Understanding the workers’ compensation eligibility guidelines in Rome is integral to ensuring you file a valid claim or know how to make a successful appeal. Our Rome workers’ compensation lawyers can help you navigate these guidelines and ensure you meet them.
Call Bader Law Injury Lawyers today to get started with your workers’ compensation claim.
What Are the Rome Workers’ Compensation Eligibility Guidelines?
There are two sets of workers’ compensation eligibility guidelines to be aware of in Rome, GA. To qualify for workers’ compensation, you must be able to prove that you:
- Were injured at work or due to your work/suffered an illness due to your work
- Were an employee at the time you suffered your work-related injury or illness
This can seem straightforward, but establishing these criteria is often difficult.
There are other related criteria you must establish. You must also be able to prove the following:
- You did not cause your injury.
- You were intoxicated or engaged in horseplay at the time of your accident/your injury resulted from a fight.
If you do not meet all of these criteria, your employer’s workers’ compensation insurer will likely deny your claim. Our Rome personal injury lawyers can help.
For a free legal consultation with a workers' compensation eligibility guidelines lawyer serving Rome, call (404) 888-8888
What Can I Do If I Have Trouble Establishing My Eligibility for Workers’ Compensation?
As stated above, it can be difficult to establish even seemingly simple criteria. For example, your employer or their insurer may claim that you did not give proper notice of your accident or injury. They could also claim that your injury resulted from an accident that was outside the course or scope of your employment.
A lawyer can help you gather evidence that establishes that you were injured at work and that you did inform your employer within the necessary period of time. Any evidence you have could be tremendously helpful. For example, if you have a copy of the email or text message you sent your employer, that can help us shut down their argument.
Proving the second set of criteria is often more difficult. You must prove that you did not intentionally cause your injury. This does not mean that your negligence cannot have caused it. It just means that you must prove you are not attempting to recover workers’ compensation benefits through a fraudulent claim.
Appealing a Denial
If your claim is denied, you have the right to request a hearing. To do so, you must fill out Notice of Claim: Form WC-14. Be sure to do this as soon as possible after receiving the denial.
If the workers’ compensation administrative law judge (WLJ) upholds the original decision, you have the right to appeal this decision. You must do so within 20 days on the date of the decision.
Our team can help you appeal a denial but you must get in touch with us immediately after receiving your denial. Call Bader Law Injury Lawyers today to get started.
Rome Workers' Compensation Eligibility Guidelines Lawyer Near Me (404) 888-8888
What Medical Benefits Can I Recover?
All of your reasonable medical treatment expenses should be covered by workers’ compensation. Reasonable medical expenses may include physician’s expenses, hospitalization costs, physical therapy, prescriptions, and any travel costs if you need to travel for care.
However, you must receive care from an approved physician. Your employer must post a list of these approved doctors or the name of the Workers’ Compensation Managed Care Organization (MCO). A representative from this MCO will help you schedule an appointment with an eligible healthcare provider of your choice.
These benefits will continue for up to 400 weeks. If you suffered a catastrophic injury, you could receive lifetime benefits.
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What Wage Benefits Can I Recover?
You are entitled to wage loss benefits if you are unable to work while you recover. You can receive 2/3 of your average weekly wage (AWW) up to $800 per week.
It’s important to note that you will not be eligible for wage loss benefits unless you are unable to work for more than seven days. If you are unable to work for more than 21 consecutive days, you will receive payment for that first week.
These benefits will continue for up to 400 weeks. If you suffered a catastrophic injury, you could receive benefits for the rest of your life.
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What If I Can Go Back to Work But Need to Take a Lower-Paying Job?
If you are able to return to work but will be making less, you can receive a reduced benefit (up to $533 in 2024). This payment will continue for a maximum of 350 weeks. The insurer may refuse to pay you this, but our team will fight to ensure you receive it.
What Can I Do If My Employer Is Trying to End My Benefits Early?
In many cases, people injured at work find that their employer may be attempting to end their benefits early or get them back to work before they are ready. You have the right to appeal this decision. Our team can help.
What If My Workers’ Compensation Benefits Aren’t Enough?
You may have options if your benefits aren’t covering all your losses. If another party (not your employer) caused or contributed to your injury, you may be able to file a third-party claim. This could allow you to recover the entirety of your lost wages, lost earning capacity, and non-economic damages.
Our team will help you determine if you qualify to file a third-party personal injury claim.
Get Help Understanding the Workers’ Compensation Eligibility Guidelines
Understanding and meeting the guidelines for workers’ compensation eligibility can be difficult. But you don’t need to handle this alone. The Bader Law Injury Lawyers team is here to help you get the benefits you need and deserve.
Call workers’ compensation eligibility guidelines in Rome today for a free consultation. During your consultation, we’ll discuss your case, whether you qualify, what you can recover, and what you can expect to pay for our help.
Call or text (404) 888-8888 or complete a Free Case Evaluation form
