Everyone has to work somewhere and whether you are sitting or standing at your desk, working outside, driving a car, truck or working in a restaurant, injuries on the job are serious and in many cases you may need to file a workers’ compensation claim.
This coverage is supposed to help you if you get hurt on the job and can’t work. You would then file a claim for benefits so you are able to receive some compensation.
Since you are receiving benefits your employer and fellow co-workers are no longer responsible or liable for your injuries that you suffered on the job. You are no longer able to sue. That is how everything is supposed to work in a perfect world. However, we all know nothing is perfect. Insurance companies or employers sometimes try to deny and/or minimize the benefits paid out to employees injured on the job. They might allege that your injuries occurred at some other place or a time while you weren’t working. They might even claim that your injuries aren’t really that serious.
The process of recovering benefits can be time-consuming, frustrating and complicated. However, an experienced personal injury attorney could make it easier. If you or someone you know has been hurt on the job and the claim is denied, please fill out a free case evaluation form to learn more about how our Atlanta workers’ compensation lawyers may be able to help you.
Our lawyers at Hart & Hart help workers who were injured on the job in Atlanta and were denied their workers’ compensation claims.
Using our experience advocating for workers, we help them through the process of trying to recover the money they might rightfully be owed. A dedicated attorney handles on-the-job injury claims involving, but not limited to, the following:
These injuries may be the result of unavoidable accidents, dangerous working environments, inadequate training, or faulty machinery. Under workers’ compensation, however, employees are not required to prove the reason that their injury occurred, as this is a no-fault system that compensates injured workers without regard to negligence or fault.
Eligibility for benefits depends on several factors, including what state the employee’s job is in, if the employee works for the federal government, and even the industry. However, most employees are covered by a workers’ compensation plan of some sort.
For example, with some exceptions, in Georgia, businesses with three or more employees must provide insurance, with some liable for subcontractors’ employees.
The majority of unintentional injuries, diseases, illnesses, accidents, and deaths occurring in the workplace are covered by workers’ comp laws. Importantly, because of its no-fault system, workers are not required to prove fault for their injuries to recover benefits.
In many states, a worker must report a workplace injury to his or her employer within 30 days of the accident. The employee has a certain amount of time after the initial injury report to file a workers’ compensation claim — in some states that’s two years.
When first reporting the accident, the injured worker should provide specific details, such as:
The injured worker will seek an immediate medical exam to determine the extent of their injuries by an approved and authorized medical provider chosen by their employer — the specifics of this may be different depending on the state. If an injured worker seeks a second medical professional’s opinion, depending on their state there could be certain restrictions on this. The lawyers at Hart & Hart can guide you through this process.
The testimony of the doctor is very important and will influence the amount of benefits awarded. Assigned doctors can and sometimes do work with insurance companies to protect their clients’ best interests. That’s why you need an experienced workers’ compensation attorney to help guide you through the process.
An injured employee’s claim for benefits may be denied if the insurance company:
If a worker’s claim is denied, they have a right to appeal the denial of benefits. Once an employee receives the denial, they can file a petition with a workers’ compensation appeals board in their state.
Although an injured worker isn’t required to have an attorney at the hearing, it is often advisable. An experienced Atlanta workers’ compensation lawyer will know what to expect and how to better address situations that may arise during proceedings.
At the hearing, an injured employee or their attorney can present evidence showing why they are entitled to benefits. This evidence often includes all of the details first laid out when the initial claim was made and the medical treatment following the injury.
A legal representative may utilize medical records to help clarify the extent of their client’s injuries to the judge, as well as a physician’s opinion on the employee’s ability to work and how the claimant’s work injury was directly related to the job.
In some instances, medical experts may be called upon to attest to an employee’s ability to return to work and perform their job responsibilities going forward. The hearing also serves as an opportunity for insurance companies and employers to rebut evidence and attempt to prove a worker is not entitled to benefits. How long an appeal takes depends on several factors. Generally, after evidence is presented and testimony is heard, a judge will typically make a decision within 30 days.
Alternative solutions may be available through mediation to settle disputes. A mediator may be allowed to assist in obtaining a more creative and mutually acceptable resolution involving modified job assignments or monetary arrangements.