Missing the deadline for filing a workers’ comp claim is one of the most common reasons why employers dispute claims filed against them. In Georgia, you have one year from the day you got injured to file your claim. If you miss this deadline, you lose your right to file for compensation.
Outside Scope of Employment
In some instances, employers will dispute an injured worker’s claim by suggesting that they got injured outside of work hours, like during a lunch break.
Lack of Causation
Insurance companies and employers might try to dispute a claim by arguing that the injured worker has no proof that the injuries sustained and the nature of the work that they do is interrelated.
Failing to Report an Accident or Injury
Not reporting a work-related accident or injury to the relevant authorities as soon as it happens is a loophole that insurance companies and employers exploit when trying to discredit a claim. If you’ve been injured at work, make sure you report the incident as soon as it happens to increase your chances of getting the benefits you deserve.
To eliminate any chances of having your claim disputed by your employer or his insurance provider, get in touch with our workers’ comp lawyers in Vidalia for legal counsel and representation you can trust. At the Workers’ Compensation Lawyers Coalition, we’re committed to helping injured workers such as you fight for their rights to receive the benefits they deserve for their injuries.
What Do I Do If My Workers’ Comp Claim Has Been Denied?
If you’ve had your claim denied for whatever reason, you still have the option to appeal it, as long as you have the facts to support your case. Our attorneys can help you repudiate any claims made by your employer to deny you benefits. However, it’s worth noting that appealing a workers’ comp claim denial has its challenges and requires time and effort.
You start the process by filing a Notice of Claim or WC-14 form, which requests a hearing that’ll be scheduled to happen in sixty (60) days after approval. Apart from that, it is also worth noting that the window for filing an appeal in Georgia is one year from the day the claim was denied. Furthermore, due to the complexities of the process, you are required to have an attorney present to explain why you disputed the denial and represent the facts.
Types of Workers’ Compensation Disputes
Workers’ comp disputes in the state of Georgia fall under one of two categories:
Medical disputes
These entail disputes associated with the medical care and treatment of your work-related injuries or sickness. Your lawyer can outline issues related to injury management disputes, liability disputes, permanent impairment disputes, or rehab disputes, etc.
Claim disputes
These cover all matters related to the type and nature of the work you do. Your attorney can outline issues like employment benefit disputes, premium disputes, and work capacity decision review disputes.
What Is the Workers’ Comp Dispute and Appeals Process in Georgia?
There are several options to pursuing a workers’ comp dispute in Vidalia, Georgia. They include:
- Filing an appeal to have an administrative law judge review your case. Under this option, you and your attorney attend the hearing and argue your case before a judge, who then decides the matter.
- Filing an appeal with Georgia’s Appeal Court or Georgia’s State Workers’ Compensation Board. Under this option, you and your lawyer argue your case before the board or appellate judge and wait for a verdict.
- If you are satisfied with the decision reached by either option mentioned above, you can always take the matter to the Supreme Court for the final decision.
Let a Qualified Attorney Help You Handle Your Workers’ Comp Dispute in Vidalia, Georgia
Just because your claim was denied doesn’t mean that you’ve reached the end of the road. You still have the option to appeal your employer’s decision to deny your claim and receive the benefits you deserve for your injuries or illness. However, to have an easier time fighting their decision, you need a qualified team of attorneys by your side to counsel you and represent your interests.
If you need help resolving a workers’ compensation dispute in Vidalia, reach out to us at the Workers’ Compensation Lawyers Coalition for legal counsel and representation you can trust. Our attorneys are experienced legal experts with the skills and knowledge needed to discredit any claims your employer or insurance company has made concerning your injuries to deny you benefits.
Call 470-518-5026 now or visit our offices in Vidalia to learn more about how our attorneys can help you with your workers’ comp dispute.
