Even though you got hurt at work, the insurance company has denied your case. Why do workers compensation insurance companies deny you the benefits you should receive?
There are many answers to that question. One reason that they may have denied your case is they believe it saves them money.
Paying you benefits costs the insurance company money. If the insurance company pays less benefits to you and to other people, they make more money.
In Georgia, the workers compensation insurance company should follow certain rules when they deny benefits. These rules ensure that you receive information about what benefit the insurance company has denied and why they are denying benefits.
These rules require the insurance company to file certain forms with the Georgia State Board of Workers’ Compensation. The insurance company must send a copy of these forms to you. Often, these forms will include medical reports from your doctors.
The insurance company should file a Form WC-1, Form WC-2 or a Form WC-3 if they are denying you benefits. If your whole claim is denied, you should receive a Form WC-1 or Form WC-3.
The insurance company should use a Form WC-2 is when they are stopping or changing your weekly benefits. The Form WC-3 should also be used when the insurance company denies medical treatment.
What happens if the insurance company does not follow the rules when they deny my case?
Many times the insurance company does not follow the rules. They may not file any paperwork at all when they deny your case.
Georgia’s workers compensation law gives the insurance company 21 days to choose whether they are going to start paying benefits or deny your case. If you have not received any benefits or any paperwork within 21 days, you need to talk to someone.
Sometimes, the insurance company starts paying you workers compensation benefits but then denies future benefits. While they should send you some paperwork when this happens, they often do not do so.
When insurance companies do not file paperwork, you may not even know that they should be paying you benefits. This denial of benefits can harm you in a few different ways. You suffer financial harm when your weekly benefits stop and you go without a check. You suffer physical harm when you do not get the medical treatment you need.
How can you get the workers’ compensation benefits you need?
Many people do not know what to do when their benefits are denied. Some of them simply do nothing and wait.
Don’t do this. You could lose your right to benefits.
If you have already waited some time after your benefits are denied, don’t wait any longer. There may still be time to get you benefits.
The right to have your day in court and present your case is one of your most important rights. Just like there are forms to deny benefits, there is a form to request a hearing in front of a workers compensation judge.
Is there anything I should do before requesting a hearing
There is one thing you definitely need to do before requesting a hearing: talk to an attorney who specializes in workers compensation.
Going to court is tricky. You have to follow special rules to present your evidence. If you do not follow these rules, the judge will not consider all your evidence. If this happens, you will probably lose your case.
An attorney can make sure your side of the case is heard. Some people do not talk to an attorney because they think it is going to cost them a lot of money.
That is why we provide free consultations in workers compensation cases. A free consultation gives you the opportunity to talk to a workers compensation attorney before you make a decision to hire them.
If you would like to go ahead and schedule a consultation, there are two easy ways to set one up. Just call our office at (770) 214-8885 or complete and submit the free consultation request form on this page.
Jason Perkins is an attorney who specializes in representing injured workers. He regularly blogs about Georgia’s workers’ compensation system and issues that are important to injured workers and their families.
You can subscribe to his Georgia Workers Compensation channel on YouTube.