When you’ve been injured at work, it’s incredibly frustrating to learn that your workers’ compensation claim has been denied. It can feel as though someone doubts your word—your account of your injury—or that your employer is not on your side.
Before you jump to conclusions, however, it’s important to understand why your claim was denied in the first place.
Why are workers’ comp claims denied?
Once you’ve received word that your workers’ comp claim has been denied, it’s time to take a good look at what went wrong. Sometimes claims are denied due to simple clerical errors, perhaps one on your employer’s part. In other cases, claims may be denied due to the following circumstances:
- Missed deadlines
- Insufficient evidence that your injury occurred at work
- Your condition doesn’t meet state guidelines
- Your employer contests your account of the injury
- You filed your claim after leaving your job
- You didn’t receive appropriate medical treatment
So what are your options? Fortunately, the Georgia workers’ compensation system includes a path for appealing denied claims, but, like many aspects of the process, it can be complex. It’s especially important to speak with a Georgia workers’ compensation attorney if you’re facing a denied claim. While you’ll have a few chances to reverse the decision, your best chance is the first one.
How do I appeal?
After determining your claim was not denied because of a simple error, it’s time to make an appeal. As the first step in the process, you’ll need to request a hearing in front of an administrative law judge. If the judge again denies the claim, your case can proceed to the Appellate Division of the State Board of Workers’ Compensation, where the board will review the record of the previous hearing and either uphold or overturn the judge’s decision. If the board upholds the judge’s decision (as it likely will), you can move on to the Georgia Superior Court, and from there, to the Georgia Court of Appeals.
Why do I need a workers’ comp lawyer for my appeal?
While Georgia offers multiple chances to overturn your claim denial, your very best chance is your first hearing in front of the administrative law judge. That’s why it’s so important to work with an experienced workers’ comp lawyer from the start. The hearing before the judge is your one chance to introduce new evidence—for example, medical records that demonstrate your workplace injury is unrelated to previous injuries—and to make a new argument for yourself. In the later steps of the appeals process, the board or courts will review what’s already been shared. Because of this, they tend to side with the original opinion of the administrative law judge.
You’ll also be working on a tight timeline with only 20 days between each step. Your attorney understands this process and can pace your appeal appropriately.
At the Law Offices of Laura Lanzisera, we specialize in Georgia workers’ compensation cases, so we know how to mount the strongest appeal possible. Don’t give up on your case. Even if your claim has been denied, there’s still a chance to get the compensation you deserve.