Orlando Workers’ Compensation Appeals Attorneys
After you’ve been injured or fallen ill on the job, you make sure you report your incident to your boss immediately and get treated by the insurance company’s suggested medical provider.
You go through all the motions in a timely manner, and it may seem obvious to you that your injuries are work-related. It may come as a surprise, then, when you get a letter back saying that your workers’ compensation claim has been denied.
While Florida’s workers’ compensation system exists to help everyday workers like you, it can sometimes fail. When it does, you may feel tempted to give up. Van Dingenen Law is here to remind you that you have options even after your claim has been denied.
When you sit down with us in a one-on-one consultation, we can help you determine why your claim was denied and whether you’re eligible to file an appeal. You can still access your benefits with our team representing you.
For a consultation with one of our experienced attorneys, contact us online or call (407) 967-5377. Our Central Florida workers’ compensation appeals attorneys have years of experience helping clients after they’ve initially had their claims rejected.
Reasons Why Claims Are Denied
When you get your rejection letter, the reason for the refusal of your workers’ comp benefits is usually provided. This can help you and us as your attorneys when we begin filing your appeal.
You’re not alone in your denial; countless Americans have their workers’ comp claims every year for some of the same reasons, many of which can be resolved easily.
Common reasons for workers’ comp denials include:
- Not enough evidence of injury being work-related: This is one of the most common reasons for denials, as it can be hard to determine if an injury is related to work. In these cases, you may need more medical records to prove that your injury qualifies for assistance.
- Your claim wasn’t filed in time: Each state has its own laws dictating how long individuals have to file a claim. In Florida, workers have just 30 days to file for workers’ compensation, which is hardly any time compared to a state that has a one-year deadline, like Georgia. Filing your claim even just one day late is sure to result in a refusal.
- Your work injury wasn’t reported soon enough: Time is of the essence after you’ve been injured in a work-related accident. After an injury, you must report it to your employer immediately – any amount of time that transpires is enough to give people pause.
- Your employer disputed your claim: Employers are allowed to dispute claims filed by their employees. Employers may allege that your accident occurred outside of work hours, or that you were under the influence or disobeying office rules when you were injured.
Claims are also denied when there’s not enough evidence to show that you are being treated by a medical professional for your injuries. This is why it’s important to have as much documentation of your accident and injuries as possible – if you haven’t filed a claim yet, hiring an attorney is beneficial and can prevent you from facing a denial.
What to Do After Being Denied
Getting a denial does not mean your injuries aren’t serious or that your claim isn’t legitimate. In fact, there are many deserving claims that are denied for false reasons. This is where the appeal process comes in. After a denial, you as an injured worker have a right to file a formal appeal.
The appeal process can be broken down into the following steps:
- Filing a petition: The appeal process will begin when you file with the Florida Division of Workers’ Compensation. This must be done in a timely manner, as you have a limited amount of time to respond after getting your initial denial.
- Mediation: If the issue is irreconcilable, you may have a mediation hearing with the insurance company to resolve the matter. Our attorneys can prepare you for these informal meetings and represent your interests.
- Pre-trial hearing: Failed mediations will result in your case being assigned to a workers’ comp judge, who will have a pre-trial hearing to learn more about your claim. It’s during this hearing that evidence can be presented to support your claim.
- Final hearing: During the final hearing, you’ll have another opportunity to present evidence and witness testimonies, and the insurance company will also present their case. The ruling will be made and you will receive a copy of the verdict afterward.
There’s still a possibility that the judge will give you an unfavorable ruling. If this happens, you have a legal right to appeal this ruling, though this can make things even more complicated. You have just 30 days to appeal, which requires legal assistance.
Our attorneys have successfully secured benefits for many of our Florida clients after they’ve had their claims denied and know what evidence we need to strengthen your appeal. You can trust our team knowing that we are aggressive in achieving our legal goals and won’t rest until you get the benefits you’re entitled to under the law.
It’s not the end of the road when your workers’ comp claim is denied. Our Central Florida attorneys can help you file an appeal when you call (407) 967-5377 to learn more about your options.