What to Do if My Workers’ Compensation Claim Is Denied?
If you have been injured in a work-related accident, you can apply for workers’ compensation benefits. These benefits are also available if you incur an occupational disease. Workers’ comp covers the medical costs of your injury or illness as well as lost wages and lost earning capacity. However, you must meet certain requirements before you can receive these benefits. In many cases, workers’ compensation claims are not properly filed or do not meet the requirements. This results in a denial of the claim. That being said, denial of a workers’ compensation claim is no cause for worry, a Florida workers’ compensation attorney can help. If your claim has been denied, you should follow these steps.
Identify The Reason Your Workers’ Compensation Claim Was Denied
This should be your immediate concern in the wake of a claim denial. Once you know the reason for denial, you can find a way to remedy the cause. Typically, workers’ compensation claims are rejected for these reasons:
- Disputed Injury: Only injuries that are incurred while you are performing your job and directly caused by it qualify for workers’ compensation. When you file a claim, your employer may argue that your injury wasn’t directly caused by your work. For instance, if your injury took place when you had taken a break at work or indulged in horseplay, it may not qualify for comp benefits. Similarly, an employer may argue that a pre-existing medical condition caused your illness, not the conditions at work.
- Delayed Application: Florida Statutes 440.185 require you to notify your employer of an injury within 30 days. If you fail to meet this deadline, your employer can deny your benefits by citing the delay.
- Illness Not Covered: A number of occupational diseases qualify for workers’ comp benefits, and a number of diseases do not. If your condition does not meet the criterion set by the state, your compensation claim may be denied.
Remedy The Objections
Once you know the reasons, it is time to remedy the objections to your compensation claim. If your injury is being disputed, you will need to consult a workers’ compensation attorney. An attorney can help you counter the objections leveled against your claim by an insurance company or employer.
You will also need to gather medical evidence, testimony of a relevant medical expert and other supporting materials. This evidence will be of central importance when you appeal the denial.
File An Appeal
Once you receive a letter stating that your workers’ compensation claim has been denied, you can file an appeal against it. The letter typically includes detailed instructions on how to file such an appeal. So it is important to go through it in detail. In Florida, you must appeal the rejection by filing a Petition for Benefits within two years of the injury. Although this gives you plenty of time to prepare for the appeal, it is advised that you file the appeal as early as possible.
As part of the appeal process, you will then be required to present your case in front of an administrative judge. You can also present any relevant evidence during this hearing. If the judge approves your claim based on the evidence you present, you qualify for the benefits. However, if the judge doesn’t find sufficient evidence to suggest that you qualify for compensation benefits, you can appeal at higher levels.
Hire An Attorney
Hiring an attorney is an essential step if your workers’ compensation claim has been denied. The denial means that you will now have to present evidence and arguments to support your claim. This is quite hard, especially when you are up against the expensive lawyers hired by an insurance company. An attorney with the right expertise can help you navigate the complex appeals process. The attorney can also help you bring together the relevant evidence and argue your case in a more coherent manner.
Finding An Attorney In Florida For Your Workers’ Compensation Claim
Here at Burnetti, P.A., our attorneys specialize in Florida workers’ compensation law. We are also very well-acquainted with the insurance landscape across the state. This allows us to help you seek the workers’ compensation benefits you deserve. If your claim has been turned down by an employer or insurance company, make no delays and contact us right away.
If you failed to meet any requirements, our attorneys will identify these and help you meet them. If the case needs to go to a hearing, our lawyers will work with you to gather the evidence and prepare a case. With our attorney on your side, you odds of winning the appeal will be a lot better. Contact us today for a FREE consultation with our attorneys.