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Reasons Your Georgia Workers’ Compensation Claim Might Be Denied

If you’ve been injured at work, Georgia allows you to seek workers’ compensation benefits. You also have the right to appeal if your job’s insurance company denies your claim or says you don’t qualify for benefits. Here’s a look at some of the reasons why your claim might be denied.

You Didn’t Report the Injury in Time

One of the most common reasons a workers’ compensation claim is denied is because the employee didn’t report the accident in a timely manner. There is no reason or benefit to wait, so you should report it as soon as possible. Technically, there is a 30-day notice period allowed, but the longer you wait and the closer it is to the 30-day cut off, the more likely your claim is to be denied.

The Carrier Doesn’t Believe You Qualify for Coverage

The insurance company may deny your claim because it believes you do not qualify for coverage. The law in Georgia does not allow for workers’ compensation coverage in select circumstances, including:

  • Another person hurt you for personal reasons
  • You hurt yourself intentionally
  • You had a stroke, heart attack, or something similar, unless you can show it resulted from your regular work activities
  • Your own misconduct caused the injuries, like being under the influence of drugs or alcohol or failure to use a safety device

You Don’t Go to the Doctor Soon Enough

If you report the accident and injury in a timely manner, you need to seek medical assistance in a timely manner as well. You should speak to your supervisor or human resources department to see a company doctor right away. If your employer does not answer your request, then seek prompt medical attention on your own. Like a delay in reporting the claim, a delay in seeking treatment could result in a denial.

Failure to Disclose Prior Injuries

The workers’ compensation carrier may deny your claim if you failed to disclose prior injuries, especially significant ones or ones that are similar to the current work-related injury.

If you do disclose your prior injuries, the workers’ compensation carrier may still try to deny your claim. However, Georgia law allows that workers with prior injuries can recover if the accident aggravated a pre-existing condition.

Employer Doesn’t Carry Workers’ Compensation Coverage

If your employer doesn’t carry workers’ compensation coverage, although required by law, the company likely can’t pay for your injuries. Businesses in Georgia are required to have workers’ compensation coverage if they have three or more employees.

You Fail a Drug Test

If you fail a drug test, your employer’s workers’ compensation carrier will almost always deny your claim.

There are No Witnesses in a Disputed Claim

There may be an instance when you are injured while working alone and there are no witnesses. If your employer disputes the claim in any way, it could be denied due to lack of witnesses.

Retaining a Workers’ Compensation Attorney in Georgia

If your workers’ compensation claim has been denied, a skilled Georgia workers’ compensation attorney can help you overcome a denial. Contact Christopher Simon Attorney at Law at (404) 259-7635 to schedule a consultation.

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visit us 2860 Piedmont Rd NE #210
Atlanta, GA 30305