Most Georgia workers are covered by the workers’ compensation insurance fund. Unfortunately, many workers continue to have financial difficulties after suffering workplace injuries because their workers’ compensation benefit claims have been denied. This naturally brings about the additional stress of lost wages and unpaid medical bills along with the inability to maintain rent or mortgage payments, car installments and day-to-day expenses.
Workers’ compensation claims can be rejected for several reasons, including an employer claiming the injury was not work-related or that the severity of the injury did not justify absence from work. Insurers may deny claims because of failure to file it timely or because medical treatment was not immediately sought. In some cases, it is claimed that the injury was a condition that existed prior to the workplace accident.
Regardless of the reason, denied claims may be challenged or appealed. When a worker receives a formal notice of denial of the claim from the insurance adjuster, he or she may benefit from reaching out to the experienced workers’ compensation attorneys at Mark A. Skibiel P.C. Our legal team will investigate the facts of the injury and the related medical records, and we will conduct interviews with witnesses. If necessary, we will also consult expert and factual witnesses.
If our presentation to the workers’ compensation administrative judge does not lead to compensation, we can file an appeal. Under Georgia workers’ compensation laws, the burden to prove why the claim must be paid falls on the injured worker. If the claim remains denied through the various administrative hearings and appeals, there may be merits for appeals through the county’s superior court or the state’s appellate court. We have also experienced a high rate of success with settling workers’ compensation claims and resolving issues through the mediation process.