The workplace is one of the few places that anyone ever expects to get injured or harmed – unless you are working in a high-risk environment such as construction and mining. However, what you may not realize is that workplace accidents leading to serious injuries as well as illnesses caused by exposure to substances or the nature of the job are quite common in almost all sectors, which is why Florida Law requires that all employers with at least 4 employees provide workers’ compensation insurance for all their employees. There is, however, an exception in the construction industry as all employers are required to carry this insurance regardless of the number of employees.
Florida’s workers’ compensation is a system designed to provide financial support to employees injured while on the job. While this might be the case, there are instances when an employer or their insurance company may deny an employee’s claim or offer a less than favorable compensation offer. Our team of experts can help you with your workers’ compensation disputes in Fort Lauderdale, FL.
Suffering a workplace injury can be highly distressing as this often means staying out of work for an extended period of time and having to deal with ever-increasing medical bills. The situation only gets worse if your workers’ compensation claim is denied for whatever reason. If this has happened to you and you believe that your claim was unjustly denied, a Ft. Lauderdale workers’ compensation attorney at Miami Workers’ Compensation Lawyers Coalition can help fight for your rights and provide you with the most effective legal solution in your Miami workers’ compensation dispute. Contact us today to schedule an appointment with one of our skilled attorneys.
Table of Contents
Causes Of Workers’ Compensation Disputes
There are many reasons why your workers’ compensation claim might be denied. Understanding the exact reason why your claim was denied can help you determine the best way forward and if you have a valid claim that was unfairly denied. If your claim is denied, you will receive a “Denial of Claim” letter from the insurance company which details why your claim was denied and the possibility of an appeal. Here are some of the valid reasons your employer or their insurance company may use to deny your claim:
Your employment status is one of the most important factors considered when determining whether you have valid workers’ compensation. In this regard, you are only entitled to workers’ compensation benefits if you are an employee ( part-time or full-time) of the company. This means that if you quit, were fired, or were laid off before filing your workers’ compensation claim, then you aren’t entitled to workers’ compensation benefits. However, if the claim was filed before you quit or were laid off or fired, you have a valid claim.
Outside Scope of Employment
Essentially, for an injury to be covered under Florida’s workers’ compensation benefits, it should have occurred while performing a work-related activity. The insurance company will have legal grounds to deny your claim if your injuries arose from something that isn’t related to or within the scope of your employment.
Lack of Causation
There has to be a causal connection between your job and your injuries for your claim to be valid. This means that you have to prove that your injuries were caused while in the course of you performing your job or were a result of a particular unsafe condition in your job.
When it comes to filing a workers’ compensation claim in Florida, there are certain deadlines that have to be met. First of all, you are required to notify your employer (preferably in writing) about your injury within thirty days of the accident, or in the case of occupational illness, within 30 days of discovering about the illness.
For a successful claim, you need to provide as much information as possible to the workers’ compensation insurance company in regards to your injury and how it happened. Some of the main reasons why insurance companies deny claims are the lack of witnesses and enough information to support an employee’s claim.
What Should I Do If My Workers’ Compensation Claim Is Denied In Florida?
Just because your claim has been initially denied, it doesn’t mean the end of the road for you. You have the option to appeal that decision as well as any other subsequent denials. In the unfortunate event that your claim is denied, here is what you need to:
Request Hearing Before the Industrial Commission
If your workers’ compensation claim has been denied, you need to file what is known as a “Petition for Benefits” claim within two years of the injury with Florida’s Division for Workers’ Compensation who will have a judge assigned to your case. Typically, the judge will recommend having the case settled through alternative dispute resolution strategies i.e mediation.
If your case can’t be resolved through mediation, you can request a hearing before the Office of the Judges of Compensation Claims. Here, the judge will make a decision on the benefits and issue a ruling within 30 days of the hearing. If you are unsatisfied with the decision, you can file an appeal with the First District Court of Appeal in Florida within 30 days of the judge’s decision.
Contact an Attorney
If your claim has been denied, it is crucial that you contact an experienced workers’ compensation attorney right away. An attorney will negotiate with the insurance company on your behalf and help reach a favorable settlement for you. If the negotiations aren’t fruitful, the attorney will help collect all the necessary evidence to build a strong case for you during the appeals process.
Types Of Workers’ Compensation Disputes in Fort Lauderdale
There are various grounds on which your employer or their insurance company may dispute your claim. Basically, there are two main categories of workers compensation disputes:
These types of disputes arise when the employer or their insurance company denies your claim on medical grounds. For instance, the employer may argue that you had suffered the injury before the supposed event, had an underlying condition, or your occupational illness was caused by some other factors.
These types of disputes arise when the employer or their insurance company denies your claim on grounds that you failed to follow the rules and procedures involved in Florida workers’ compensation claims. For instance, the insurance company may claim you failed to file the claim within the set deadline. The employer may also claim that the injury didn’t occur within the scope of your employment, you were under the influence of drugs, and so on.
Contact An Experienced Ft. Lauderdale Workers Compensation Lawyer Today
If you recently suffered a workplace injury and have had your workers’ compensation claim denied, you might be understandably worried and distressed. Fortunately, this doesn’t mean that you aren’t eligible to receive workers’ compensation benefits. You still have legal recourse, but you need to act fast to protect your rights. With the assistance of an experienced workers’ compensation attorney at Miami Workers’ Compensation Lawyers Coalition, you can effectively appeal the denial and secure your legally owed financial compensation. Call us today at (786) 686-2857 for an evaluation of your case.