Employers in Florida must ensure that they provide a safe work environment for their employees. If an employee gets injured or ill on the job, the employer must give the employee some compensation to cover medical costs and other financial losses. But this isn’t always automatic, and many employees find out that the insurance company denied their compensation claim for one reason or another.
Sometimes, the reason for the denial is flimsy because insurance companies hate to pay compensation and try to avoid it at all costs. At other times, it may be valid. Regardless of the reason they give, you have the right to appeal the denial, and with a good Florida workers compensation lawyer, you should be able to get your compensation in due time. But first, what are the common reasons insurance companies give for denying a workers' compensation claim?
Why Was My Workers Compensation Claim Denied?
These are the likely reasons why the insurance company contested your worker’s compensation claim:
1. Lack of Evidence
The insurance company wouldn’t just take your word for it. They will carry out their private investigations to verify that you have a valid worker’s compensation claim. To aid their research, they’d need you to produce proof that you were injured while carrying out your legitimate work duties. Without evidence that you received medical treatment and no witness to verify that you got injured at work, it would be challenging to prove the merits of your worker’s compensation claim.
2. You Exceeded the Time Limit
You have to report your work-related injury to your employer within 30 days of the incident in Florida. If you made a late application for compensation, the insurance company could leverage this to refuse or reduce your payment. It’s always safer to report your work-related injuries as soon as it happens.
3. There Was a Pre-Existing Injury
If you already had an injury or medical condition before the incident at work, insurance companies would be too glad to point that out. They’d claim that the incident resulted from your pre-existing condition, and as such, they wouldn’t pay you any compensation.
4. The Injury is Your Fault
Worker’s compensation covers injuries that happened when you were carrying out your regular, legitimate work. If the insurance company can prove that the damage resulted from negligence on your part or that you were drunk or intoxicated, they can deny your claim.
5. Your Injury Is Not Work-Related
The injury you are seeking compensation from must be work-related. This means that you must have been carrying out your work description within the official hours at your workplace. You would also get compensated if the injury occurred while carrying your off-site work duties. But the insurance company would deny any claim that, for example, proves that you sustained the injury while commuting to work and not on the work premises.
How To Fight A Denied Workers Compensation Claim In Florida
Depending on the reason for the denial, you can still get compensation for your work-related injury with these steps:
1. File an Appeal at Florida’s Employer Assistance and Ombudsman Office
You can contest a denied claim by appealing to the Employed Assistance and Ombudsman office in Florida. You should do this within two years after the work incident occurred. If you file your appeal later, the ombudsman office may elect to ignore it.
It’s always better to file an appeal as soon as your claim gets denied because the longer time passes, the harder it becomes to prove your claim. If you are appealing for medical treatment, the time limit is a year from the date the work-related injury occurred.
2. Get a Florida Workers Comp Attorney
This is by far a better option than filing an appeal at Florida’s Employer Assistance and Ombudsman Office by yourself. Administrative hearings and appeals have too many intricacies and complexities that only a workers comp attorney can seamlessly navigate.
Hiring the services of qualified Florida workers comp attorneys would simplify the process for you and increase your chances of success at appeals. Your attorney would ensure that you get the compensation you deserve as quickly as possible at the administrative appeals and, if that doesn’t yield desirable results, in court.
Let Our Experienced Florida Workers Comp Lawyers Get You The Compensation You Deserve!
You don’t have to wait till your worker’s compensation claim gets denied before you contact us at Burnetti P.A. Our attorneys would ensure that the insurance company has no reason to refuse your request from the get-go. But if you’ve made the mistake of not contacting an attorney and now need one for your appeals, our work comp attorneys are always prepared to offer you the assistance you need.
