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Most workplaces spend time and money each year on efforts to promote safety, from training sessions to new equipment. While these activities often reduce the risk of accidents, sometimes people still experience workplace injuries.
If you’ve been hurt on the job, you may be unsure how to handle medical bills and lost income—especially if your boss discourages you from making a Workers’ Compensation claim or says you don’t qualify. Or, you might file a claim, only to be denied for various reasons despite having a valid injury.
Can a Duluth Workers’ Compensation Attorney Help With Your Claim?
In many cases, we’re able to help injured people secure the Workers’ Compensation benefits they deserve. The best way to learn the options for your case is to seek a free consultation with a Workers’ Comp lawyer who can review the details and answer your questions.
Additionally, we can assist you with filing your claim, or we can review your case if you’ve received a claim denial. In some situations, we may be able to appeal a claim denial and fight for the benefits you need.
Who Is Eligible for Workers’ Compensation in Georgia?
With few exceptions, Georgia requires employers to take out Workers’ Compensation insurance if they have at least three employees.
If you are a W2 employee—you have a job where your employer withholds taxes—then you should be covered by Worker’s Compensation if you have an injury on the job. However, there are some reasons why your claim may be denied, which we’ll discuss in the next section.
Workers’ Compensation does not cover Independent contractors or freelancers, but it’s essential to be sure that you’re really an employee. Sometimes, we find that an employer is using a contractor to do the work of an employee but with none of the benefits.
It’s a good idea to speak with a lawyer so we can determine if you are actually an employee (regardless of any paperwork you signed or what your job title is). If so, we can not only seek Workers’ Compensation but also back benefits such as health insurance or retirement account funding.
If you are a contractor, we’ll discuss your accident to learn more about what happened. Workers’ Compensation is meant to help employees receive medical care and lost wages after an injury without having to file a lawsuit and prove negligence in court, but if you aren’t eligible for Workers’ Comp, you can file a personal injury claim if your injury was due to another party’s negligence.
The other party could be your employer, or it might be a third party, such as a manufacturer of a defective piece of equipment.
Why Was Your Workers’ Comp Claim Denied?
Workers’ Compensation claims can be rejected for a wide variety of reasons, but most commonly, the issue is that your employer disagrees with your account of what happened in some way. Here are some examples of issues that we often see in Workers’ Comp cases:
Your Employer Doesn’t Believe You Suffered a Real, Significant Injury
There are several ways the employer (or their insurance company) might object to your explanation of your injuries:
- They might think that you weren’t injured at all.
- They might believe you suffered a small injury, but it wasn’t serious. Essentially, they think you’re “milking” a minor affliction to avoid work.
- They may think your injury was significant but should be healed by now.
These situations are always frustrating for the injured person, who is likely in pain and may need further treatment. One of the best ways to avoid disagreements about the validity of your injuries is to seek medical care right away.
Even if your injury seems mild, it’s a good idea to see a doctor and establish a record of what kind of injury you have. Your doctor will evaluate you to rule out more serious complications, and if you continue to have symptoms or feel worse, it will be easier to seek treatment later.
Georgia law does allow employers some input into your choice of physician, but they can’t force you to see one specific healthcare provider. Instead, an employer is required to post a “panel of physicians” that workers can see about a workplace injury.
You can choose any healthcare provider on this list, which must include at least six healthcare providers and at least one orthopedic surgeon.
If you’re injured on the job, report the injury to your supervisor immediately. If you can’t find a posted list of physicians, ask your supervisor or an HR representative for it and choose a provider from the list.
In a severe medical emergency, you can go straight to the hospital, but you will need to use a provider from the list for follow-up care.
Your Claim Wasn’t Filed in Time, or Your Employer Says You Didn’t Report the Injury in a Timely Manner
When initially reporting your injury to your supervisor, you may tell them about it verbally, but be sure to follow up with an electronic communication you can save—an email from a personal account or a text from your personal phone are good options.
The reason we recommend keeping a record of your report is just in case your supervisor claims you didn’t report the injury or didn’t report it right away (a surprisingly common reason for claim rejections.) You may not always be in control of a company phone or email address, which is why we suggest using a personal account so you will always have access to your saved messages.
Your Employer Doubts That the Injury Happened at Work
If there are extensive medical records showing you have a legitimate injury, the employer or insurance company may instead question how, where, and when your injury occurred. They might argue that your injury happened outside of work and, therefore, doesn’t count for Workers’ Compensation.
This is especially likely if there were no witnesses to your accident or if you have a repetitive motion injury that happens over time rather than in one incident. In these cases, we will work to establish that the injury did occur on the job.
Our investigators will seek out any photo or video evidence, review time card data, and interview potential witnesses. We may also consult with medical experts to determine if it’s likely your injury could have happened in other ways outside of work or to get their testimony about how repetitive motion injuries develop.
Your Employer Believes You Were Intoxicated, Engaging in Horseplay, or Injured Yourself On Purpose
Generally, Workers’ Compensation is a no-fault system. You don’t have to prove your employer was negligent or that they caused your injury, only that it happened while you were at work.
If you made an honest mistake that caused your injury—such as accidentally dropping a tool—you can’t be denied coverage simply because it was your fault. However, there are some exceptions to the no-fault rule, and you can be denied if one of the following is true:
- You were under the influence at work. This is why many employers seek a drug and alcohol test immediately after any accident on the job. If you believe your results were inaccurate for some reason, let your attorney know.
- You were engaging in horseplay or reckless behavior. Anyone can make a mistake, but if your boss says you were horsing around when your accident happened, the insurance company may deny your claim.
- You intentionally injured yourself. Most people don’t intentionally hurt themselves to receive the limited benefits available from Workers’ Compensation (medical bills and two-thirds of your typical weekly pay). If your boss or their insurance company adjuster believes your injuries were self-inflicted, you will be understandably upset. But don’t argue with the insurance company or your supervisor—this often makes things worse. Instead, contact an attorney right away so we can investigate your accident and gather evidence to show your injuries were not intentional.
Your Employer May Be Violating Workers’ Compensation Laws
Sometimes, the problem isn’t that the claim was rejected, but instead that it was never filed.
Your supervisor or HR person might stall, saying they lost your paperwork or the person in charge of those claims has been out of the office. If your employer seems uninterested in getting your claim filed promptly, your lawyer can help you file it on your own.
In some cases, the employer might come up with a reason why you don’t qualify for Workers’ Compensation, such as, “You didn’t work here long enough,” or, “We haven’t added you to the policy yet.” These are falsehoods—under Workers’ Compensation laws, you are eligible for benefits even if you get hurt on your first day on the job.
If you’re in this situation, don’t argue with your employer—wait until you leave the office, then call a lawyer as soon as you can.
Get Help From a Workers’ Compensation Law Firm in Duluth Today
Please contact the CEO Lawyer Personal Injury Law Firm for a free consultation about your Workers’ Compensation case or on-the-job injury. We’ll discuss what happened, answer your questions, and explain your options for seeking compensation.
Your initial consultation is free, and if we take your case, you won’t owe us anything until we win or settle it.
The CEO Lawyer Personal Injury Law Firm was founded by attorney Ali Awad, who made it into one of the fastest-growing law firms in the country. With more than twenty years of combined experience, Mr. Awad and his legal team have recovered millions of dollars in compensation for injured people and their families.
When he’s not fighting for clients in the boardroom or the courtroom, he can be found giving no-nonsense legal advice to more than a million followers on social media. Contact his expert legal team today by calling 833-254-2923.