If you get injured on the job in Macon, GA, you’ll likely need to file a workers’ compensation claim to cover lost wages, medical treatment, and other benefits. However, these claims sometimes get denied. Why might your workers’ comp claim be denied in Georgia, and what can you do about it?
Common Reasons for Denied Workers’ Comp Claims in GA
There are many reasons a workers’ comp claim could be denied. Some common reasons are not having enough proof, giving wrong information, and not sending all the needed papers. The insurance company needs strong proof you got hurt at work. They also need the right paperwork filled out fully. If any of that is missing, they may deny your claim.
Some other top reasons workers’ comp claims get denied include:
- Failing to formally report the injury – You must properly report your on-the-job injury to your employer. Failing to follow procedure can allow the insurer to later deny the claim.
- Misclassified employment status – Independent contractors are not eligible for workers’ comp. If your status is misclassified, the claim may be denied.
- Pre-existing conditions – Insurers can deny claims if they can prove the injury is related to a pre-existing condition, not your job duties. This is common with back injuries.
- Missed deadlines – There are strict filing deadlines. Missing these or failing to respond to requests on time can lead to a denial.
- Lack of medical evidence – Solid medical documentation is key. Weak medical evidence linking the injury to your employment can result in a denied claim.
- Failing a drug or alcohol test – Testing positive for drugs or alcohol close to the time of injury may result in the insurer denying the claim.
- Misconduct violations – Wilfully violating company safety policies could give the insurer reason to deny coverage.
Fighting Back Against Wrongful Denials
Navigating the workers’ comp system and dealing with claim denials can be overwhelming. But you don’t have to go it alone. An experienced workers comp attorney Macon GA can improve your chances of getting the benefits you deserve.
Here are some of the ways a dedicated lawyer can help:
- Review the denial and pinpoint the exact reasons given. Look for errors or wrongful justifications.
- Gather additional evidence and documentation to address any issues or inadequacies with the original claim filing.
- Initiate appeals processes and negotiate with insurers to have your claim reconsidered and reversed.
- Represent you at workers’ comp hearings to fight against the denial.
- File a lawsuit against your employer and/or insurer if the denial violates Georgia workers’ comp laws.
Don’t let wrongful claim denials prevent you from getting the wage replacement, medical coverage, and rehabilitation benefits you need. The workers’ comp attorneys at Thomas W. Herman are experts in contested cases and will aggressively appeal improper claim denials on your behalf. Contact today to learn more and get a free consultation.
Phone: +1 478-747-6409 Email: email@example.com