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Workers’ Compensation and the Administrative Review Process

Workers’ compensation claims are initially processed through an administrative agency known as the workers’ compensation administration, not a court.  This can create some confusion for people making workers’ compensation claims, since a workers’ compensation hearing resembles a traditional judicial hearing in many ways, but the resulting ruling is actually an executive determination appealable in the superior courts.  This post explains the administrative process as it relates to the judicial process in the context of workers’ compensation claims.

What is an Administrative Agency?

Administrative agencies exist at both the federal and state level, and deal in one way or another with almost every aspect of our lives, from driving a car to regulating consumer products.  Each agency is created and given its authority by an enabling statute.  The enabling statute defines an agency’s mission and the scope of its authority.  Besides this specific grant of authority, agencies are also governed by the Administrative Procedure Act.  Every state and the federal government has such a statute.

The Administrative Procedure Act defines the way in which all agencies must perform their various roles.  This is essential because agencies are technically a part of the executive branch of government.  However, they perform functions that bear similarities to those of the judicial and legislative branches as well.  They perform legislative functions when they promulgate regulations that “interpret” statutes.  Though these regulations are not considered to have the force of law, courts will generally defer to them as correct interpretations.

Agencies also perform judicial functions when they hear disputed matters under the enabling act.  In the case of workers’ compensation claims, this process begins by filing a claim with the Georgia Workers’ Compensation Administration.  If there is no dispute, payments will issue within a set period of time.  If the claim is disputed or denied, a hearing will be held before an administrative law judge.  The administrative law judge will hear evidence and make a determination as to the disputed issues.  Generally these hearings are processed in a matter of a few months, which is one advantage of the administrative system compared to the courts, where litigation can go on for years.

When is an Administrative Decision Appealable in Court?

In order to appeal a decision of an administrative agency, a claimant must have exhausted all administrative remedies and obtained a final decision from the agency.  If a claim is denied by the agency’s final review process, an injured claimant may then seek review of the agency decision in court.

Contact an Attorney Before it’s too Late

Sometimes workers may be hesitant to hire an attorney for a workers’ compensation claim because they fear that the costs of hiring an attorney may not be worth the award collected.  This is not true.  In fact, Georgia law limits attorney’s fees in such cases for this very reason.  Fees can only exceed the prescribed amount in certain cases and with the approval of the agency.  At Bader Scott Injury Lawyers, our Georgia attorneys have the experience of handling a high volume of these cases, and know how to resolve most cases quickly and inexpensively.  We resolve most of our cases at the administrative stage, keeping our clients out of court. In the long run, you actually run the risk of spending more in attorneys fees if you try navigating the administrative system alone and wind up in court.  Get a speedy resolution of your claim today.  Call us for a free consultation.

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Seth Bader
(678) 562-5595