Dealing with a workers’ compensation claim rejection can be quite challenging. But worry not, there are steps you can take to navigate this situation.
We’ll break down the process, offering practical advice on how to proceed. From the reasons claims might be denied to the specific steps you can take, our blog will walk you all through it. Also, it would be wise to consult an experienced Atlanta worker’s compensation lawyer. These professionals can provide you with valuable insights to make your case strong.
Understanding the Reasons Behind Claim Denial
The first thing to do after a worker compensation claim denial is to find the reason behind it. Insurance companies may deny a claim for various reasons, and being aware of these factors can assist injured workers in navigating the claims process more effectively.
Some typical reasons for the denial of workers’ compensation benefits are listed below:
1. Disputed Injury
Workers’ compensation generally covers injuries that occur while actively performing job duties and are directly caused by those duties. However, when filing a claim, your employer might dispute it, claiming that your injury wasn’t directly linked to your work. For, if you were on a break or engaging in playful activities when injured, your claim may be denied. Also, employers may claim that a pre-existing medical condition, rather than work conditions, caused your illness.
Thus, it’s essential to be aware of these possibilities and understand that certain circumstances may lead to challenges in qualifying for workers’ compensation benefits.
2. Late Reporting
After being injured in a work accident, you have the right to file a worker’s compensation claim. As per OCGA §34-9-82, the time limit, also known as the statute of limitations, for a workers’ compensation case in Georgia is one year. It means that you have only 12 months to reach out to an Atlanta worker’s compensation lawyer, get your workers’ compensation claim ready, and submit it.
Failing to meet this deadline might affect your ability to pursue a claim, so it’s advised to act promptly within the stipulated time frame
3. Incomplete Documentation
It is equally essential to provide sufficient information about your injury and medical care. Inappropriate or incomplete information can lead to your claim denial.
4. Failure to Get Medical Attention
When injured workers don’t promptly seek medical attention after getting hurt, it may result in the denial of their claim. The insurance company could claim that the delay suggests the injury isn’t severe. Hence, to qualify for workers’ comp benefits, it’s crucial to get medical treatment.
5. Injuries Are Not Compensable
Proving claims for stress-related injuries can be challenging in many states. However, in Atlanta, GA, workers’ compensation laws explicitly address and cover stress-related injuries.
Key Takeaway
You may feel depressed after getting a claim denial. However, in many cases, denial can be successfully appealed, but you have to work with legal professionals like a criminal attorney in Atlanta or a worker’s compensation lawyer to ensure everything is handled accurately. A lawyer can assist you in responding to the objections raised by an insurance company or employer regarding your claim.
