Appeal a Workers Compensation Denial
Appeal a Workers Compensation Denial in Atlanta
Did you or a loved one get injured at work and denied your workers' comp benefits? Don’t lose hope! Atlanta employees have the right to appeal a workers' compensation denial, and The Law Offices of Darwin F. Johnson can help! We understand how frustrating it can be to go through the lengthy process of an injury claim to have it denied. Our legal team understands the emotional, physical, and financial struggle you are going through and will help you file a strong appeal.
As a premier workers’ compensation firm for employees and their families throughout Gwinnett County, GA, we have over four decades of experience in these matters. Read on to learn more about why workers' comp claims get denied and how our representation can make a difference!
How We Can Help
Our Workers' Compensation Cases We Accept:
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INDUSTRIES WE SERVE
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EMPLOYERS
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WORKPLACE INJURIES
You Have the Right to Appeal Workers Compensation Claim Denials in Gwinnett County
When you get hurt at work, the hardships your injuries put on your household can pile up quickly. Being unable to work and pay your bills coupled with needing medical care is overwhelming. The physical trauma of your accident requires rehabilitation and makes the prospect of returning to work feel impossible.
Georgia workers' compensation was designed to help alleviate the financial impact of unexpected and debilitating job injuries. But what options do you have once you receive a denial letter? You can’t return to work in your current condition, and the idea of having to file an appeal can feel like a hopeless battle. Fortunately, with proper legal guidance and experienced representation by your side, you don’t have to accept your loss.
As mentioned earlier, there are countless reasons why workers' comp claims get denied. Often, insurers do so unfairly and can get away with it because of how complex state law is regarding workers’ compensation. If you live in Gwinnett County, GA, you can have the decision reviewed by the Georgia SWBC, and if that gets denied, you can file an appeal in court. This step requires the premier worker’s comp attorneys at The Law Offices of Darwin F. Johnson. You can trust our decades of combined experience to build and position your case favorably with the court.
Over $250 Million Recovered. Over 10,000 Cases Handled.
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$4,200,000
Catastrophic Workers Comp
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$2,400,000
Catastrophic Workers Comp
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$1,200,000
Catastrophic Workers Comp
How Do I Appeal a Workers Compensation Denial in Atlanta?
If you believe you are entitled to benefits but get denied, state law allows you an appeal. Regardless of why you received a denial, at The Law Offices of Darwin F. Johnson, we know how companies and their insurers manipulate the system. Our workers' compensation attorneys help Atlanta area workers every step of the way. Below is a brief step-by-step overview of the appeals process in Georgia:
Hearing with the Board
Upon receiving your initial denial, you and your attorney will appeal the decision in a hearing with the Georgia State Board of Workers Compensation. You only have one year from the date of your injury to file, and then you lose your right to appeal. If you receive a denial at the review, the next step is heading to court.
Attend Mediation
Usually, before you can take your case to the courtroom, the SBWC requires all parties involved to enter mediation. This is a type of proceeding that focuses on avoiding litigation by working with a neutral mediator to come to a resolution. These representatives don’t have the authority to make any decisions on your case and are simply facilitating the negotiation process.
Court Hearing
If mediation fails, your attorney will then request a hearing before an administrative law judge. This proceeding allows you to present your case and supporting evidence to the judge, who will then issue a benefits decision.
Appellate Court
Should the administrative judge deny your benefits request, the next step is to file to appeal appeal a workers' compensation denial with the appellate division of the SBWC. You must complete your request within 20 days of receiving the denial for the Appellate Division to make a decision. This is the final step available in the appeals process.
Due to the complex nature of worker’s compensation denial appeals, you are allowed to have an attorney represent your case throughout the process. A highly skilled Atlanta work comp lawyer is your most valuable asset. The Law Offices of Darwin F. Johnson not only provide a fair evaluation of your work injury circumstances, but we can determine your eligibility for worker’s compensation benefits.
To be eligible for Workers Compensation, You must have incurred at least one of the following criteria from each section to qualify:
- On-The-Job Injury
- Injury occurred while working
- Injured due to the job you perform
- Employment Status
- You are a legal employee of the person or company you work for
- The company or person you work for has 3+ employees regularly in service
If you have not experienced or only have one piece of criteria from the above, please see our Personal Injury section to see how we can help you recover.
Trust Darwin F. Johnson with Your Workers Compensation Denial Appeal
If you recently suffered a serious work injury and had your compensation claim denied, you need a knowledgeable Gwinnett County workers’ compensation attorney. Don’t let a denial stand in the way of benefits you rightly deserve and need to recover. At The Law Offices of Darwin F. Johnson, we can ensure that your appeal is filed quickly and gets the representation it needs to be taken seriously.
Our over forty years of representing worker’s compensation claims throughout Atlanta has made us the premier firm to rely on when employers dispute worker injuries. We understand that the primary motivation for denials is saving money on insurance premiums. The talented workman’s comp attorneys we have in our law practice won’t let that stand. Your physical, emotional, and financial well-being are of the utmost importance to our legal team. Call us to set up your free consultation at (470) 285-8246 or contact us online to schedule an appointment today.
Why Did I Receive a Workers Compensation Claim Denial?
To better understand why denials happen, below is a list of the top ten culprits:
Why a workers’ compensation claim gets denied can stem from several causes. More
confusing is that you can receive a partial denial while the Georgia State Board
of Worker’s Compensation (SWBC) accepts the other portion of your application. This
is why an appeal is critical to ensure that you have the opportunity to clear up
any issues with your original claim and get the approval you need.
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Your Injury was Non-Work-RelatedA common misconception that many workman’s compensation filers don’t understand is that benefits are for injuries that happened due to employment-related circumstances. If you are riding your bike to get lunch and crash, breaking your ankle, this isn’t a work injury.
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You Filed a Claim After Being Fired or Laid OffEven if you were legitimately injured at work and didn’t have time to pursue a claim, filing after leaving the company is difficult. Insurers rarely are willing to accept this type of claim situation and try to claim it is a revenge action on your part. This scenario is why you should always file your injury claim right away. Trying to convince the insurer and or an SBWC judge that you did have a workplace injury under these circumstances rarely gets approved.
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Your Own Negligence Caused Your InjuriesGeorgia’s workers compensation is a no-fault system, but there are situations where you might jeopardize your eligibility. In cases where you were intoxicated on the job when getting hurt or breaking clear company policy, you may not qualify. These behaviors may also include some forms of roughhousing and practical jokes that have no benefit to your employer.
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Not Submitting Necessary DocumentationDocumentation is vital to any work injury claim. This includes submitting a notice of your injuries to your employer in writing within 30 days of the incident. If your employer failed to fill out a Georgia first report of injury form, you could also find yourself denied. Another essential piece of paperwork is a physician’s letter regarding your health condition. If it doesn’t clearly link a work-related accident to your disability or injury, you could receive a denial.
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Having a Pre-Existing Condition Can Lead to DenialsEven if you have a pre-existing condition that gets aggravated by a workplace injury, it’s not uncommon to receive a denial. Keep in mind that you cannot receive benefits for that condition, only the aggravation of it, along with any new injuries you sustained. Failing to disclose this health issue can also lead to a denial.
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You Weren’t Injured at WorkYou have to be hurt while performing duties related to your job. Your morning commute you make to work generally doesn’t fall under a work injury. Typically, one must be at their job site working when an accident occurs to qualify for workers compensation coverage. There are some exceptions for those who do travel as part of their job role.
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The Severity or Nature of Your Injury or Disability is Unbelievable
Any time an insurer doesn’t believe you are actually hurt or disabled, they will issue a worker’s compensation denial. This often occurs if an employee just wants time off to rest the injury and doesn’t get medical care for it. To qualify for coverage, you must actively seek treatment and undergo an exam documenting your condition. Usually, the physician you see will be a preferred provider chosen by your company’s workers compensation insurance company.
This makes working with a Gwinnett County workplace injury attorney like those at The Law Offices of Darwin F. Johnson a critical first step. We can ensure that your rights and best interests are the number one priority throughout the claims process.
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"Couldn't have asked for a better lawyer."
He was on top of everything he kept us up to date front start to finish, got are case finished in a timely manner, answered all the question that we asked and explained the whole process, we was happy with are settlement.Thank you for helping us.
Melissa R. -
"Attorney Johnson has a heart."
He and his staff, Matt and Yohandra, nurtured me through a very difficult time and achieved a fair settlement expediently. Thank You!
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"The law office is professional, and friendly."Attorney Darwin Johnson Is the best !!! I would tell anybody to give my attorney the chance to work on your case you will be satisfied with the results. Matt, Attorney Berman, and Yohandra are the best staff that I have ever had the chance to meet and work with.Janice C.
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"Great law firm and even better people!"We just settled!!! I was injured on the job and they tried to fire me! Wrong thing to do when you got attorneys like this that will fight for your rights! Took a year for me to be compensated but it was worth the wait! If your injured on the job don’t hesitate! Contact Darwin Johnson!Jermey H.
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"What set Mr. Johnson apart, however, was his unwavering commitment to his clients."He was always available to answer my questions, address my concerns, and provide emotional support during what was an incredibly stressful time. His compassionate nature and genuine interest in my recovery made me feel valued as a person, not just a client.Connie C.
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"Mr.Johnson and his team were extremely helpful."
He was very straight forward and got me the best offer for my settlement. You’ll be in great hands.
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"Helped me through my Workmen’s Compensation stuff."
I highly recommend him is there through it all you don’t have to worry about anything if you hire Darwin Johnson.
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"Darwin is a bold man, the Business Man!"
God is Good!!! Darwin Law Firm is the best Workers Compensation Team!!! I am very very please with my settlement!!! It was worth the wait!!! Thank yall!! I recommend this Law Firm to everyone!!
Former Client