If you suffered an injury on the job, you may be entitled to workers’ compensation benefits. Unfortunately, many employees file a claim only to see it denied entirely or partially. While this can be frustrating, you still have options available to secure fair compensation for your injuries.
In this situation, the support of a Winder workers’ compensation denial lawyer can be invaluable. You can file an appeal and potentially get the benefits you deserve. Do not give up before discussing your options with a dedicated workers’ compensation attorney first.
Insurance companies often give different reasons for rejecting workers’ compensation claims. Thankfully, a workers’ compensation attorney could assist with various denial scenarios in Winder.
The deadlines that apply to workers’ compensation claims are strictly enforced. This includes the amount of time a person has to report an injury, as well as the deadline for the claim itself.
These benefits are exclusively for injuries and illnesses that occur at work. Conditions that existed before the work-related incident are not covered, although benefits are available if that condition is worsened by an accident on the job.
Injuries stemming from certain behaviors are not covered, even when they happen on the clock. For example, a person will not be eligible for benefits if they are hurt during horseplay or because of their voluntary intoxication.
Regardless of the reason for your claim denial, an attorney could help you file an appeal.
There are two different types of denials in workers’ compensation cases. The first involves the complete rejection of a claim for reasons like the injury occurred away from work or the deadline to file was missed. The second type of denial is partial. The end result might be benefits, but certain parts of the claim—like specific injuries or conditions—are not covered.
In either scenario, the guidance of a workers’ compensation denial lawyer in Winder could make a significant difference. The appeals process gives employees the chance to clear up misconceptions or errors that may have limited their recovery. However, facing the appellate process alone could lead to costly mistakes that jeopardize your claim.
While workers’ compensation appeals are unique, they must follow the same general path after the initial claim is denied. There are four stages of an appeal, and a favorable result in any of them can lead to granted benefits. A workers’ compensation denial attorney in Winder could assist you during each stage of the process to ensure your rights are upheld.
An injured worker must first appeal the initial denial letter to an administrative law judge (ALJ). This involves a hearing where the ALJ will consider evidence from both sides before making a final ruling.
If the ALJ upholds the denial, the next step is the Appellate Division of the State Board of Workers’ Compensation. There is a narrow 20-day window to file an appeal after the ALJ issues a decision.
The final two stages occur outside of the Board of Workers’ Compensation entirely. They include a review by a Superior Court judge, followed by the last stage at the Georgia Court of Appeals.
Having your claim denied can be frustrating, but it is not hopeless. You may still be able to secure the benefits you deserve, but doing this on your own can be difficult. Let a Winder workers’ compensation denial lawyer handle every aspect of your appeal. Speak with Smith Hulsey Law for a private consultation today.
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