No one expects to get injured at work. Unfortunately, accidents do happen on the job, with alarming regularity and oftentimes resulting in serious injuries. Work-related injuries result in untold suffering and out of pocket expenses; in addition to their medical expenses, workers often have to deal with the financial repercussions of lost wages. It’s for this very reason that workers’ compensation exists. The Florida legislature established the workers’ compensation law so that workers injured on the job could have medical and disability benefits delivered to them in the fastest and most efficient way possible. However, not every worker gets the benefits they deserve. If you’ve been denied workers’ compensation for injuries or illness you’ve suffered as a result or in the course of your job, it’s important to know you don’t have to take ‘no’ for an answer.
Potential Reasons Your Claim May Be Denied
Workers’ compensation is a form of insurance your employer carries in the event a worker is injured or becomes ill on the job. Any injury or illness suffered by a worker as a direct result of their employment should be immediately reported to a supervisor, who can then ensure it is reported to the insurance carrier. Like any insurance, if a claim isn’t reported immediately, the validity of the claim may be disputed and the claim denied.
Failure to promptly report a claim is only one of a number of reasons that your workers’ compensation claim may be denied. Under the Florida State Statutes, potential reasons for denial of workers’ compensation benefits include:
- Your injury or illness is minor and determined to not warrant a claim;
- Your injury or illness was not directly caused or related to your employment;
- Your injury or illness isn’t documented by a medical professional;
- Your injury or illness doesn’t prevent you from being able to work and perform the duties of your job; or
- It is determined that you were under the influence of alcohol or drugs at the time of your injury.
Your Right To Appeal
If you suffer an on the job illness or injury and your claim is denied, under Florida law you have the right to appeal the decision. According to the Florida Division of Workers’ Compensation, rights of workers with job-related injuries or illnesses include:
- The right to receive timely notice of denial of benefits. If the insurance company is going to deny your claim, they must do so within 14 days.
- Employees are entitled to file a petition for benefits if all or even part of their claim is denied.
- The insurance company must respond to the petition for benefits within 14 days.
- If an agreement as to benefits can’t be reached, the employee is entitled to mediation within 130 days of filing the petition.
If the claim still isn’t not settled, you can request your case be heard before a judge. There will be an additional opportunity to settle the claim at a pretrial hearing. If the claim is still unsettled, a judge will hear evidence and take testimony before deciding the matter in a court hearing. If the injured worker is unhappy with the ruling, the judge’s decision may be appealed to the district court.
Contact Our Experienced Florida Workers’ Compensation Attorneys
If you have suffered an job-related injury or illness and been denied workers’ compensation, contact our experienced Florida attorneys immediately. Fighting a claim denial is often an uphill battle, but well worth the time and effort to get the compensation you need for past, current, and future medical expenses and lost wages. At Hogan Frick, we’ll help build your case against the insurance company, and get you the benefits you deserve.