What You Need to Do If Your Workplace Injury Claim Was Denied?

Workplace Injury Claim

Workplace accidents can be stressful since they often result in serious injuries, loss of income, medical expenses, and dealing with pain and suffering. If you are injured at work, you have a legal right to claim workers’ compensation benefits. All employers are required to have workers’ compensation insurance to protect their employees. However, securing the settlement that you deserve for your injuries is not always easy. 

Insurance companies may underpay injured workers since they are concerned about securing their profits and interests. If your initial compensation claim is denied, you have other options that you can pursue to recover the benefits that you deserve. Read on to learn what you need to do if your workplace injury claim was denied. 

Request a Fair and Impartial Hearing

You have a legal right to request a fair hearing before the judge of the State Board of Workers’ Compensation if your claim has been denied. The employer and the insurance company can deny your compensation if they dispute the credibility of your injury. The employer may claim that you were not injured at work due to insufficient evidence to support your claim. The employer may also argue that your claim is based on a pre-existing condition. If you find yourself in this predicament, you have a right to be heard by an administrative law judge representing the workers’ compensation board. All the same, you will need the help of a workers’ compensation attorney to prepare your claim for hearing. 

Prepare for the Hearing

In the state of Georgia, when the workers’ compensation board grants your hearing, you should be able to prepare your case. You should enlist the services of an attorney who will help with your workers’ comp claim to increase your chances of winning the case. Your lawyer will review your claim and prepare a solid case to present before the judge. Your attorney will first try to establish the reasons why your initial claim was denied. Therefore, you should be prepared to answer several questions from the lawyer and try to be truthful otherwise your case may be rejected again.

Collect Relevant Evidence

To win your case, you need clear evidence that can support your claim when you go for a hearing. You must collect all medical records that specify that your injury was a result of a work-related accident. In some cases, your employer might suggest the doctor you should visit after the accident. You can also see an independent physician. However, you must send a request to your employer for permission to visit a different doctor. On the other hand, the insurance company may also request an independent medical examination (IME), so you must be prepared to get this. 

You must get all the medical records from all the physicians that you have visited after the workplace injury to support your case. You can also request a medical testimony from your doctor that you can present at a hearing. It is vital to ensure that the doctor sends correct information to the insurance company to avoid issues that may impact the outcome of the hearing. 

File a Lawsuit

If the administrative law judge fails to award you the compensation you expect and deserve despite the glaring evidence you present for your injuries, you can consider filing a lawsuit in a court of law. While lawsuits involving workers’ compensation disputes are rare, you can consider this option if you believe that you have a strong and valid case against the employer.

Remember the Deadline 

After receiving a letter of denial of your claim from the insurance company, you can appeal the decision. However, you must remember that there is a deadline for filing a workers’ compensation appeal. The deadlines vary from state to state, so you should check the requirements in your area. If the deadline passes without filing your appeal, you may lose your legal right to get any compensation. 

It is disheartening to learn that your compensation claim was rejected after suffering injuries from a work-related accident. However, the denial of your first claim does not mean the end of the world since there are other options that you can consider to get the compensation you deserve. You can appeal the decision and request a hearing from the administrative law judge of the workers’ compensation judge. To increase your chances of winning the case, you must gather all evidence that can support your claim. As a last resort, you can consider filing a lawsuit if all other avenues fail to yield positive results.