When you are injured or become ill due to your job, the workers’ compensation program should provide medical care and pay a partial wage if you must miss work. However, sometimes your employer or its insurer denies a valid claim.
If that happens to you, contact an Orlando workers’ compensation denial lawyer immediately. Recognized by Super Lawyers and Best Lawyers in America, our attorneys at The Florida Firm have consistently been trusted to handle the most complex workers’ compensation disputes. We are proud to have achieved multimillion-dollar recoveries for injured workers across the state. Local lawyers and other professionals refer their family members and friends to us, demonstrating their trust in our representation.
Understand the Program’s Basics
Almost every employer in Florida with four or more employees is required to have workers’ compensation insurance. Some larger employers self-insure, but many purchase coverage for their workers from insurance companies. The insurance takes effect on your first day of work, and the insurer provides coverage even if your job is seasonal or part-time.
Workers’ compensation offers free medical care for work-related injuries through an employer-approved health care provider. If your injury prevents you from performing your job for eight days or more, the program pays you a partial wage. Workers’ compensation covers work-related injuries, which are injuries you sustain while working, or illnesses or health problems you develop because of your working conditions.
Insurance carriers pay most workers’ compensation claims promptly. However, sometimes your employer or the insurance carrier disputes some aspect of your claim and denies it. Regardless of the reason for the denial, our Orlando attorneys can help you contest it and gain access to your workers’ compensation benefits.
Why Might Your Claim Be Denied?
There are several reasons an insurance company or your employer could cite when denying your workers’ compensation claim. One common reason for a denial is failure to notify your employer of your injury promptly. Florida Statutes § 440.185 requires you to notify your employer within 30 days of a work-related injury or condition, and the insurer has the right to deny your claim if you miss the deadline.
There are numerous other grounds an insurance company might cite when denying a claim. For example, if a drug test shows you were under the influence of drugs or alcohol when you sustained the injury, workers’ compensation will not cover it. However, you could contest the method the testing authorities used to administer the test and challenge its accuracy.
Your employer or its insurer may believe your injury is not covered because you sustained it outside of work or because it resulted from a pre-existing condition. Our Orlando-based attorneys could present medical records, statements from people who witnessed the incident, and other relevant information to establish that you are entitled to workers’ compensation coverage for the injury.
How To Appeal the Denial
When you receive a letter denying workers’ compensation benefits, it cites the reason for the denial and provides detailed information explaining how to appeal the decision. The law allows you two years to file an appeal, but delaying makes it difficult to collect the necessary information. The best approach is to contact our lawyers in Orlando as soon as you receive the workers’ compensation denial letter.
Once we have compiled evidence establishing that the denial was unjustified, we will submit a petition for benefits. The petition is a detailed form that describes the injury or condition, the events leading up to it, and why you believe you are entitled to benefits. Submission of the petition to the Office of the Judges of Compensation Claims begins the formal appeals process.
Direct negotiations between our attorneys and your employer or its insurance company often resolve the dispute, but some cases proceed to mandatory mediation. If mediation does not result in a settlement, you will have a hearing before a judge where you can call witnesses and present evidence. If the judge issues an unfavorable decision, you may pursue further appeals.
Contact an Orlando Workers’ Compensation Denial Attorney About Your Claim
At The Florida Firm, we understand that workers’ compensation benefits provide essential support when you are injured or ill. Our Orlando workers’ compensation denial lawyers apply their skills and experience to ensure you receive the benefits you deserve.
You will not pay any up-front fees or expenses, and our team is available to review your case. Contact Colling Gilbert Wright today to schedule your free consultation.