If you were developed a medical condition because of your work (cancer, lung illnesses, hearing loss, skin issues, etc.), you are eligible to file for a workers’ compensation claim.
But there are cases where the worker is denied the claim for various reasons. If that is your case, you perhaps wonder why this happened to you and what you can do to change that.
Before we continue with the article, you should know that for cases like these, the best way to get justice on your side is by hiring an Atlanta workers’ compensation attorney.
Workers’ Compensation Process
When you get injured at work or develop an occupational injury, you should file for a workers’ compensation claim. Your employer will have an investigation before they agree to pay you the benefits. This is because not every claim is legitimate or compensable. If your employer believes that your claim is not valid, they may deny it.
Not Covered by Insurance
Workers’ compensation will not cover every worker. Independent contractors are often excluded from the coverage. Some executives, agricultural workers, domestic employees, or individuals covered under various policies may not get coverage. This does not necessarily mean that the employer is not legally responsible for the worker’s injuries, but it may be adequate to deny the workers’ compensation claim.
The Worker Did Not Provide Notice
The first thing the injured workers should provide is a notice to their employer once they suffer a work-related injury (or develop the occupational illness). Often the deadline is 30, 45, or 90 days after the injury or illness occurred. This varies in different states; there are states that have a short deadline of only four days. If the employee fails to report the illness within the deadline, the employer may be able to deny the claim.
Georgia has a deadline of 30 days.
Statute of limitations
An employer may deny your workers’ compensation claim because the relevant statute of limitations is over. This statute of limitations sets the time limit in which the injured employee must file the claim. Once the time goes by, the employee no longer has the right to pursue the claim. There may be exceptions in cases when the employee suffers from an occupational disease.
Non-work Related Illness
Workers’ compensation coverage only provides benefits for injuries or illnesses that happened at work or because of the exposure to the risk of the job. Your employer may allege that your illness did not occur because of your job. The cause of the illness must be determined before the claim can be paid.
Your condition does not meet state guidelines
The law in your state may have restrictions on workers’ comp claims for cumulative trauma or psychological conditions. Some states will not provide workers’ compensation benefits for illnesses caused by long-term emotional stress at work.
You left your job
Although you developed your occupational illness at your workplace, you risk not getting the workers’ compensation claim if you filed the claim after you quit your old job. Insurers will not think twice before denying claims that were filed after the employee left their job (this goes for being fired as well).
The applicant’s own willful negligence could be another reason why the claim is denied. If the person gets drunk or violates safety rules, the employer may use these actions and deny the claim.
The employee did not seek medical treatment
Never hesitate to get medical help because you may not get the benefits from workers’ compensation insurance. Your employer may require you to get an independent medical examination from a doctor of their choosing if state law covers the process. If you refuse or fail to seek medical treatment, then you may never get the claim; the insurance company would see this as a sign that you were well enough and that you don’t need money for medical treatments.
Your workers’ compensation is denied. Now what?
If your workers’ compensation is denied after you reported an occupational illness, you should seek help from a workers’ compensation attorney.
A denied claim is not uncommon, so it would be better to go through the process with a skilled attorney who knows what to do.
Our team at Worker Compensation Lawyer Coalition is here to help you with every question you have. Allow our team to review your case and guide you into the process. We will be by your side till the very end.
Call and schedule today.