Why Was My Worker’s Compensation Claim Denied?

In a majority of circumstances, Atlanta workers that are injured while performing their job have the right to receive workers’ compensation benefits as specified by Georgia law. The workers’ compensation insurance system in Georgia is based on no-fault rules, meaning that no negligence or fault must be proven for the worker to receive the benefits. Even so, each year many Atlanta workers’ compensation claims are denied. When a worker has truly been injured in a work accident and their claim is denied, they may feel angry and confused. Speaking with an Atlanta workers’ compensation lawyer can help you understand exactly what your rights and legal options are in regards to your claim.

Common Reasons Why Workers’ Compensation Claims Are Denied in Georgia

If you sustained an injury on the job and your claim was denied, you can still file for an appeal to receive your benefits. However, it is vital to understand exactly why your claim was denied. Often times, the answer is simple: money. Employers pay a premium for the insurance and when an injured worker files for benefits, those premiums are directly affected. As a consequence, an employer may deny your claim. There are, however, several other common reasons that your claim may have been denied.  
  • The claim was not filed on time. Workers’ compensation claims must be filed in a timely manner. If you are injured on-the-job, you should report it to your supervisor immediately. You should file the claim as soon as possible, but you have up to a year after the accident.
 
  • No proof was provided that the injury was work-related. Although you do not have to prove negligence in Georgia, you do need to demonstrate that the injury took place while you were working. Witness statements or video footage can be used as evidence.
 
  • The claim was filed incorrectly. Many claims are denied solely based on technicalities including incorrect paperwork, passed deadlines, or vague evidence. Make sure to file everything correctly and according to Georgia guidelines.
  • Your injury is related to a pre-existing condition. Atlanta workers can still receive benefits for injuries involving pre-existing conditions provided the condition is worsened by their employment. Benefits, however, are adjusted and the claim requires different procedures and paperwork.
 
  • The injury was a consequence of misconduct. Injured workers in Georgia can be denied benefits if there is proof that misconduct caused the accident. For instance, if you were under the influence of alcohol and were injured on work machinery, you could lose workers’ compensation benefits.
  • Fraud. If there is any proof that you are lying or attempting to collect benefits wrongfully, the claim will be denied. Always be truthful about every aspect of your injury and the accident when seeking benefits.
If your claim is denied, a letter will be sent to you stating why. It is still possible to receive benefits by asking the board to reconsider, filing an appeal, or requesting a hearing with the Georgia Board of Workers’ Compensation. However, unless you provide additional evidence or documentation, it is likely that your claim will be denied again and it is best to seek the aid of an attorney.

Get Help From an Atlanta Workers’ Compensation Attorney

Regardless of whether or not you are at the beginning stages of filing a claim or want to file an appeal after being denied, speaking with an Atlanta workers’ compensation attorney can be helpful. A lawyer will help you prepare the strongest case and give you the best chance of receiving the maximum amount of benefits and assuring that your appeal is successful. Contact Workers Compensation Lawyers for a free consultation to talk about the specifics of your claim by calling 678-504-6565. ]]>

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