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When Workers’ Compensation Claims Are Wrongly Denied

When workers are injured on the job, they are often eligible for workers’ compensation, which pays for the injured worker’s medical expenses, treatments, and a portion of the worker’s wages. But there are many legitimate reasons why a workers’ compensation claim might be denied. The worker might not be a covered class of worker that is eligible for workers’ compensation; the worker might have been reckless or willfully responsible for his or her own injuries; or the worker might be negligently responsible for causing his or her own work-related injuries.

 

On the other hand, there are many injured workers who have workers’ compensation claims that get denied for no good or legitimate reason. Sometimes a workers’ compensation claim is accidentally denied – claim processors might be overworked or overloaded with claims and they simply deny a claim to save on time, or the workers’ compensation claim processor might not be trained well enough to know that a claim should be allowed.

 

Whatever the case may be, if you are an injured worker who needs workers’ compensation benefits for your work-related injury and you believe that your workers’ compensation claim was wrongly denied, you need to speak with an experienced workers’ compensation lawyer as soon as possible about your denied claim. An Atlanta workers’ compensation lawyer can help you appeal a denied workers’ compensation claim so you can get the workers’ compensation benefits you are entitled to.

 

Reasons Why Workers’ Compensation Claims Are Denied

 

In addition to certain acts that can make a worker ineligible for workers’ compensation benefits, there are other reasons why a workers’ compensation claim will be wrongly denied. Some common reasons why workers’ compensation claims are denied include, but are not limited to:

 

  • Processor’s mistake. It is possible that the workers’ compensation claim processor made a mistake when processing your claim. The processor could have been working too quickly, or could have been inadequately trained. When a workers’ compensation claim is denied by mistake, it is usually fairly easy to show that there was an error.

 

  • Questions about reporting deadlines. When a worker is injured on the job, the worker has a duty to report his or her injury to their supervisor, boss or employer within 30 days of suffering the injury. This report must include the injured worker’s request for medical treatment. This is considered notice to your employer and it is required for every workers’ compensation claim. If there is any question regarding whether you, as the injured worker, gave proper and timely notification of your injury to your employer, then there is a possibility that your workers’ compensation claim will be denied. An experienced workers’ compensation lawyer can help you demonstrate that you reported the accident and your injuries as required, and that you workers’ compensation claim should not be denied for not notifying your employer.

 

  • Questions about filing deadlines. Injured workers have one year from the date of their injury to file a workers’ compensation claim. This is in addition to reporting the work-related injury to your employer within 30 days of suffering your injury. Claims that are not filed within one year of suffering the injury are considered time barred and will not be actionable. If there is a question about whether or not your workers’ compensation claim was filed within the one year deadline for filing, the claim processor may deny your claim.

 

  • Questions as to whether the worker actually needs medical treatment. A workers’ compensation processor or employer might deem the worker’s reported injury as not requiring medical care. But if you believe that your injuries do require care, then your claim should not be unduly denied.

 

When Employers Discourage Workers From Using Workers’ Compensation

 

Some employers try to dodge their responsibility to provide workers with workers’ compensation benefits, and will try anything to discourage a worker from filing a claim. The employer might tell a worker that they are not entitled to workers’ compensation for their injury, or that you must seek medical care on your own. This is not true.

 

Nearly all employers are required to have workers’ compensation insurance for nearly all types of employees. This means that practically all employees in Georgia are eligible for workers’ compensation benefits. Your employer cannot tell you  to seek medical care for your work-related injury through your own health insurance or that you must pay for medical treatment for work-related injuries out of pocket. If you are covered by workers’ compensation, your employer also cannot or require you to take sick leave in order to recover instead of seeing a doctor.

 

Employers also might try and avoid paying for the injured worker’s medical care by not following up with the injured worker. The employer might send the injured worker to a doctor initially, but when that doctor recommends additional treatment with specialists, the employer might unnecessarily drag its feet to coordinate the prescribed treatment for the injured worker. During this time, the injured worker is helpless since he or she cannot seek out medical care on their own. They might feel like they are at the mercy of their employer and their employer’s workers’ compensation coordinator. When your employer wrongly denies your workers’ compensation claim, or unduly delays your treatment in Atlanta, you need to consult with an experienced workers’ compensation lawyer as soon as possible.

 

Workers’ Compensation Lawyers Ready to Help You

 

All too often in Georgia, honest workers who are injured on the job are denied workers’ compensation benefits for one reason or another. However, these injured workers often have a legitimate claim and they are genuinely in need of medical treatment for their work-related injuries. Having your workers’ compensation claim denied can be devastating and can leave you not knowing what to do. But do not worry – you should reach out to an experienced Atlanta workers’ compensation attorney about your situation as soon as you can. 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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Seth Bader

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(678) 562-5595