Here’s What You Should Do If Your Workers’ Compensation Claim Is Denied/Converted

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Don’t panic. In fact, expect workers’ compensation insurers to deny your claims following workplace accidents. Private workers’ comp carriers are looking out for their bottom line, not injured workers. They frequently deny claims by alleging that they’re untimely or unrelated to workplace trauma. The experienced workers’ compensation appeals lawyers at Gearhart Law Group know how insurers operate and can fight for the rights of injured workers in Georgia. Here’s what to do if your workers’ compensation insurer denies your initial claim.

Review the Denial Reason Closely

Claims personnel must explain why your claim was denied. This means any letter should include a denial reason. The most common reasons workers’ compensation carriers deny claims include:

  • Failure to receive a response and/or income paperwork from your employer
  • Failure to receive requested evidence from the claimant
  • Untimely filings
  • Uncovered injuries
  • Failure to attend mandatory medical examinations

Despite numerous requests, employers frequently negligent to submit the paperwork necessary to support workers’ compensation claims. These documents generally include pay information, incident reports, job descriptions, and witness information. This isn’t the claimant’s fault, and you have the right to force employers to provide the information and request the insurer reopen your claims. Likewise, you always have the right to obtain secondary medical opinions and explain yourself to administrative officials.

Request an Immediate Appeal & Gather Evidence

It’s important to lodge an immediate appeal to prevent losing your essential rights. Always request an appeal in writing with additional time to prepare appropriate evidence. Attorneys frequently recommend mailing a certified appeals letter and emailing a copy of this letter to the claims adjuster. At the very least, this gives you additional time to contact a lawyer and gather essential evidence.

After requesting an appeal, it’s important to start gathering evidence supporting your workers’ compensation claims. This may include providing statements about the circumstances of your injuries, copies of pay stubs, witness reports, and supporting medical records. A dedicated workers’ compensation attorney can frequently preserve your appeals rights and prepare your case for administrative review.

Retain an Experienced Local Workers’ Compensation Appeals Lawyer

Fighting workers’ compensation denials can seem overwhelming, especially when you’re already struggling with painful injuries and lost wages. Most claimants don’t know how to locate insurance doctors, obtain affidavits, or request certified medical records explaining their injuries. Dedicated Georgia workers’ comp lawyers may do all this for you and more. If you’ve been denied essential benefits, it’s essential to schedule a free consultation with Gearhart Law Group immediately by calling (404) 445-8370 or reaching out online.

Georgia Workers’ Compensation FAQs

How much does it cost to retain a workers’ compensation lawyer?

Workers’ comp lawyers accept cases on a contingency fee basis, meaning clients generally pay nothing unless their attorneys recover settlements for them. After this, lawyers typically take 33% of the settlement plus costs as their fee.

Can I take my workers’ compensation case to court?

While you can’t sue your employer for injuries covered by workers’ compensation laws, you may appeal denials to higher divisions of the state workers’ compensation board and Georgia courts. You only have a few weeks to take this appeal, and you must follow the steps outline in the appeals process.

How much can I get in weekly workers’ compensation benefits?

Up to $725 per week or two-thirds of your average weekly salary, including overtime, whichever is lower. You may also obtain 100% medical coverage for your workplace injuries.

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