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How you may appeal your workers’ compensation denial

On Behalf of | Jun 15, 2020 | Workers' Compensation |

The use of workers’ compensation in the state of Georgia helps people who have sustained an injury on the job to receive coverage for their medical treatment. However, not every worker’s comp case results in a quick approval of benefits. Sometimes an insurer denies a claim filed by a worker. If this happens, the worker may appeal the denial. 

According to the Georgia State Board of Workers’ Compensation website, a denied worker can begin the appeals process by filing a Form WC-14 with the State Board of Workers’ Compensation. A worker must do this within a year of the injury. The website goes on to explain how the worker may appeal a denied claim. 

Appeal hearings 

To appeal a claim denial, an injured worker may ask for a hearing. Generally, a hearing will take place in the county or close to the county where the injury had occurred, so a worker should not have to travel far. An appeals hearing will usually commence within 60 days of a judge receiving a Form WC-14. 

An Administrative Law Judge will preside over the hearing. The ALJ will listen to the arguments of the injured worker and the employer. The ALJ may decide not to award benefits, or may rule that the worker deserves some benefits, or the ALJ may rule that the entire claim of the worker is valid. 

Legal representation 

Injured workers might feel nervous about arguing their case in a hearing, especially if they have no previous experience with a hearing or a trial. Fortunately, a worker does not have to go to an appeals hearing alone. An injured worker has the right to bring an attorney to the hearing to present the case of the worker to the ALJ. 

In addition, the employer might have an attorney at the hearing as well. An injured worker could be at a disadvantage in this situation without the help of a legal representative who understands the rights of the worker and knows how to prevent the other side from taking advantage of the worker in the hearing.