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How to Appeal a Workers’ Compensation Claim Denial

When you apply for workers’ compensation benefits after suffering a work-related injury, either your employer’s workers’ compensation administrator or your employer’s workers’ compensation insurance provider will review your claim. This reviewer will either approve or deny your claim. There are many reasons why a claim could be denied. For instance, there could be questions about whether you reported your injury to your employer when it happened, or your claim could have been denied by mistake. Workers’ compensation claim denials happen to many injured workers who have legitimate claims. If your workers’ compensation claim has been denied, you should get into touch with an experienced Atlanta workers’ compensation attorney as soon as possible.

 

When a workers’ compensation claim is denied, you will receive a notification that includes an explanation as to why your claim was denied. This explanation provides you with some sort of understanding of what is wrong or incorrect about your claim. When your claim is denied, you do not need to panic or fret. If you believe that the denial of your workers’ compensation claim was improper, you can appeal your denial to the Georgia State Board of Workers’ Compensation by requesting a hearing.  You have one year from the date of your injury to file your claim with the State Board of Workers’ Compensation. If your workers’ compensation claim was denied, and you are unsure what to do, you can reach out to a Georgia workers’ compensation lawyer to help you understand your options.

 

How to Appeal Your Denied Workers’ Compensation Claim

 

Presuming that you reported your injury when it happened to your employer (i.e., within 30 days of the injury occurrence), that you sought medical care from one of the doctors on your employer’s list of approved workers’ compensation physicians, and that you filed your workers’ compensation claim within one year from the day you suffered the injury, if your claim was denied, then the next step is to seek a hearing from the Georgia State Board of Workers’ Compensation. This appeal is a second chance to have your workers’ compensation claim reviewed. It is important to understand that the appeals process can take some time, and can be challenging.

 

When it comes to appealing any sort of denied claim, whether it is for workers’ compensation or otherwise, it is always important to seek help from an experienced attorney. A workers’ compensation lawyer specializes in workers’ compensation claims, and knows all of the laws and processes for how to get a claim approved. A lawyer can help you attempt to appeal your denied Atlanta worker’s compensation claim.

 

The appeals process for a denied workers’ compensation claim starts with filing a WC-14 form with the Georgia State Board of Workers’ Compensation. Once submitted, a copy of your WC-14 form will be sent to your employer and/or your employer’s workers’ compensation insurer.  You may request a hearing or mediation with this form. You may be required to file additional forms or documentation, and an experienced workers’ compensation lawyer can help you through the filing process with the State Board of Workers’ Compensation.

 

Mediation for Your Denied Workers’ Compensation Claim

 

Once your forms are completed and reviewed by the Georgia State Board of Workers’ Compensation, you will be scheduled a hearing date, or you may be required to go to mediation for you workers’ compensation denial. When you are sent to mediate your denied claim, the hope is that you, your workers’ compensation lawyer, and your employer or your employer’s workers’ compensation insurer will be able to come to a settlement agreement quickly.

 

A neutral mediator works with the parties to try and arrive at an agreement of some sort. Settlement is a desirable resolution to denied workers’ compensation claims since it gives the parties a chance to work things out on their own in a less formal environment that the trial-like review by the Georgia State Board of Workers’ Compensation hearing. If a settlement is reached, there will be no need to go before the State Board of Workers’ Compensation judge.  

 

A Hearing for Your Denied Workers’ Compensation Claim

 

When mediation does not work, your claim filing expressly requested a hearing, or the Georgia State Board of Workers’ Compensation believes that your denied workers’ compensation claim should go straight to a hearing, your case will be presented to a judge in a trial-like hearing. During the hearing, you and your workers’ compensation lawyer will need to:

 

  • Prove your claim;
  • Prove that your injury was incurred while you were on the job;
  • Prove that your injury occurred during the performance of your work duties; and
  • Prove that you properly reported your injury and filed your workers’ compensation claim within the appropriate time limits.

 

The goal of your hearing before the State Board of Workers’ Compensation is to demonstrate that your workers’ compensation claim is valid and that your workers’ compensation benefits are being wrongly denied. The judge will hear you case, review the evidence and testimony that you and your lawyer have presented, and will make a decision whether you should be granted workers’ compensation or not. If the judge also denies your claim, you can appeal your workers’ compensation claim denial further up the appeals process. Within 20 days of your Georgia State Board of Workers’ Compensation hearing decision, you can appeal your Georgia State Board of Workers’ Compensation.

 

Contact an Atlanta Workers’ Compensation Lawyer – Bader Law Firm, LLC Is Ready to Serve You!

 

When you are injured on the job, and need workers’ compensation benefits to help you get through your recovery, a denied workers’ compensation claim can be devastating. However, there are many legitimate workers’ compensation claims that are wrongly denied, and there is an appeals process that can be utilized to get your claim reviewed again. When you need assistance appealing a workers’ compensation claim that has been denied, you should consult with a determined workers’ compensation attorney in Atlanta. The professionals at Bader Law Firm, LLC can assist you with every aspect of your workers’ compensation claim. Contact us today.

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