Follow the rules closely to secure compensation after a workplace injuryYou’ve been hurt at work and you are confident that you qualify for workers’ compensation. Yet sometimes even a valid workers’ compensation claim is denied either because of mistakes made by the worker during the claim process or for reasons outside the worker’s control.

Don’t Let This Happen to You

In order to prevent your workers’ compensation claim from being denied, it is important to understand the common reasons why valid claims are denied so that you can avoid certain mistakes or take actions to overcome obstacles. Specifically, Georgia workers’ compensation claims are often rejected because:

  1. The employee doesn’t report the accident and injury quickly enough. There is no benefit to waiting. As soon as you can, you should report the accident to your supervisor, to human resources, or to someone in charge. The longer you wait, the more likely it is that your otherwise valid workers’ comp claim will be denied.  There is technically a 30 day notice requirement, but waiting anywhere near that long will probably result in a denial.
  2. The employee doesn’t go to the doctor right away. If you’ve been hurt, then you should immediately ask your supervisor or someone in human resources if you can go to one of their company doctors. If they are resistant to your request for medical treatment, then go to the emergency room if necessary or seek prompt medical attention. The longer you wait to get medical help, the more likely it is that your claim will be denied because your employer and the insurance company will argue that your injury was caused by something other than your workplace accident.
  3. The employer gives the employee the run-around after an accident report is made. Do not wait for your employer to take action. Instead, you have the right to consult with an attorney and to file a claim with the State Board of Workers’ Compensation.
  4. The accident was not witnessed by anyone and is disputed. Sometimes you may get hurt working alone. This should not prevent your fair recovery. Instead, the right evidence can be presented to substantiate your claim and prove that an accident occurred while you are working.
  5. The employer argues that the employee has a history of prior injuries. The employer or the insurance company may argue that your injury existed prior to the accident. However, Georgia law allows injured workers to recover for an aggravation of a pre-existing condition.  So, even if you have injured the same part of your body previously, you are still entitled to a recovery for a re-injury sustained in a new workplace accident.
  6. The employee failed to disclose a significant prior injury when specifically asked about prior injuries. If you fail to disclose a significant prior injury when asked about it during the hiring process, or after, and you suffer a similar injury, then the employer and the insurance company may seek to deny your claim.
  7. The employer tries to blame the employee based on the employee’s past behavior. The employer may, for example, deny a claim just because a worker has a criminal history. Any past criminal behavior is irrelevant to whether or not you are entitled to benefits under a workers’ compensation claim.
  8. The employee fails a drug test. Failing a post-accident drug test will almost always result in a denial of a workers’ compensation claim. While it is certainly an easier case for you if you do not have any drugs or alcohol in your system at the time of the accident, an experienced workers compensation lawyer may be able to help you overcome a failed drug test.
  9. The employer argues that the injury could have occurred off the job just as easily as it did on the job. If, for example, you suffer a heart attack or stroke and you just happen to be at work, then you may not qualify for workers’ compensation. In order to be eligible for workers’ compensation, you would need to prove that your heart attack or stroke was caused by a workplace accident or workplace conditions.
  10. The employer does not carry workers’ compensation insurance as required by law. In this situation, the employer may not be able to pay for your injuries.  However, as long as the employer has three or more employees, they are subject to the workers’ compensation laws.  Even if your employer doesn’t have insurance, you should definitely still consult an attorney to see if they can help you with your case.

It is important to be proactive in your workers’ compensation claim, to avoid any mistakes that could deny you the benefits you deserve, and to overcome any obstacles that your employer or your employer’s insurance company put in your way. That way, you can get the workers’ comp benefits that you deserve as quickly as possible.

What If Your Workers’ Comp Claim Is Denied Anyway?

Once a workers’ compensation claim has been denied, it is almost impossible to turn the situation around and to get benefits without the help of an experienced workers’ comp lawyer. An attorney knows how to present the evidence and how to make convincing legal arguments to get you the fair recovery that you deserve. Call us today to schedule a free consultation and to make sure that a mistake doesn’t cause your workers’ compensation claim to be unfairly denied.

Jaret A. Spevak
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Atlanta Personal Injury & Workers’ Compensation Attorney With 20+ Years Experience