If you suffer a workplace injury and need workers’ compensation benefits to help you get back on your feet financially, a denial of your claim can feel devastating. However, there are effective options for appealing the decision.
Workers’ compensation exists to provide the benefits you need after a job-related injury. That is why it is important to exercise your right to have the denial reviewed through an appeals process.
Steps to appeal a denied claim
The first step in appealing a denied workers’ compensation claim in Georgia involves filing a notice of claim with the Georgia State Board of Workers’ Compensation. You must submit this notice, known as a WC-14 form, within one year of the denial or the last received benefit payment. After submitting the request, you can request a hearing to present the appeal.
The hearing process
During the hearing, an Administrative Law Judge will review the case. This hearing is like a trial, where you can present evidence, call witnesses and argue why the court should overturn the denial. The employer and insurance company will also have the opportunity to present their side.
What if the appeal meets with denial again?
If the ALJ upholds the denial, you can further appeal to the Appellate Division of the Georgia State Board of Workers’ Compensation. In this second appeal, the Appellate Division reviews the evidence from the original hearing and decides whether to affirm, modify or reverse the ALJ’s decision.
If the Appellate Division upholds the denial, you then have the option to appeal to the Georgia Superior Court. This process involves a higher level of review and may include legal challenges based on the interpretation of Georgia workers’ compensation laws.
Appealing a denied workers’ compensation claim in Georgia is possible through this structured process. Understanding the steps to take and the timelines involved can make a difference in receiving the benefits you need after a work-related injury or illness. Time limits for each step are strict, so it is important to act quickly if a claim gets denied.