Employers in Florida must make sure they offer a secure work environment for their workers. When a worker becomes injured or ill at work, the employer should provide the employee some reimbursement to cover medical expenses and other financial deficits. However, this is not always automatic, and lots of employees find out the insurer refused their reimbursement claim for just one reason or the other.
Occasionally, the cause of the refusal is flimsy because insurance businesses hate to cover reimbursement and attempt to avoid it at any cost. Sometimes, it could be valid. No matter the reason they provide, you have the right to appeal the refusal and work with a great Miami workers’ compensation attorney. You need to be able to acquire your settlement in due time. But, what are the usual reasons insurance companies offer for denying a workers’ compensation case?
Why Were My Employees Compensation Claim Denied?
All these are the probable reasons why the insurer contested your employee’s compensation claim:
Deficiency of Proof
The insurance provider would not only take your word for this. They’ll carry out their personal investigations to confirm you are in possession of a legitimate worker’s compensation case. To help their study, they would need one to make proof that you’re hurt while carrying out your valid work duties. Without evidence which you obtained medical therapy and no opinion to confirm you got injured on the job, it could be difficult to show the merits of your employee’s compensation case.
You Missed the Time Limit
If you created a late application for reimbursement, the insurance provider may leverage this to deny or lower your payment. It is always safer to record your work-related accidents when it occurs.
That Was a Pre-Existing Injury
In the event that you had an accident or medical condition prior to the incident on the job, insurance companies are too pleased to point out that. They would assert that the incident was caused by a pre-existing illness, and therefore, they would not pay you any compensation.
The Injury Is The Fault
Workers’ compensation covers injuries that occurred when you’re carrying out your routine, legitimate work. In the event the insurance provider can demonstrate that the damage resulted from neglect on your part or who you’re drunk or drunk, they could deny your claim.
Your Injury Isn’t Work-Related
The harm you’re trying to find reimbursement from has to be work-related. You have to have been carrying out your job description within the official hours of work. You would also get paid if the injury happened while carrying your off-road work assignments. However, the insurance provider would deny any claim which, by way of instance, demonstrates that you sustained the injury when commuting to work rather than on the job premises.
Can You Recover Compensation Even If Your Claim Was Denied?
Based on the reason for the refusal, you can still receive compensation for your work-related harm with these measures:
You should do it within two years following the job incident happened. Should you file your appeal afterward, the Ombudsman office might choose to dismiss it.
It is always much better to submit an appeal once your claim has denied since the longer you wait, the tougher it becomes to establish your claim. If you require medical therapy, the time limitation is annually from the date that the work-related accident happened.
Your lawyer will make certain you receive the reimbursement you deserve as speedily as you can in the administrative appeals and, even if this does not yield desired outcomes, in court.
That is undoubtedly a better option than submitting an appeal in Florida’s Employer Assistance and Ombudsman Office on your own.
You don’t need to wait until your claim has denied until you contact our workers’ compensation law firm. Our lawyers would make certain that the insurer doesn’t have any reason to deny your request from the get-go. But if you’ve made the error of not calling a lawyer and now need one for an appeal, our lawyers are always ready to provide you the help you require.