What To Do If Your Workers’ Comp Claim Is Denied in Athens, GA

Following a job-related accident in Georgia, you have the right to file for workers’ comp benefits. Our state has a no-fault workers’ comp system. You do not have to prove that your employer was “at fault” or otherwise “negligent” to hold them liable for your accident. Still, getting workers’ comp benefits can sometimes prove to be challenging. As frustrating as a workers’ comp denial can be, it is important to know that you have the right to file an appeal. Here, our Athens workers’ compensation attorney highlights the steps to take if your workers’ comp claim was denied in Georgia.

Denied Workers’ Comp Claim in Athens? Four Steps that You Need to Take

Step #1: Preserve the Denial Letter

When a workers’ comp claim is denied in Georgia, an injured worker has a right to receive a written denial letter that explains the reasoning as to why that adverse decision was made. Your denial letter is the foundation of your appeal. It explains exactly why your workers’ comp claim was rejected. That information will guide every step you take moving forward. However, the details of a workers’ comp denial letter can often be difficult to parse. You should carefully read the letter to understand the stated reasons. It could be missing documentation, a dispute over whether your injury is work-related, or another issue. You should also keep the original letter in a safe place and make copies or scans for your records. Organization is key to a successful workers’ comp appeal.

Step #2: Consult With a Workers’ Comp Appeal Lawyer

Neither your employer nor the insurance company has the unilateral right to render the final decision in your claim. You do not have to take them on alone. A top-rated Athens, GA workers’ comp attorney can review your case, answer your questions, and help you develop a comprehensive plan of action to get justice and the maximum available benefits. Your attorney will help you with every aspect of your workers’ comp appeal, including how to initiate your claim. Georgia’s workers’ comp laws have strict deadlines and procedural requirements, and missing a step can harm your chances. The right legal representation can make a very big difference in your claim.

Step #3: Gather and Prepare Supporting Evidence

Evidence is the key to any successful legal claim. Workers’ compensation cases are certainly no exception to the rule. A successful appeal depends on the strength of your evidence. You should start by collecting all medical records related to your injury, including diagnostic reports, treatment notes, and recommendations from your doctor. You may also want to consider getting things like written statements from any witnesses who saw the accident or can confirm your job duties and injury impact. Employment records (such as timecards, incident reports, and job descriptions) can also help prove your case. If your denial was based on a claim that your injury is not work-related, you may need expert medical opinions to clarify the connection. Once again, you are not alone. Your Athens, GA workers’ comp lawyer can help identify gaps in your evidence and request additional documentation. The more thorough your evidence, the better positioned you will be to appeal.

Step #4: Escalate Your Appeal to a Higher Level of Review

If your initial appeal is unsuccessful, you still have options. In Georgia, workers’ comp disputes can be escalated beyond the first hearing to higher review levels, including the Appellate Division of the State Board of Workers’ Compensation and, in some cases, the Georgia Superior Court. Indeed, under Georgia law (GA Code § 34-9-103), there is a multiple-stage process for workers’ comp appeals. Your Athens, GA workers’ comp attorney can assess whether the judge made legal or factual errors that could be challenged. Even if your initial appeal is not successful, that does not mean that you are entirely out of options. You have the right to go the distance to challenge an unfair workers’ compensation denial.

Why You Need a Denied Workers’ Compensation Claim Lawyer

The denial of workers’ compensation benefits in Georgia can be stressful, frustrating, and even overwhelming. Knowing what to do is one of the keys to getting results. If your workers’ comp claim has been denied in Georgia, the right workers’ comp attorney can make a big difference. Here are four reasons why you need an Athens workers’ comp appeals attorney:

1. In-Depth Knowledge of Georgia Workers’ Comp Law: Workers’ compensation laws are complex. They are highly technical, especially when it comes to appeals. A lawyer understands these rules in detail and ensures your claim is handled the right way.
2. The Right Strategy to Build Your Case: An Athens, GA workers’ comp attorney can review your denial letter, identify weaknesses in the insurance company’s reasoning, and gather targeted evidence to counter their arguments. A strategic approach is a must if the insurance company is trying to deny you workers’ comp benefits.
3. Proactive, Effective Communication with Insurers: Insurance companies often try to minimize payouts or deny valid claims. They are not on your side, especially if your claim has already been denied. Your Athens, GA workers’ comp lawyer acts as your advocate. They can handle all communications with insurance adjusters.
4. Skilled Representation at Hearings: If your Georgia workers’ case proceeds to a hearing, your lawyer will present evidence, question witnesses, and make persuasive legal arguments on your behalf. Experience at hearings is a must when looking for a lawyer.

What Types of Workers’ Comp Benefits are Available On Appeal in Georgia?

If your workers’ compensation claim is approved on appeal in Georgia, you may be entitled to several types of benefits. What exactly you can seek as part of a workers’ comp appeal is case-specific. With that being said, some of the common benefits that are at issue include:

• Medical Benefits: In Georgia, medical Benefits cover all reasonable and necessary treatment related to your work injury, including doctor visits, hospital care, surgeries, prescription medications, physical therapy, and rehabilitation services. These benefits have no dollar limit. All reasonable and necessary care is covered.
• Wage Loss: In Georgia, there are income benefits that are available to replace a portion of your lost wages if you cannot work due to your injury. Temporary Total Disability (TTD) benefits pay two-thirds of your pre-injury average weekly wage, up to the state maximum amount. In cases where you continue to work while under work restrictions, and where your pay is reduced as a result thereof, you can also be entitled to Temporary Partial Disability (TPD) benefits, which pay two-thirds of the difference between your pre-injury average weekly wage and any new reduced wages during periods where you are eligible for TPD, and up to the state maximum amount. One thing to note is that you cannot receive TTD and TPD at the same time – you either receive one when you are completely out of work or the other when you are working light duty at a lower income than before your injury.
• Permanent Disability Benefits: With more serious injuries, permanent disability benefits may be available if your injury results in lasting impairment. These benefits are based on a doctor’s impairment rating and Georgia’s benefit schedule. PPD benefits can be paid out as a one-time lump sum payment or otherwise paid out on a weekly basis once all TTD and/or TPD benefits have been paid out.

The Larrison Law Firm is a Leader in Handling Workers’ Comp Denials

Workers’ comp appeals are complicated. If your benefits were denied, you have a right to take action to challenge that denial. It is imperative that you have a strong, experienced attorney on your side.

At The Larrison Law Firm, we are solutions-focused. Our case results tell the story of what we can do for injured workers, including in workers’ comp appeals in Georgia. Athens, GA, is known for its vibrant culture, historic architecture, and thriving university community. Injured workers in Athens deserve the same level of protection and advocacy as employees anywhere else in Georgia. For a free, no-obligation initial consultation with a top-rated Athens, GA workers’ comp lawyer, please contact us today.

Contact Our Athens, GA Workers’ Comp Attorney Today

At The Larrison Law Firm, our Athens workers’ comp attorney is standing by, ready to protect your rights and your interests. If you are struggling to get access to your workers’ comp benefits, we are here to help. Call us now or contact us online for a free, no obligation initial consultation. With an office in Athens, we handle workers’ comp appeals throughout the region in Georgia. If you are located in Athens or nearby neighborhoods, our office is conveniently situated in the 30601 zip code.