How to Deal with Delays in Atlanta Workers’ Compensation Approvals

Workers’ compensation is a form of insurance coverage that is offered by all employers who employ more than three workers (full-time or part-time). The benefits are provided to employees in case they are injured on the job. The objective of the benefits is to ensure that the employees receive immediate medical care as well as income replacement benefits in case the injury does not allow them to return to work for a certain amount of time. As per the law, the employer cannot resort to legal defense if an employee claims compensation to cover any costs incurred as a result of a work-related injury. The only time an employer can take legal action is when they clearly believe that the employee is making a false claim.

While in theory, the system of workers’ compensation is designed to benefit both the employer and the employee, the actual process can sometimes prove to be quite frustrating for the injured party. This is unfortunate since the entire purpose of this coverage is to ensure that the employees do not have to go through any legal hassles to get the money they deserve and the employer does not have to deal with unnecessary and potentially expensive lawsuits. 

Despite the mutually beneficial concept of workers’ compensation, thousands of Georgians are injured on the job each year and while they are covered under workers’ compensation, actually getting access to funds and to medical care can often be quite problematic.  

The fact is that the system of workers’ compensation in Atlanta, Georgia can be fairly complex. There have been cases of workers who were badly injured on the job and had to go through significant delays in getting long-term care. Access to emergency care is generally not an issue as long as you follow the procedure and consult a healthcare provider who is in your employer’s approved panel of doctors. You can seek medical attention elsewhere if these doctors are unavailable at the time.

But if the injuries result in the employee having to miss work for a long period of time, the process of approvals for follow-up medical care, prescription drugs, and medical supplies can be quite agonizing. Workers may have to deal with denials and delays to the point that they can, and sometimes do, become frustrated with the process.

Are Delays Common for Georgia Workers’ Compensation Claims?

According to a study conducted by the Workers’ Compensation Research Institute (WCRI), 18% of Georgians who were injured at work and who experienced more than seven days of lost work time reported significant problems getting approvals for services that their primary provider believed they needed. Nearly 52% of these injured workers gave up on fighting the employer and/or the insurer in question. The study also revealed that Georgians who get injured on the job have one of the lowest return-to-work rates, which could be because they got so frustrated and disillusioned with their employers and the system in general.

Most of the time, the delays are for ridiculous reasons. Even though the workers’ compensation law in Georgia does not require prior approval of medical treatments or medical supplies, even then the doctors, who are on the approved panel for workers’ compensation demand upfront payment guarantees. Till they get paid, they delay treatment which can have negative consequences for the worker who is already suffering from injuries and emotional trauma.

It is thus evident that while the workers’ compensation program may guarantee benefits to injured workers in theory, actually getting those benefits can be quite difficult in certain cases. Emergency care is one thing, but workers who suffer injuries that result in long-term disability or long-term absence from work often have to face deliberate delays in approval of their benefits.

If you are an employee in Atlanta, Georgia and you work in a high-risk industry, you should be aware that the workers’ compensation law provides you the following rights:

  • Payment of all authorized medical bills, hospital bills, rehabilitation, physical therapy, prescriptions and travel expenses (if any) for any work-related injury;
  • Weekly income benefits if the employee has lost more than seven days of work time due to a work-related injury;
  • Two-Thirds of average weekly wage up to the maximum allowed as per the state law in case of a catastrophic injury;
  • Two-Thirds of average weekly wage but not more than the maximum allowed in case of a non-catastrophic injury;
  • Weekly income benefits for a maximum period of 350 weeks if the employee can return to work but to a lower paying job; and/or,
  • Burial expenses in case of death and two-thirds of average weekly wage as benefits for dependents.

It is important to note that as an employee, you are only entitled to these benefits if the injury was actually due to a work-related task or activity. Making a false claim in this regard can lead to legal charges against you. Also, if you are injured at work, you are obligated to report the injury as soon as possible. If you do not report it within 30 days, your benefits can be denied. As this discussion demonstrates, employers and insurance companies often create issues when approving claims and the last thing you need is to make a mistake when reporting the incident. As long as you provide all the necessary details and submit the documentation within the required time, you have fulfilled your obligation.

Consult with an Atlanta Attorney to Discuss Your Workers’ Compensation Case

If you have suffered an injury at work and are facing challenges getting the benefits you deserve, please contact our workers comp lawyers in Atlanta at Ted A. Greve & Associates. It is our commitment to serve you and to provide you the best possible representation. Our legal team includes very experienced and highly skilled attorneys who know the workers’ compensation system in Atlanta. They are aware that there is a specific type of compensation for each type of injury but the trick is to ensure that you get these benefits. Speak to one of our lawyers in Atlanta today to find out your options and how you should proceed with your claim.