Getting hurt on the job can cause a number of challenges. From physical pain to medical bills to a temporary or permanent inability to work, an injury can have lasting consequences. On top of that, injured workers face the hassle of navigating insurance claims and workers’ compensation reports. With so many procedural technicalities, even relatively small errors can lead to a claim denial, depriving you of the money you need to pay your bills.
Fortunately, a workers’ comp attorney can help you appeal a denied claim. A Clarksville workers’ compensation denial lawyer at Smith Hulsey Law can guide you through this process and represent you in court.
Workers’ compensation claims may be denied because the injured employee does not qualify to receive benefits or because of procedural errors in a claim. One such qualification depends on the size of the employer’s workforce. In Georgia, most employers who have three or more employees must carry workers’ comp insurance. Exceptions apply for independent contractors, who are typically not eligible for coverage, per O.C.G.A. 34 § 9-2(d). In addition, commercial railroad workers, federal agents, certain agricultural laborers, and some corporate executives may be excluded from workers’ compensation benefits.
The employee’s conduct at the time of the injury can also impact their eligibility. Under O.C.G.A. 34 § 9-17, an employer’s insurance company is generally exempt from covering injuries that were caused by the injured employee’s own misconduct. Intentional self-injury, disregard for known safety precautions, and intoxication could all disqualify an employee from receiving benefits.
Statute O.C.G.A. 34 § 9-82 sets time limits for when workers’ claims can be filed. Generally, an injured employee must inform their employer of the injury within 30 days of the accident unless the extent of the injury prevents them from doing so. Not meeting this deadline without a valid reason could impact benefits. Additionally, the employee has one year from the date of the injury to file their claim, or else they will typically be barred from collecting compensation.
Workers’ compensation is only available for injuries or illnesses sustained in “a workplace environment” while an employee is doing tasks related to their job. For example, an injurious accident while an employee is traveling to an off-site location for work may qualify for benefits, but an employee who is in an accident while heading out to get food on their lunch break is unlikely to qualify.
A Clarkesville attorney can help injured employees identify the reasons their workers’ compensation claim was denied and potential next steps for filing an appeal.
When an injured employee is notified that their workers’ compensation benefits claim was denied, they have options to appeal the decision. Under O.C.G.A. 34 § 9-102, employees have five years from the date of the denial to request an appeal hearing from the Georgia State Board of Workers’ Compensation (SBWC).
At the hearing, the employee will present their argument to an administrative judge. They must follow standard court procedures during this process, such as abiding by rules for discovery and evidence admissibility. This is the employee’s opportunity to convince the court that they should receive workers’ compensation.
Procedural errors, misapplication of the law, and weaknesses in how an argument is presented could negatively impact an inexperienced employee who goes into this hearing alone. To strengthen their case and stay within the procedural requirements of the court, injured employees in Clarkesville should work with a workers’ compensation denial attorney at Smith Hulsey Law.
Workers’ comp benefits can make a dramatic difference in an injured employee’s ability to pay for treatment and support themselves while they are unable to work. If your claim has been rejected, a Clarkesville workers’ compensation denial lawyer could help you determine the merits of your appeal case and then represent your interests in court. Call Smith Hulsey Law to schedule your legal consultation.
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