Gainesville Workers’ Compensation Denial Lawyer

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Workers’ compensation insurance policies are supposed to provide benefits to people who cannot work because of a job-related illness or injury. In fact, affected employees may rely on these benefits to pay their bills and receive the medical care required to make an optimal recovery.

Sadly, denials of workers’ compensation insurance claims are common. These denials could significantly lengthen the time that passes before receiving benefits or even end with a total denial of coverage. Understanding the reasons for these denials and the legal basis for these steps is crucial to protecting your rights. A Gainesville workers’ compensation denial lawyer is ready to explore the reasons for your denial, evaluate your next options, and take the lead in protecting your future. To discuss your denial with a dedicated attorney, do not hesitate to contact Smith Hulsey today.

What Medical Reasons Might Lead an Insurance Company to Deny a Claim?

Workers’ compensation insurance is a way for employees to collect benefits after a workplace illness or injury. As a result, many cases revolve around whether a person’s current condition was a result of them doing their jobs.

State law under the Official Code of Georgia Annotated § 34-9-1(4) defines a compensable injury as one that arises out of work that an employee did in the course and scope of employment. This means that the person seeking benefits will need to tie their medical condition to the performance of their job duties.

Disputes over this connection are a common reason for a denial. A Gainesville workers’ compensation denial attorney could work to thoroughly investigate the incident that caused an illness or injury. This includes making the vital connection between a person performing their job and their current diagnosis.

Insurance Companies May Dispute the Facts Leading Up to an Injury or Illness

A vital portion of any workers’ compensation insurance claim is showing that the injury or illness took place while on the job. There may be no doubt that an employee is currently unable to work or can only work in a limited capacity. Nevertheless, an insurance company may not believe that their injury or illness occurred because of their job.

Insurance companies may argue that coverage is inappropriate because:

  • The injury did not occur while a person was on the clock
  • The injury occurred while on the way to or from a worksite
  • The injury was the result of horseplay
  • The worker was intoxicated or under the influence of drugs leading up to the event

An inability to make this connection is another common reason for a workers’ compensation denial. A knowledgeable Gainesville attorney could further explain the elements of a successful receipt of benefits and evaluate an insurance company’s stated reason for a workers’ compensation denial.

A Gainesville Workers’ Compensation Denial Attorney Could Help

People seeking workers’ compensation benefits must prove two main concepts. First, they must show that they are currently suffering from a medical condition that prevents them from working. Next, they need to prove that their current condition resulted from doing their job. Failures in either area could result in a denial of benefits.

A Gainesville workers’ compensation denial lawyer is ready to explain the state’s workers’ compensation laws and why your case has resulted in a denial. They will then advise you of the next possible steps to pursue the compensation you need to make things right. If you have further questions about this process, contact Smith Hulsey today to learn more.

Smith Hulsey Law

Smith Hulsey Law