When you are injured on the job, you count on workers’ compensation benefits to cover you until you can get back on your feet. Unfortunately, some employers and workers’ compensation insurers may choose to deny a worker’s claim for benefits. If your work injury claim is denied, you should speak to an experienced workers’ compensation appeal lawyer as soon as possible.
At the Law Offices of William F. Underwood, III, P.C., we have extensive experience successfully appealing denied workers’ compensation claims. Our attorneys have the skills and the resources to take on insurance companies that try to deny or limit the compensation you receive. We know the Georgia workers’ compensation laws inside and out, and you can trust that we will explore every legal option available to pursue the benefits you deserve.
If your workers’ comp claim has been denied, contact us now for a free case evaluation.
Why Workers’ Comp Claims Are Denied
Unfortunately, many workers’ comp claims are denied even when an employee suffers a work-related injury or illness. Workers’ compensation claims may be denied for reasons that include:
- Your employer or its insurer says that your injury or illness did not arise in the course and scope of your employment.
- You failed to timely report your work accident and injury or the onset of symptoms of an occupational illness.
- You intentionally injured yourself, or your injury or illness occurred due to your willful misconduct, such as engaging in horseplay or showing up to work under the influence of alcohol or drugs.
- Your occupational illness arose from a pre-existing condition, such as a heart attack or stroke on the job being caused by pre-existing cardiovascular disease.
- You failed to seek prompt treatment of your injury or illness, giving your employer or its insurer cause to doubt the severity of your injury or doubt that the injury or illness was caused by your work.
A denied workers’ compensation claim is not the end of the road. You have the right to continue your fight for benefits. Let us help. Contact the Law Offices of William F. Underwood, III, P.C., for a free consultation.
What to Expect in Appealing a Workers’ Comp Claim Denial
If you choose to appeal the denial of your workers’ compensation claim, you can expect the appeals process to involve the following:
- Your employer or its workers’ compensation insurer may have an administrative appeals process for you to challenge the denial of your claim or to request that your employer or its insurer reconsider your claim for benefits.
- Alternatively, you may choose to file a Form WC-14 with the Georgia State Board of Workers’ Compensation. You should also forward a copy of the completed form to your employer and its workers’ compensation insurer. Through the form, you can request a formal hearing to resolve the denial of benefits. Or you can request mediation between you and your employer and its insurer to try to reach a settlement of your claim.
- After you’ve filed a formal claim with the state board and requested a hearing, you and your employer will engage in the process of discovery, where you exchange documents and information. During discovery, your employer or its insurer may request that you provide sworn testimony in a deposition or submit to an independent medical examination to determine the extent of your injury or illness.
- If you request a formal hearing, your claim will be heard by an administrative law judge. The hearing functions like a trial, where you and your employer or its insurer will present evidence or testimony to the judge. The judge will then render a decision either affirming the denial of your workers’ comp claim or ruling that you are entitled to benefits.
- If you disagree with the judge’s decision, you can file an appeal to the state board’s appellate division. If the denial of your claim is still upheld, your next path involves appealing your case to the courts. However, the courts will only review any legal errors made by the state board and will defer to the factual findings of the administrative law judge.
How Long Does It Take to Appeal a Denied Claim?
If your employer denies you workers’ compensation benefits, you must file the Form WC-14 with the state board to begin the formal claims process with the state within one year of the date of your work injury or the onset of an occupational illness. If you request a hearing, it will typically take place within 60 days of you filing the claim form. The hearing judge will render a decision within 30 days of the hearing.
If the judge affirms the denial of your claim, you can appeal to the state board’s appellate division within 20 days of receiving the judge’s ruling. An appellate hearing will be heard within 60 days of the filing of your appeal.
If you remain unsatisfied with the state board’s decision, you can continue your appeal to the courts within 20 days of the appellate division’s ruling. Your appeal will first be heard by the Superior Court. If the superior court rules against you, you have 20 days to appeal your case to the court of appeals.
The appeals process is complex and requires extensive legal knowledge. It is in your best interests to work with a trusted attorney who has a track record of successfully appealing denied claims. Contact the Law Offices of William F. Underwood, III, P.C., to learn how we can help you through this stressful process.
Why You Need a Workers’ Compensation Attorney to Appeal a Wrongfully Denied Claim
If your workers’ comp claim has been denied, do not try to navigate the appeals process on your own. Let a knowledgeable workers’ compensation attorney from the Law Offices of William F. Underwood, III, P.C., help by:
- Investigating the underlying facts and circumstances of your injury or illness to establish that it qualifies as work-related
- Communicating with your treating providers to understand the extent of your injury or illness and how it impacts your ability to return to work
- Explaining your rights and options for appealing the denial of benefits, such as pursuing mediation or going to a formal hearing before an administrative law judge
- Filing your formal workers’ comp claim with the state board on your behalf
- Preparing your case for mediation or a formal hearing and advocating for your rights at the hearing
- Guiding you through the appeals process if your claim is initially denied by the administrative law judge
Talk to an Albany Workers’ Compensation Lawyer Now
If you were hurt on the job, you may be entitled to workers’ compensation benefits to help you recover from your injuries and get back on your feet. Don’t let your employer or the insurance company unfairly deny you the help you need. Contact the Law Offices of William F. Underwood, III, P.C., today for a free consultation with an experienced Albany workers’ compensation lawyer. Call us today or reach us online.
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