What Are My Options If My Workers' Comp Claim Has Been Denied?

Workers’ compensation insurance provides financial relief for medical bills, loss of wages, transportation to and from medical appointments, rehabilitation, and other injury-related costs. However, there are a variety of reasons your workers’ comp claim may be denied. If you failed to notify your employer in a timely manner, or you did not receive medical treatment, the insurance company may dispute or deny your claim.

If your workers’ compensation claim has been denied, you should:

  • Hire an attorney. If you have received a notice saying your workers’ compensation claim has been denied, it is important to hire an experienced attorney to uphold your right to a settlement. The workers’ compensation appeals process in Georgia can be difficult to navigate, and the insurance company and your employer may dispute your case. A lawyer can help you file the necessary documents within the time limit, explain complex legal terms, and guide you through the process.
  • Gather evidence. Evidence is necessary to prove that your injuries occurred at work. This may involve pictures or videos of the incident, witness statements, and medical records. It is important to see a doctor as soon as possible after an accident, even if you feel fine. Some injuries, such as whiplash, traumatic brain injuries, and muscle or ligament sprains, may not exhibit symptoms right away. By seeing a doctor as soon as possible, you can provide evidence of the nature and extent of your injuries.
  • Request a hearing. Once you receive a notice of denial, you will be able to request a hearing with the Georgia State Board of Workers’ Compensation (SBWC). However, there is a time limit. In Georgia, you only have 1 year from the date of your injury to request a hearing. If you miss this deadline, you will likely be unable to receive the benefits you deserve.
  • Proceed through mediation. In many cases, the SBWC will make you go through mediation to try to amicably reach an agreement. During mediation, an impartial mediator will facilitate discussions between you and your employer. Your attorney will negotiate a fair settlement with the insurance company. If this fails and you are still unable to reach an agreement, your case will proceed to a formal hearing. You will present evidence to support your claim, and the administrative law judge will issue a decision about your workers’ compensation benefits.
  • Appeal your case. If mediation and the formal hearing does not provide a beneficial solution, you have the ability to appeal the decision to a higher court. You will need to request an appeal with the SBWC’s Appellate Division within 20 days of the hearing results. The Appellate Division will review your case and issue a final judgment concerning your benefits. This is the last step in the appeals process as you seek workers' compensation benefits.

Discuss Your Situation with Our Atlanta Workers’ Comp Attorneys – (770) 629-9321

If your workers’ compensation claim has been denied, it is important to act quickly to appeal the decision. The Law Offices of Nathaniel F. Hansford, LLC has more than 2 decades of combined legal experience. We have guided hundreds of clients to successful settlements. Whatever your situation, our Atlanta workers' compensation lawyers will discuss your options for appealing the denial and work tirelessly to build your case.

Contact our firm today to request a free initial case review.

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