While many companies invest money and time in safety programs or training to prevent workplace injuries, these on-the-job accidents still occur and can leave an employee unable to work for days, weeks, or even months. If you’ve been hurt at work, you will probably look to Worker’s Compensation to cover your medical bills and replace some of your lost income.
Worker’s Compensation is a no-fault system meant to be easily accessible for workers, yet some employees still have difficulty collecting their benefits.
A Gwinnett County Workers’ Compensation attorney can help you avoid common struggles with Workers’ Comp claims by reviewing your case and claim. If we believe additional documentation will be helpful, we can advise you on how to obtain it and what the insurance company will want to see.
If you have already submitted a Workers’ Comp claim and received a denial, we may also be able to help gather more evidence and appeal the decision. Please contact us immediately if your claim has been rejected so we can start working on your case.
The longer you wait, the more difficult it may be to find evidence to support your claim.
Any employee who suffers an injury during assigned work hours should qualify for Worker’s Compensation in most situations. Sometimes, we see cases where there is a disagreement about whether an accident happened at work.
If you were performing a work task outside of the workplace when you were hurt, you should still be eligible.
Usually, injuries that happen on your lunch break or before you begin your work are not covered unless they are caused by an inherent hazard in the workplace. For instance, if you slip and fall on the breakroom floor because of a ceiling leak, you might be eligible for Workers’ Compensation.
If you have been told you are not eligible for any reason, it’s a good idea to check with an attorney. In some cases, a manager or HR clerk may be misinformed or misleading you to save the company money on insurance premiums.
A no-fault system should make things easy for an injured worker who needs to recover benefits, but that’s not always the case. Almost all businesses with three or more employees are required to carry Workers’ Compensation insurance, so in most cases, your claim will eventually be reviewed by an insurance adjuster.
In general, insurance adjusters are concerned with reducing costs for the insurance company and are well-informed about what their policies do and don’t cover. They will comb through your claim, looking for any excuse to deny it, including some of these common reasons:
This is the first thing the insurance adjuster will consider—no injury, no payout. Frequently, insurance adjusters are inclined to think that workers are faking their injuries to collect benefits and avoid working. The reality is that Workers’ Compensation benefits only cover medical costs and two-thirds of an employee’s average pay, so this type of scam isn’t particularly lucrative. There may be a few people who will fake an injury so they can stay home at reduced pay, but this happens far less often than the average insurance adjuster believes.
The result is that your adjuster will open your claim and start looking for indications that you weren’t really hurt. Or, they may agree that you suffered an injury but believe it was mild and that you should be back at work already.
One thing adjusters look for is an injury that wasn’t reported right away or a situation where the worker didn’t seek medical help in a reasonable time frame after the accident. Although there are sometimes legitimate reasons for these issues, the insurance adjuster is unlikely to see your case that way.
The best solution to head off this type of denial is to:
If you have extensive medical records clearly showing you suffered an injury, the insurance adjuster may accept that you were hurt. At this point, they will consider whether your injuries really happened at work.
This is sometimes an issue if no one witnessed your accident or if you have a repetitive motion injury, which occurs over time and is not related to any one specific incident.
If the insurance company denies your claim because they don’t think you were at work when you got hurt, please contact an attorney immediately. We’ll work to find evidence of how your injury happened, such as tracking down security camera footage, looking for witnesses, reviewing records of time card punches, and more.
If you have a repetitive strain injury, we may develop a strategy to show that nothing you do in your leisure time could have caused this type of injury. Or, we might interview medical experts about the work-related activities you do that could have caused it.
Even a “no-fault” system has exceptions; if you made a simple mistake—such as accidentally dropping a hammer on your foot—you can’t be turned down for being at fault. However, your claim can be denied if you were horsing around if you were under the influence at work, or if you hurt yourself on purpose.
These situations are often incredibly exasperating for an injured person who simply wants to access healthcare and lost income benefits. You may be inclined to call and argue with the insurance adjuster who thinks you were irresponsible or intentionally hurt yourself, but this is not a good option.
Many people make their cases more challenging by calling the insurance adjuster, who will record everything you say and look for more reasons to deny your claim. Instead, contact a lawyer right away and let us compile evidence to show that the insurance company’s claims are unfounded.
Many Workers’ Comp claims are denied because certain paperwork wasn’t filed on time. Sometimes, the employer promises to put in a claim, then conveniently loses it, swears they submitted it, etc. Then, the worker tries to check on their claim and finds out it was never submitted.
This is why we advise keeping a written record of your reports to your employer in case you need to prove what you did and when. It’s also helpful to follow up with the HR department if you don’t hear back within 21 days, which is how long the insurance company has to conduct an investigation.
These investigations usually involve interviewing the injured employee, so if you don’t hear from the insurance company, you have reason to be concerned that your claim was never filed.
If your employer seems clueless or determined to ignore your rights as an employee, an attorney can help you file your own claim with the State Board of Workers’ Compensation. You should also know that you can speak with a lawyer confidentially during this time, either before or after filing your claim, for advice about the process.
We’re always happy to answer questions or advise clients before they speak with the insurance adjuster, which can be daunting for many people. It’s important to think through what you want to say and choose your words carefully because the insurance adjuster will be looking for any reason to deny your claim.
Please contact the CEO Lawyer Personal Injury Law Firm for a free consultation. Our legal team will review your claim, advise you about any potential challenges, and answer any questions you have.
We can also check a claim denial if you’ve already received one, and in many cases, we have successfully appealed denials.
Attorney Ali Awad founded the CEO Lawyer Personal Injury Law Firm and worked tirelessly to transform it into one of the fastest-growing law firms in the country. Dedicated to helping injured people recover the compensation they need to move forward, he and his team have recovered millions of dollars for their clients.
When he’s not working on a case, Mr. Awad uses social media to deliver entertaining yet informative posts about legal topics to more than a million followers. Work with the CEO Lawyer today by calling 833-254-2923.
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After a personal injury, you're bound to have legal questions. The CEO Lawyer Ali Awad can provide you with answers to these questions, just as he's given answers to his millions of curious social media followers. Take a look at some of the most common personal injury law questions for general information, and then reach out to one of our seasoned attorneys for specific guidance on your case!
To quickly resolve matters following an accident, insurance companies will offer you less than you deserve in compensation for your injuries. Many victims feel pressured to accept these offers as the bills begin to pile up, but that is rarely a good idea. The insurance company is looking to protect its bottom line; and will offer injured victims less than they deserve. An experienced personal injury attorney understands how to negotiate with the insurance company and can look out for your best interests by getting you the compensation you deserve after an injury. If you or a loved one has been injured in an accident, it is important to avoid negotiating or providing recorded statements to the insurance company without first seeking help from a qualified personal injury attorney.
The best way to determine if you have a personal injury case is to speak with a knowledgeable attorney. Our legal professionals have the expertise to evaluate your case and determine a strong legal strategy so that you can obtain the greatest amount of compensation possible under the law. We will enlist investigators, assistants, and other specialists to collect accident reports, speak with witnesses to your accident, and put together a plan. While you focus on your physical recovery, we will remain committed to fighting for the compensation that you deserve.
Accident victims have a limited time to file a personal injury lawsuit. This time period is referred to as the statute of limitations. This means that if you or a loved one has been injured in an accident, you have only two years to pursue a personal injury suit. If you wait too long to reach out to an experienced attorney, you might be forever barred from seeking the compensation you deserve.
During your initial consultation with CEO Lawyer team, we will go over the important details of your personal injury accident, which include the nature and extent of your injuries, how your injuries have impacted your ability to earn a paycheck, the cost of your medical treatment, and whether further medical treatment will be required. We will answer any questions you might have, as well, in regards to our experience, our track record of success, and what to expect from the legal process. Many personal injury victims wonder if they will be able to afford the legal fees required to pursue a lawsuit. CEO Lawyer injury and accident attorneys will not ask for any type of upfront fee unless we are successful in obtaining compensation for you. That means that if you have been harmed in a motor vehicle accident, slip and fall accident, defective product accident, or any other type of personal injury accident, you can absolutely afford to contact our law office today for assistance. In fact, you cannot afford to wait. Reach out today. We understand that some accident victims might have already obtained the assistance of an attorney but may be dissatisfied with the services provided. We are standing by and prepared to help you change legal representation, regardless of where you are in the process.
If you or a loved one has been injured in any type of personal injury accident, you should not hesitate to speak with the experienced attorneys at CEO Lawyer personal injury law firm. Call, email, or fill out our online contact form today so that we can begin helping you pursue the compensation you deserve.