I Have Been Denied Workers' Comp Benefits, What Now?

Have you been denied benefits by your employer and their insurance company after being injured on the job? Employers and insurance companies often deny claims in hopes that you not hire a lawyer and pursue the matter by filing a formal claim with the State Board of Workers’ Compensation.

The following are several reasons the employer and insurance company may allege they have grounds to deny benefits:

  • The accident did not occur in the course and scope of employment,
  • The employer suspected you were intoxicated,
  • You had a “pre-existing condition”,
  • The accident occurred on a rest break,
  • You are an independent contractor as opposed to an employee,
  • You were on a personal mission when you were injured, or
  • You failed to notify the employer of the accident in a timely manner.

If you are denied benefits, your recourse is to file a formal notice of claim and request for hearing with the State Board of Workers’ Compensation. At a hearing, you will be required to present testimony and evidence of the injury and your disability. Often, the parties engage in mediation or settlement talks prior to a hearing. In many cases, it makes sense to settle for a lump sum prior to a hearing.

If you are denied benefits at the initial hearing, you may then appeal your case to the Appellate Division of the Georgia State Board of Workers’ Compensation. Appeals from the Appellate Division are filed with the Superior Court in the County where the injury occurred. Appeals from Superior Court are filed with the Georgia Court of Appeals in Atlanta.

Remember, at a hearing, the Georgia Rules of Evidence and Georgia Civil Practice Act will apply. You will be expected to present your evidence and testimony in a manner consistent with the rules of evidence and civil procedure. You can bet that the employer and insurance company will have a defense lawyer on their side. You need an experienced Georgia workers’ compensation advocate on your side. As a former insurance defense lawyer, I know how to battle the insurance company and win cases. Call me today for a free consultation and case evaluation.