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Workers’ compensation is a form of insurance that provides wage-loss benefits, medical benefits, vocational rehabilitation, and other benefits to workers injured or who become ill due to their employment.
Workers’ compensation is considered as the right to be compensated for injuries or illnesses suffered on the job. Workers Compensation Appeals Board is an independent quasi-judicial body that hears appeals from applicants who have been denied workers’ compensation benefits by their employers or have been denied an occupational disease claim.
What is Workers Compensation Appeals Board?
The worker’s compensation appeals board in Atlanta is an organization that handles workers’ compensation cases. The Board’s members are appointed by the Governor and it has jurisdiction over all matters of law, equity, and justice arising from disputes between employers and employees or their beneficiaries arising from injuries or diseases sustained in the course of employment.
The Board consists of five members appointed by the Governor with consent from the Senate. The Board hears and decides appeals from decisions made by the Georgia Department of Labor, which includes a variety of issues such as eligibility for benefits, medical treatment, vocational rehabilitation, and work-related injuries or illnesses.
The hearings are open to the public and provide a forum for both employers and employees to present their cases. The Board will then decide whether or not to uphold, reverse, modify, or remand the decision of the Division of Workers’ Compensation.
How Do Workers Compensation Appeals Work in Atlanta?
You can appeal a denial by submitting a hearing request and getting ready for trial.
The hearing request needs to be submitted promptly before the statute of limitations runs out.
Usually, the parties engage in discovery before a hearing is scheduled.
This implies that both the insurance provider and the wounded employee get interrogatories and requests for the production of documentation. Depositions are taken and medical records are collected.
The Georgia State Board of Workers’ Compensation notifies all parties concerned when a hearing is requested.
The hearing’s date, time, and place are all disclosed in this notice. The administrative law judge who will preside over the matter is also identified in the notice of hearing.
Prior to the hearing, this judge considers all motions, conflicts over discovery, and other evidentiary-related matters. She also serves as the hearing judge.
According to O.C.G.A. 34-9-102, the hearing for workers’ compensation should not be delayed for more than 90 days after the hearing request.
What are the Functions of WCAB?
The functions of WCAB include hearing and deciding appeals. This is usually done over the decisions made by the Workers’ Compensation Administrative Law Judges (ALJs) regarding workers’ compensation claims. The WCAB has the authority to review and make final decisions on issues such as:
Claim for compensation: WCAB has the power to decide whether an employee is entitled to workers’ compensation benefits or not.
Award of benefits: WCAB can determine the number of benefits to be awarded to the employee, including medical treatment and temporary or permanent disability payments.
Medical treatment: WCAB can approve or disapprove the medical treatment recommended by the employee’s physician.
Dispute resolution: WCAB can resolve disputes between employers, employees, and insurance companies regarding workers’ compensation claims.
Review of ALJ decisions: WCAB can review and overturn the decisions made by the ALJs if they are deemed to be incorrect or unjust.
Penalty: WCAB can impose penalties on employers for non-compliance with the workers’ compensation laws.
Administrative penalties: WCAB can impose penalties on employers for noncompliance with the workers’ compensation laws, and also on insurance carriers for noncompliance with the regulations.
Regulation: WCAB can adopt and amend regulations as necessary to administer the workers’ compensation system.
What Happens During a Worker's Compensation Appeal in Atlanta?
Workers’ compensation appeals are a necessary part of the process when a worker compensation appeal for the injured worker is denied. If you have been denied workers’ compensation, there are two options for you: file for an appeal or go to trial.
Here are the events that take place during a workers’ compensation appeal.
- The appeal is reviewed by the board as soon as you submit a claim to the appeals board. Any supporting evidence you may have should be submitted to hasten the review process. Your chances of success can be greatly increased if you have a tonne of supporting documentation.
- Your employer or the employer’s insurer must now state its position on the denial as part of the appeals procedure. Employers and insurance providers can now provide whatever proof they have to back up their decision to reject the claim.
- Both employers’ and insurers’ legal representatives may make arguments in a hearing after the board has reviewed the appeal and both sides have had an opportunity to submit their positions. When the appeals board sets a hearing before a commissioner or judge, this will start. The case might then be discussed by each side.
- The commissioner or judge will determine whether to accept your appeal after the hearing. You might be able to gain benefits as a result of this choice, or you might need to take more action to get them back. Before the judge or commissioner makes a ruling, it may take more than a month.
Conclusion
Although the denial process is important, it can be an uphill battle for employees to appeal their denials. This is because many employers will not provide the necessary information for an appeal and instead only provide general information about their policies. Appealing a denial in workers’ compensation is important because it gives employees access to the benefits that they deserve. It is important to consult a qualified atlanta worker comp attorney for that matter.
Frequently Asked Questions
What is the Structure of the Workers Compensation Appeals Board (WCAB)?
Workers Compensation Appeals Board (WCAB) is a board of three members appointed by the governor. It hears and decides appeals of workers’ compensation cases that arise from decisions made by the Industrial Commission, which is an administrative body that adjudicates all issues related to workers’ compensation claims.
What is the Mission of the WCAB?
Their mission is to ensure that injured workers have timely access to fair compensation for their injuries and disabilities while also preserving employer’s rights and providing economic stability for employers through the prompt resolution of disputed claims.
What Do I Need to Know About the Employees’ Compensation Appeals Board (ECAB)?
The ECAB is an independent body that hears appeals from employees who are not satisfied with their compensation decisions from the Workers’ Compensation Board. The ECAB can also make decisions on matters related to compensation, such as reconsidering the decision made by a medical officer or deciding whether or not an employee should be compensated for medical reasons.
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