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Why might my work comp claim get denied?

| Jan 17, 2019 | Workers' Compensation

In Georgia, workers’ compensation is meant to be an efficient system that allows injured workers to get help with medical bills and lost wages quickly.

The goal of setting up workers’ compensation in this manner is to ensure that those in Rome and elsewhere in this state who sacrifice themselves for their employers get help when they are in need of it.

Unfortunately, despite legal and procedural safeguards, workers’ compensation claims do often get denied for a variety of reasons. Employers, particularly if they are self-insured, do not want to pay more claims than they have to, and insurance companies representing them may for a number of reasons choose to draw a hard line and deny a claim.

Sometimes these reasons involve a procedural mistake. For example, injured workers have to fulfill certain obligations before proceeding with a claim. Some of these obligations involve strict deadlines after which a person’s claim may be forfeited.

In other cases, an employer or insurance company may contend that the type of injury being claimed does not qualify for compensation. For example, it may be hard to get benefits for something like stress or for any injury that does not require treatment.

Finally, employers and insurance companies may contend that the employee is not eligible for benefits for one reason or another. Most commonly, the employer may argue that the injury is not work-related or, rather, that there is not proof that the injury was indeed related to one’s job duties.

Having a workers’ compensation claim denied can be a distressing experience for an injured worker. There are options available in this circumstance, including a potential legal appeal. A Georgia resident should consult with an experienced workers’ compensation attorney if he or she has questions.