Whether you work in the construction industry or do a desk job, the chances of getting into an accident while performing your duties are never nil. That’s why Georgia law mandates every business or company with three or more employees to carry workers’ compensation insurance. This is a form of coverage that provides monetary benefits for medical expenses and lost wages for workers who have fallen ill or sustained injury while at work.
For a policy that’s government-mandated, it seems that making a claim for these benefits should be a breeze. However, that is not always the case. Some employers and insurance companies can unjustly deny valid claims. Our lawyers know how to resolve workers’ compensation disputes in Winston. They will gather medical evidence and records, conduct legal research, and take depositions from parties like physicians.
If you think your claim has been unjustly denied, look no further than the Workers’ Compensation Lawyer Coalition. Our Winston workers’ compensation lawyers will carefully review your claim to determine if an appeal is worth it. We won’t charge you any upfront fees and our initial consultations are free. So, do not hesitate to reach out by calling us today at 470-518-5026 !
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Causes of Workers’ Compensation Disputes in Winston, Georgia
As an employee, you can claim benefits for lost wages, medical expenses, disability, and death. However, your employer or their insurance carrier can deny or dispute the claim for an array of reasons. These include:
Employment Status
In Georgia, both full-time and part-time workers injured while performing their work duties are entitled to workers’ compensation benefits as long as the company has three or more employees. Keep in mind that independent contractors do not qualify for these benefits under state law. In some cases, employers argue that the employee is an independent contractor, and therefore, not eligible for workers’ comp benefits. If this occurs, seek legal representation as soon as possible.
Also, keep in mind that if you are no longer an employee and happened to have been injured while still employed, you cannot file for workers’ comp benefits after leaving the company. You need to be a current employee of the company in order to claim benefits.
Outside Scope of Employment
If you were injured while doing something outside your employment scope, your employer or the insurance company can deny your claim. A good example is sustaining injury off-site while on a break. In such a case, your injury is not compensable.
Lack of Causation
In order to qualify for workers’ comp benefits, there has to be a causal link between your injuries and the nature of your job. This simply implies the injury should have been a result of your work activities or an unsafe condition at the workplace.
Failure to Report the Injury
You need to report the injury soon after the accident. Failure to do so only complicates the claims process. Even if you feel the injury is minor, it is important to report it, just in case it develops into something serious. According to Georgia’s Workers Comp Act, you are required to report the injury in writing to your employer or supervisor within 30 days. This will help prevent a dispute or denial of your WC claim due to a missed deadline.
A Pre-existing Condition or Injury
If you suffer a work-related injury and fail to disclose any pre-existing condition or injury, your claim is likely to be denied. Keep in mind that if you had prior injuries that worsened after the accident, you’re eligible for workers’ compensation benefits. So, ensure you disclose any prior injuries to avoid a dispute or denial.
No Workers’ Compensation Insurance
If your employer does not have a workers’ comp policy, then you won’t get any benefits. However, if this occurs and you’re in a company with three or more workers, seek our services to discover your legal options.
What Do I Do If My Workers’ Compensation Claim Is Denied in Georgia?
If your workers’ compensation claim has been denied for any reason, you shouldn’t give up as there are several options to pursue.
The first is to ask for a hearing before the State Board of Workers Compensation. Here, the judge will listen to both sides of the story and determine whether you deserve compensation. To ask for a hearing, simply file Form WC-14. However, ensure you do this within one year from the date of injury.
After facing a claim denial, it’s even more important to involve a lawyer. An experienced workers’ compensation disputes lawyer should help you handle the appeals process. They will ensure that everything is done according to the law and help in gathering all the necessary evidence.
Types of Workers’ Comp Disputes
Generally, there are two categories of workers’ compensation disputes in Winston, Georgia.
Medical Disputes
As the name suggests, these disputes arise due to medical reasons. Here, the employer or insurance company may claim that you failed to seek medical attention as soon as possible, and so, the injury was not as severe as you claimed. Also, they may argue that the injury wasn’t caused by the nature of your job or it was pre-existing.
Claim Disputes
These are based on technicalities and mistakes made in the claims process. For instance, the employer or insurance provider may claim that didn’t report the injury on time or the deadline for filing a claim had already passed.
What Is the Workers’ Compensation Dispute and Appeals Process in Georgia?
These are the stages of the workers’ compensation dispute and appeal process:
- Filing The Notice of Claim
- Mediation
- Workers’ Compensation Hearing
- Appeals to the Appellate Division
- Appealing to the Georgia Superior Court
- Appealing to the Georgia Court of Appeals
Get the Best Lawyer for Your Winston Workers’ Compensation Dispute!
Experiencing a work-related injury or disease can be painful and stressful. This only becomes worse when your claim is unjustly denied by your employer or their insurance carrier. Luckily, the Workers’ Compensation Lawyer Coalition exists to help employees based in Winston to fight for their rights. Our team will fight aggressively no matter how daunting the appeals process may be. Get in touch by calling 470-518-5026 and get the best legal representation in the state.
