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Appealing a Denied Workers’ Compensation Claim

Published in Workers Compensation on November 26, 2019.

If you have suffered an injury or illness while you were at your job and while you were working in the course of your employment, you are likely entitled to workers’ compensation benefits. In some instances, however, employers and their insurance companies deny these benefits for workers’ compensation. For example, your employer might allege that you were acting outside the scope of your employment at the time you were injured. Moreover, your employer could argue that you were not working at your job when you were injured (or became ill), or that you were traveling to or from work.

If you believe that you were wrongfully denied benefits for workers’ compensation, you might be able to appeal that denial by requesting a hearing before the state Workers’ Compensation Board. Appealing a workers’ compensation claim can be a difficult process if you are on your own. Consequently, it is essential that you have an experienced lawyer representing you throughout the appeals process. A Macon workers’ compensation attorney at Nelson & Smith Attorneys at Law could help you assert your claim and pursue benefits. 

The Mediation Process

Prior to taking part in an appeal hearing, you may be required to participate in the mediation process. During mediation, both sides will meet with a neutral third-party mediator who will work with both sides to try and resolve the disputed issue. Anything which is said by either side during the mediation is off the record, meaning that it cannot be used against you later on in the process or during an appeal hearing. If the dispute is not resolved at the mediation session, the case will proceed forward to an appeals hearing in front of a judge.

The Appeals Hearing

During a workers’ compensation hearing, the case will proceed forward like a trial. Just like during a trial, all of the procedural rules and evidentiary rules will be enforced. Also, like at a trial, each side will be allowed to introduce evidence which supports his or her respective version of the case. Evidence may include witness testimony and documentation that tends to show that the accident victim suffered his or her injury while in the scope of employment and proving that he or she is entitled to workers’ compensation benefits. Your doctor may also need to provide testimony which causally relates your injury or illness to the workplace accident.

Following the appeals hearing, a judge will consider all of the evidence that was presented and will draft a written decision in your case regarding benefits. In the event that you disagree with the judge’s decision, you will have 20 days to appeal your case to the appeals division of the state Worker’s Compensation Board. The appeals division could then review all of the evidence and render a decision in your case. In most cases, a workers’ compensation appeal is held in the county where the accident victim allegedly suffered his or her workplace injury or illness.

Call a Macon Workers’ Compensation Attorney Today

Let the experienced attorneys at Nelson & Smith Attorneys at Law assist you with filing an appeal in your denied Workers’ Compensation benefits case today. To schedule a free case evaluation and legal consultation with a Macon workers’ compensation lawyer, please call us at (478) 746-1468 or contact us online to learn more about how we could assist you with filing your appeal today.  

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