What Are the Odds that Your Atlanta Workers Comp Claim Will Be Denied?

Atlanta workers comp claims can show up when you least expect them. If you’re injured on the job, you should be able to depend on your employer to take care of you. If your workers compensation claim is denied, you’re going to be angry and frustrated. Medical care is expensive. Even if your private health insurance covers your care, you’ll still be responsible for co-pays and out of pocket bills. That’s why so many people whose claims are denied retain an experienced Atlanta workers comp lawyer.

While your attorney can’t guarantee they’ll get your claim approved, they will work hard to settle it with the insurance company. The main thing is to make sure your medical bills are covered. You’ll also want to receive replacement wages for the time that you’re out of work. If you haven’t already consulted with a lawyer, it’s a good idea to call one sooner rather than later.

You Must Meet Certain Criteria to Be Eligible for Benefits

In order to qualify for workers comp, you need to meet certain requirements. Regardless of where you live in Georgia, these requirements will be the same. At a minimum, you must demonstrate the following if you expect to receive workers comp benefits:

  • Your injury happened while on company time
  • You were on company property at the time of your accident
  • You were acting within the scope of your employment when you were hurt
  • You weren’t under the influence of drugs or alcohol
  • You agree to submit to a drug test prior to treatment
  • You are seen and treated by a company-approved doctor
  • You comply with all your doctor’s treatment recommendations

If you fail to meet these basic requirements, there’s a good chance your claim will be denied. Depending on the reason for the denial, your Atlanta workers comp lawyer may be able to file an appeal on your behalf.

What Are Some of the More Common Reasons for Denial?

Most workers comp claims that are denied in Atlanta are denied for a certain reason. Some reasons are more common than others. Atlanta workers comp lawyers see claims denied for one of the following reasons:

  • You didn’t report your accident in a timely fashion
  • There is reason to suspect your injuries are the result of something other than your job
  • You were drunk or under the influence of drugs at the time of your accident
  • You refused to be treated by an approved doctor
  • You don’t show up for your doctor’s appointments or physical therapy

Sometimes, a claim is denied for a simple reason. Perhaps you didn’t fill out the proper paperwork. If it’s something this minor, there’s a good chance your Atlanta workers comp lawyer will be able to get your claim reopened and approved. If it was denied for any of the reasons listed above, it will be a bit harder to convince the insurance company to pay your claim.

Nobody Is Ever Guaranteed Benefits

There’s no such thing as a guarantee when it comes to workplace accidents. Even if you fill out all of the proper paperwork, your claim could still be denied. The truth is that insurance companies make mistakes. There could be a reasonable explanation for why your claim wasn’t approved. One of the first things your attorney will do is reach out to the insurance company to find out a reason for the denial. Once they have this information, they’ll have a better idea of what they need to do to get you the benefits you deserve.

In Atlanta, injured workers are entitled to some or all of the following benefits:

  • Your medical care will be covered
  • You’ll receive weekly benefits equal to 2/3 of your average weekly wages
  • Your weekly benefits cannot exceed $675
  • You will only receive benefits for 400 weeks

If you happen to exhaust the 400 weeks, your benefits will run out. Very few cases ever get to that point. Normally, an injured worker will return to work within a few weeks or months. Even if you’re still hurt after a year or more, your Atlanta workers comp lawyer will have found a way to settle your case.

It’s Best to Call an Experienced Atlanta Workers Comp Lawyer Right Away

Whether your workers comp claim has been denied or not, you should call our office. An Atlanta workers comp lawyer will ensure that your case is handled properly from the start. Call and schedule your free, initial consultation as soon as possible after your accident.