Potential Defenses in Atlanta Workers' Compensation Cases


March 25, 2013

When you suffer a serious on-the-job injury in the greater Atlanta metro area, or anywhere in Georgia, workers' compensation benefits provide medical care and compensate for lost income. Although workers' compensation is a “no fault” system, this does not mean that there are not defenses that the workers' compensation insurance company will use to avoid or minimize liability. At Montlick and Associates, our experienced Atlanta workers' compensation attorneys diligently pursue the benefits our clients need to recover from their injuries and support their family.

While there is no requirement that you establish “negligence” by your employer when seeking workers' compensation benefits, an insurance company may still assert certain defenses including:

Failure to Report the Injury to your Employer: An employee has an obligation to report an on-the-job injury to his or her employer as soon as “practical” after the employee has been injured. The notice may be given verbally if it is provided within thirty days. When verbal notice is not provided within thirty days, written notice is required. If you do not comply with the notice requirements, this may provide a basis for denying workers' compensation benefits. When the employer knows of the work-related injury, this may excuse the failure to provide notice.

Failure to File a Timely Claim: A workers' compensation claim must be filed within one year from the date of injury or disability or last remedial treatment by an employer. Generally, the workers' compensation provider can deny benefits if your workers' compensation claim is not filed in a timely manner. The legal definition and requirements for “filing” a claim are very specific, so it is important that you consult with an experienced workers’ compensation lawyer if you have any doubts as to the proper filing of your claim. Failure to meet filing requirements could seriously hurt your ability to receive proper compensation.

Accident Caused by Drug or Alcohol Impairment: Drug or alcohol impairment may provide a viable defense to a workers' compensation claim. If you produce a positive drug test within eight hours of an accident resulting in a work-related injury, you may be denied workers' compensation benefits. The same rule applies if you test positive for alcohol within three hours of suffering your injury. A positive drug test is not an absolute bar to benefits, it is best to consult with an experienced workers’ compensation lawyer to determine your rights in such a situation.

Altercation Unrelated to Job Duties: If you are involved in a physical assault or altercation with a co-worker or supervisor that is unrelated to your job duties, this may provide a defense. For example, a fight related to an affair with a co-worker’s paramour/lover will not justify workers' compensation benefits even if it occurred at the worksite during work hours. However, if the dispute is about a work-related issue like allegations of poor job performance, this may justify workers' compensation benefits.

Injury Not Arising Out of Employment: When car accidents occur during a work commute or trip to lunch, these types of accidents generally will not be deemed as rising out of one’s employment so they do not qualify for workers' compensation benefits. If you are engaged in a function for the benefit of your employer, however, you still qualify for benefits. In some cases, injuries that occur while entering or leaving the premises of your workplace may be covered under workers’ compensation. The issue of whether your injury arises out of employment can be extremely complex.

Willful Misconduct: Certain types of misconduct may disqualify a claimant, including:

  • Injuries that occur when trying to injure another
  • Injuries that are intentionally self-inflicted
  • Intentional failure to use safety equipment or perform a duty required by law

Non-Disclosure of Pre-Existing Condition: If you fail to disclose a pre-existing condition when you are hired, this may constitute a defense if you are subsequently disabled due in part to your pre-existing condition. However, this disclosure requirement only arises if you failed to inform your employer when asked during the hiring process or pre-employment examination.

At the Atlanta workers' compensation law firm of Montlick and Associates, we are familiar with the types of defenses used by insurance companies in workers' compensation cases and diligently seek the compensation our clients are entitled to receive.

Our Atlanta workers' compensation lawyers are available to provide effective workers' compensation representation to clients throughout all of Georgia and the Southeast, including but not limited to Albany, Athens, Atlanta, Augusta, Columbus, Gainesville, Macon, Marietta, Rome, Roswell, Savannah, Smyrna, Valdosta, Warner Robins and all smaller cities and rural areas in the state.

No matter where you are located our attorneys are just a phone call away, and we will even come to you. Call us 24 hours a day/7 days a week for your Free Consultation at 1-800-LAW-NEED (1-800-529-6333). You can also visit us online at www.montlick.com and use our Free Case Evaluation Form or 24-hour Live Online Chat.


Please Note:
Many of our blog articles discuss the law. All information provided about the law is very general in nature and should not be relied upon as legal advice. Every situation is different, and should be analyzed by a lawyer who can provide individualized advice based on the facts involved in your unique situation, and a consideration of all of the nuances of the statutes and case law that apply at the time.