All workers deserve the ability to perform their jobs without worrying about the potential injuries or illnesses that may affect them. To reinforce this right, state law requires most employers with three or more workers to obtain a workers’ compensation insurance policy. These policies can provide medical care and wage reimbursement after a workplace illness or injury.
However, collecting these benefits can be difficult without guidance from a skilled injury attorney. Employers or insurance companies may deny a claim or issue a benefits package that is insufficient for your needs. If this occurs, you should contact a Sandy Springs workers’ compensation lawyer. They can explain how workers’ compensation functions, explore why your claim has ended with a denial, and fight the benefits you deserve through the appropriate appeals processes.
An employee injured in the line of work is eligible for a range of benefits under the Workers’ Compensation Act. The Official Code of Georgia § 34-9-6 states employees are eligible to collect:
While the law does not require you to get an attorney to collect benefits, it is often beneficial. A workplace injury lawyer in Sandy Springs could help you through the complex process and recover the total amount the law entitles you to collect.
Workers’ compensation insurance should provide a simple way for employees to collect compensation and medical care after a workplace illness or injury. However, there are still processes that they must follow to receive these benefits. Chief among them is providing proper notice to employers and the State.
The Official Code of Georgia Annotated § 34-9-80 says that workers must inform their bosses of an illness or injury within 30 days of the onset of that condition. In addition, employees must complete and submit form WC-14 with the State Board of Workers’ Compensation.
A successful claim must also tie a worker’s condition to the performance of their job duties. A failure to make this connection is a common reason why workers’ compensation insurance companies deny a claim for benefits. Talking with a Sandy Springs attorney could help employees to understand their obligations under the law and to evaluate the reason for a workers’ compensation denial.
There is a no-fault insurance system for workers’ compensation in this state. If an employee sustains injuries at work, they can collect the benefits regardless of whether they share responsibility for the accident.
The no-fault system removes the need to investigate for the purpose of collecting evidence to prove liability. However, that does not mean collecting benefits is a simple process. A slight error could cause an initial denial and a lengthier claim process.
Even with the workers’ compensation no-fault system, it is not uncommon to receive a denial after filing to collect benefits. For that reason, many injured employees reach out to an experienced workers’ comp attorney in Sandy Springs right away after an accident.
Some of the common reasons for denial after filing for workers’ compensation include:
To collect workers’ compensation benefits, you must report the injury to your employer right away. If it is not possible to report to them immediately, you must give notice within 30 days. They must also file a claim to collect benefits within one year of the accident.
Insurers commonly deny benefits by asserting the injury did not occur at work. They may also claim the medical conditions you are suffering are not because of the workplace injury.
No matter the reason why an insurance company has denied a request for benefits, workers have the right to pursue an appeal. The State Board of Workers’ Compensation hears all appeals concerning denials. An employee has the right to submit an appeal immediately after a denial. When the Board receives this paperwork, it will schedule a hearing date before a judge.
Even so, a full hearing may not be necessary to obtain the benefits that a worker deserves. The Board has the authority to order workers, employers, and insurance companies to attend mediation sessions. These sessions could help lead to a settlement.
If these mediation sessions fail, the trial will move forward. During this session, both employees and insurance companies will present evidence and provide testimony to the judge, who will make the final decision concerning appropriate benefits. Hiring a Sandy Springs lawyer to take the lead in an appeal could help to increase the chances of success and help workers remain organized when seeking compensation.
All people who suffer injuries or illnesses because of doing their job deserve benefits through a workers’ compensation insurance plan. These benefits can include free medical care, temporary wage reimbursement, and payments for any resulting permanent disability.
However, employers and insurance companies will look for any reason to deny a claim. These may include a failure to properly notify an employer about an injury, the injury not being connected to work, or the injury not being sufficiently serious to merit benefits.
If you have received a denial of benefits following the filing of a workers’ compensation claim, a Sandy Springs workers’ compensation lawyer may be able to help. Contact us today.