What To Do When Your Workers’ Compensation Claim Has Been Denied
Brian O Sutter
Personal Injury
When you’ve been injured at work, regardless whether it was an accident-related injury, a cumulative trauma from physical stress or strain, or even an occupational disease, you are entitled to workers’ compensation. However, your employer or their insurance company may deny your claim leaving you to foot the bill for expensive medical treatments of long term disability. So what do you do when your claim has been denied?Reasons A Worker’s Compensation Claim Could Be Denied
There are several factors employers and their insurance companies consider when investigating a claim. Many of factor things can lead to your claim being denied. The most common reasons a claim can be denied are:
- The claim was not reported in the required time frame
- Your employer may dispute the connection between your work and your injury or illness
- Your insurance company or employer may not believe your injury is serious
- There are discrepancies between your claim and your medical bills
- There were no witnesses to your accident
- You did not sign the proper authorization forms
- You filed your claim after being fired or laid off
Furthermore, workers’ compensation claims cost employers money in insurance premiums, so they will not be eager to pay these claims. Additionally, insurance companies side with employers on workers’ compensation claims because they do not want to pay for the injury or illness. So filing a claim can be an uphill battle.
You Have A Right To Worker’s Compensation
Regardless of why your claim is denied, you have a right to worker’s compensation. Florida law stipulates very specific guidelines to filing a worker’s compensation claim. First you have to report your injury within 30 days of the accident to your employer. If you are suffering from cumulative trauma or developed an occupational illness, you have 30 days from your diagnosis to report your condition. Next, you need to fill out the worker’s compensation forms DFS-F2-DWC-1 and possibly DFS-F2-DWC-1a or DFS-F2-DWC-3. Your employer should provide you these forms. If they have not or will not, you can get them from the Employee Assistance Office of the Florida Department of Workers’ Compensation. Under Florida law, your employer and their insurance company must review these forms and if your claim is legitimate, pay for your medical treatments, any lost current or future wages, and other possible compensation like benefits and disability.
What To Do If Your Claim Is Denied
Unfortunately, many workers’ compensation claims are denied. Luckily, there is something you can do. You can appeal the denial. To appeal the denial you must file a petition to the Florida Division of Administrative Hearings to have your dispute heard by the Judge of Compensation Claims. You will review notice of a mediation conference within 40 days and then within 130 you will have your mediation. If the mediation fails to find a fair resolution both parties can agree upon, a trial date will be set within the following 3 months. Finally, if at court the Judge rules against your favor, within 30 days you can file an appeal with the First District Court of Appeals.
Hire An Attorney
However, petitioning the courts, navigating the mediation process, going to trial, and filing an appeal is a very difficult process, especially when you’re still recovering from a work related injury. Furthermore, insurance companies and employers often times have expensive legal teams that can make sure you still do not get the compensation you deserve. That is why if your workers’ compensation claim has been denied, it is crucial you hire an attorney. A good attorney, like the experienced professionals at All Injuries Law Firm can help you navigate the appeals process and make sure that you get the compensation you deserve. So contact us today for a free consultation to see if you have a case for appeal.