There are dozens of businesses in the city that are required by law to purchase a workers’ compensation policy for their employees. This no-fault type of accident insurance provides substantial benefits for workers who have suffered a job-related injury or illness, including coverage for medical expenses and wage replacement. Workers who were injured or developed an illness at work should consult a workers’ compensation attorney to thoroughly understand workers’ compensation claim eligibility in Clarkesville.
Determining eligibility for a workers’ compensation claim in Clarkesville requires a clear understanding of local laws and procedures. Generally, workers are not eligible for disability benefits from their employers’ workers’ compensation insurance until their job-related injury or illness requires them to miss at least seven days of work. If they are absent from work for at least 21 days because of their injury or illness, then they are eligible for a retroactive payment of two-thirds of the first seven days of work missed. Workers can usually receive wage replacement benefits until they reach maximum medical improvement or for a maximum of 400 weeks.
To qualify for workers’ compensation benefits, the employee must have sustained an injury or illness during or as a result of performing their job duties during work hours. Injuries incurred while the employee was traveling to or from work or running personal errands during a break from work are generally not covered. Any aggravations of pre-existing injuries will typically result in qualification, but injuries arising from employee horseplay or pranks at work generally will not. To maintain eligibility for workers’ compensation benefits in Clarkesville, workers must promptly report their injury or illness to their employer, file a claim, and seek medical treatment from a provider on the employer’s list of authorized healthcare providers. Failing to report an injury to the employer within 30 days of the injury or diagnosis of a work-related illness may result in disqualification for benefits.
The state’s workers’ compensation laws require all private businesses, corporations, and nonprofit organizations with three or more workers, including regular part-time workers, to carry workers’ compensation insurance. Those who are not required to provide workers’ compensation insurance include the following:
Sole proprietors or individuals involved in a business partnership are generally regarded as employers rather than employees and are not required to be covered by workers’ compensation insurance. However, they can elect to obtain workers’ compensation coverage for themselves if they wish.
Employers and workers’ comp insurers may deny claims entirely or partly for several reasons, such as if they believe the injury or illness did not occur because of or during a job-related task. Additionally, claim denials may occur if the employer believes the injury happened due to horseplay or if the treatment you received was provided by someone who was not on the employer’s list of authorized healthcare providers. Workers’ compensation claim denials can be appealed by presenting the case to the State Board of Workers’ Compensation Claims.
During an initial consultation, a lawyer at Smith Hulsey Law could explain eligibility requirements for workers’ compensation claims in Clarkesville and help you secure maximum benefits.
Workers’ compensation is designed to provide essential benefits for injured or ill workers. However, many challenges can arise during the claims process that can result in a person not receiving their needed benefits. For more information on workers’ compensation claim eligibility in Clarkesville, get in touch with the legal team at Smith Hulsey Law for a free case evaluation.
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