The Bureau of Labor Statistics reported 2.6 million nonfatal workplace injuries in 2021. Accidents in the workplace happen all the time, and they can often lead to time off work, distress or excessive pain.
Workers’ compensation offers a safety net for employees to obtain benefits for medical treatment and lost wages. However, in some cases, a workers’ comp claim may face denial in Georgia, leaving individuals in a difficult situation. Consider the implications of the denial of your workers’ comp claim and the available options.
The denial process
When Georgia workers’ comp denies your claim, it signifies that the insurance company has determined that your injury or illness does not fall under the coverage of workers’ compensation. Although disheartening, it is important to understand the necessary steps when facing claim denial.
Appealing the decision
Upon claim denial, you possess the right to appeal the decision. The letter outlines the reasons for the denial and specifies any required documentation or evidence to support your claim. Strengthening your case during the appeal process involves gathering supporting evidence such as medical records and test results.
The appeals process
Initiating the formal appeals process involves filing a request for a hearing with the Georgia State Board of Workers’ Compensation. This request must include a comprehensive explanation as to why they should approve your claim. Subsequently, your case will receive a hearing before an administrative law judge, during which you can present your case, provide evidence and testify about your injury or illness.
Possible outcomes
Following the hearing, the administrative law judge reviews the evidence and delivers a decision. If the judge rules in your favor, you will receive your workers’ comp benefits, granting you access to necessary medical treatment and compensation for lost wages.
In the event of a denied workers’ comp claim in Georgia, maintain hope and take action. You possess the right to appeal the decision and present your case to an administrative law judge.
