Workers Compensation Claim Denial for Personal Reasons

When our Atlanta workers compensation attorneys meet with a client for the first time, they usually just want to hear your story and find out what happened. Depending on what stage your workers compensation claim is in, your Atlanta injury lawyer may need to reach out to the insurance carrier.

They will find out if your claim is still being processed or, if it has already been denied, they will ask for a specific reason. Odds are that your employer and the insurance adjuster will have an allegedly valid reason for denying your claim.

A lot of our clients take things personally when they find out that their workers’ comp claim was denied. They insist it was denied because their manager doesn’t like them or because they have a poor relationship with the owners of their company. While we understand why you may feel this way, very rarely is this truly the case.

Here, we will discuss the possibility of your workers’ compensation claim being denied for personal reasons. We will also discuss some of the more common reasons why workers’ compensation claims are rejected by the insurance carrier.

There Are a Host of Reasons Why Your Workers Compensation Claim Could Be Denied

If your workers compensation claim was denied, your Letter of denial should offer a detailed explanation. It’s important that your Atlanta workers’ compensation attorney have a copy of this letter, so they know how to proceed. In our experience, employers and insurance companies deny workers compensation claims for a variety of reasons.

Some of these include:

• Your employer does not believe that your injuries were caused by a workplace accident.
• The insurance carrier sees that you have a history of filing workers compensation claims.
• You did not submit your claim properly or on time.
• You refused to be treated by a state-approved workers compensation physician.
• You were under the influence of drugs or alcohol at the time of your workplace accident.

Of course, this is not an exhaustive list. There are many other reasons why your claim was denied. While it is doubtful that your employer would deny your claim for personal reasons, that doesn’t mean it cannot happen. If you truly believe that this is why your claim was denied and your employer cannot give you a valid reason, make sure you let your Atlanta injury lawyer know right away.

Your Atlanta Workers Compensation Attorney Will Help You File an Appeal

If your claim was denied, your Atlanta workers compensation attorney can help you file an appeal. Depending on the reason for the denial, your appeal may be to your employer or it may be to the Board of Workers’ Compensation.

If your claim was denied because your employer did not have workers’ compensation insurance, then your Atlanta injury lawyer will need to reach out to the Workers’ Compensation. If, on the other hand, your employer denied the claim for a substantive reason, you would need to take your issue up with your employer’s insurance carrier.

It is Doubtful That the Insurance Company Would Deny Your Claim for Personal Reasons

As much as it may hurt to find out that your workers’ compensation claim has been denied, it is not likely that it was denied for personal reasons. If you work for a larger company, there is a good chance that the human resources director does not even know you personally.

In large companies, workers’ compensation claims are treated like any other form. Your human resources department will process your paperwork and submit it to the insurance company. They will make a recommendation to the insurance adjuster as to whether they believe your claim should be paid.

If the insurance company agrees with your employer, they may deny your claim. If, however, the insurance adjuster believes your claim is valid or it is not worth fighting, they will advise your employer to pay the claim.

Your Employer Must Have a Valid Reason for Denying Your Claim

If your employer does decide to deny your workers’ comp claim, your Atlanta workers compensation attorney will want to see this in writing. Your denial letter should list the specific reason why your claim was denied. If not, it will list a code that your Atlanta injury lawyer can investigate to find out what the true reason was for your claim being denied.

Your employer cannot simply write that the claim is being denied for general reasons. Workers compensation law in Georgia requires that they provide you and your attorney with a specific reason for why your claim was rejected. If they fail to do this, once again, your lawyer will appeal to the workers’ compensation Commission.

Your Atlanta Injury Lawyer Will Make Sure Your Claim is Handled Properly from the Start

One of the reasons our Atlanta workers compensation attorneys suggest that you contact us immediately after your workplace accident is that we can make sure your claim is handled properly. Any little mistake at the beginning of your claim could jeopardize your chance for workers comp benefits. For example, if you do not submit the proper information, your claim may never be properly submitted.

The same is true if you did not file your workers’ compensation claim on time. By reaching out to an Atlanta injury lawyer within a day or two of your workplace accident, you won’t have to worry about any of these things happening. Your attorney will make sure that your claim is submitted and handled properly.

We suggest you contact our office as soon as possible after your work injury. We offer all new clients a free, initial consultation. This gives you a chance to sit down with a seasoned Atlanta workers compensation attorney who can review your case and let you know how best to proceed. If your claim has already been denied, your Atlanta injury lawyer can help you file an appeal.

If this is unsuccessful, you can always file legal action against your employer. If you truly feel that your claim was denied for personal reasons, your lawyer will have to prove that. If they’re able to do so, you may have additional claims against your employer or the insurance carrier.

Since the initial consultation doesn’t cost you anything, it’s in your best interest to contact us today and set up a date and time to come into the office.