Marietta Workers’ Compensation Attorney

Who Qualifies for Workers’ Compensation?

Each state has its own set of laws governing workers’ compensation. As such, the eligibility requirements will differ slightly depending on where you live.

However, in general, you are entitled to workers’ compensation if you:

• Suffer an injury or illness related to your employment
• Did not negligently or intentionally inflict the injury on yourself
• Are classified as an “employee” (rather than an “independent contractor”)
• Work for a covered employer

In Georgia, covered employers include those with at least three employees. However, in certain industries, such as construction or mining, employers may be required to provide workers’ compensation for their employees even if they have fewer than the standard amount. Additionally, both part-time and full-time employees are eligible for workers’ compensation.

What Workers’ Compensation Benefits Are Available?

The benefits you may be entitled to receive through the workers’ compensation system depend on several factors, including the state in which you live and the severity of your work-related injury or illness.

Georgia offers the following workers’ compensation benefits:

• Medical Care: This includes costs associated with treating a work-related injury or illness, such as hospitalization, diagnostic tests, surgeries, treatments, rehabilitation, medications, medical equipment, etc.
• Temporary Disability: Temporary total disability (TTD) benefits are available to employees who are unable to return to work temporarily due to a work-related injury or illness. These benefits are based on a certain percentage of the worker’s average pay.
• Permanent Disability: Permanent partial disability (PPD) and/or permanent total disability (PTD) benefits are available to those who are partially or totally impaired due to a work-related injury or illness after reaching “maximum medical improvement” (MMI), as determined by a doctor.
• Death Benefits: When an employee dies in a workplace accident or due to a work-related injury or illness, their surviving dependents may be entitled to death benefits through the workers’ compensation system. These typically include wage replacement and funeral costs.
• Vocational Rehabilitation: Some injured employees may be eligible for vocational rehabilitation benefits. These may include certain costs associated with finding new employment/returning to the workforce, such as job retraining, education-related expenses, and more.

Why Was My Claim Denied?

It is not uncommon for an initial claim to be denied. Workers' compensation claims can be denied for a wide range of reasons, such as the following.

• Failure to report the injury promptly: Employees must report their workplace injuries within a specified timeframe, which varies by jurisdiction. Delayed reporting can raise questions about the claim's validity.
• Late filing of the claim: Workers must file their compensation claims within the time limit set by state or local laws.
• Disputes about where and when the injury occurred: If the injury didn't happen during work hours or at a workplace, the claim might be denied.
• Pre-existing conditions: If the injury is related to a pre-existing condition and not directly caused or worsened by work, the employer or insurer may deny the claim.
• Insufficient medical documentation: Without clear medical records or diagnosis linking the injury to work, the claim can be challenged.
• No witnesses: If there are no witnesses to corroborate the injury, the insurer might argue it didn't happen as described.
• Injury occurred while under the influence: If the worker was intoxicated or using illegal drugs at the time of the injury, the claim is likely to be denied.
• Misconduct or intentional harm: Injuries resulting from horseplay, fights, or intentional acts are typically not covered.
• Inconsistent or conflicting statements: Differences between the worker's report, medical records, or witness statements can lead to denial.
• Delaying medical treatment: Waiting too long to seek medical care can suggest the injury isn’t serious or work-related.
• Minor injuries not requiring medical treatment: Some claims are denied if the injury is too minor to qualify for compensation.
• Injuries outside the scope of employment: For example, injuries during commuting (unless under specific exceptions) are often not covered.
• Independent contractor status: Workers classified as independent contractors are typically not eligible for workers' compensation benefits, though misclassification disputes are common.
• Claim disputes by the employer: Employers might argue that the injury is not legitimate or wasn’t work-related, prompting denial by the insurer.

If a workers' compensation claim is denied, the worker typically has the option to appeal the decision by submitting additional evidence or attending a hearing to challenge the denial. Seeking legal assistance can also be beneficial, as an attorney can help navigate the appeals process, ensure proper documentation, and negotiate with the insurer to strengthen the worker’s case.

No Fees Unless We Recover Benefits for You

We understand that the cost of hiring an attorney can deter people from seeking legal help with their workers’ compensation claims. However, at The Roth Firm, LLC, we provide our legal services on a contingency fee basis.

This means that our firm handles the upfront costs associated with litigating your case, and we only collect attorney fees if/when we recover compensation for you. These fees are paid via a percentage of your total recovery, which we discuss with you prior to you hiring our firm.

We also offer free consultations, so there is absolutely zero risk in speaking to our workers’ compensation attorneys about your case and learning how we can help. We provide legal services in both English and Spanish (hablamos español) and can answer any questions you may have.

Call us today at (404) 777-4899 or submit a free online case evaluation form to schedule your appointment with our team.