Jan 30, 2017

My Workers’ Comp Claim Was Denied: What Now?

If you have been hurt while working, or if you have lost a family member in a work accident, you may have the right to receive workers’ compensation benefits to cover the cost of medical care, lost income, or lost economic support. While you may have the right to benefits, obtaining them isn’t always easy.

You may have already learned that the workers’ compensation process can be difficult, especially if your claim has been denied. Unfortunately, workers’ comp claim denials are not uncommon. This is because insurance companies are in business to make money and keep premiums low for their policyholders. In their efforts to protect their bottom line, they often place profits over people, and can deny your claim when you are in fact eligible for benefits.

If your claim has been denied, our Atlanta workers’ compensation lawyers At Hansford McDaniel – Workers’ Compensation Attorneys do not want you to feel discouraged. You are not alone in receiving a denial during the initial stage. You also have rights and options available, and our legal team is here to help you learn more about taking the next steps and how we can assist with appeals.

While every case, denial, and plan of attack to dispute the denial is different, you can gain a better understanding of what to do next from the information we’ve compiled below:

  • Determine the reason for denial – If your claim was denied, you should have received a letter that explicitly states the reason for the denial. Common reasons cited in workers’ comp denials include waiting too long to inform an employer about an injury, not filing a claim in time, being injured in an accident that was not work-related, or suffering an injury that is not covered by workers’ compensation.
  • Know that you have options – If you disagree with why your claim was denied, or believe it was denied erroneously, remember that you have options! This includes your right to appeal the decision and request a hearing with the Georgia State Board of Workers’ Compensation. You may be asked to attend mediation prior to a hearing to see if the dispute can be resolved informally. If no solution can be agreed upon, you will then have a hearing before an administrative law judge, where you can provide supporting evidence as to why you should receive benefits. If the judge again denies your claim, you still have the opportunity to appeal to a higher authority, the Board’s Appellate Division. While you’re not required to have a lawyer during the appeals process, it is strongly recommended that you do.
  • Be aware of deadlines – It is critical that you take the steps toward an appeal as soon as possible. Under Georgia law, you must file an appeal within a year of your injury, in most cases. Following a denial by the administrative law judge, you have 20 days after the decision to appeal to the Appellate Division. Being aware of these deadlines is essential if you wish to pursue benefits.
  • Speak with an attorney – The most important thing you can do following a denial is to speak with an attorney who knows how the workers’ compensation appeals process works. Our firm focuses our practice on these claims, and we’ve helped numerous clients achieve successful resolutions after their claims were denied. Our team can thoroughly investigate your claim to determine how we can challenge the denial, provide supporting evidence of our argument, and represent you during all phases of the process.

Having your claim denied can add insult to injury, but you do not have to feel discouraged. Instead, speak with an attorney from The Law Officers of Hansford McDaniel – Workers’ Compensation Attorneys to learn more about your options and how we may be able to help you appeal the decision. Over the years, our firm has recovered millions of dollars in compensation for our clients, and we’re ready to fight for the benefits you need!

Contact us for a free case review. We proudly serve clients throughout Georgia and Alabama.