Orlando Workers’ Compensation Appeals Attorneys

The workers’ compensation insurance system is intended to make it easy for a worker who suffers a workplace injury or illness to receive medical treatment and wage replacement. Instead of being required to prove fault on the part of an employer in a traditional negligence lawsuit, workers’ compensation is supposed to ensure that workers are treated and compensated quickly and without the need for expensive and time-consuming litigation. What happens though if you make a valid workers’ compensation claim and the claim is denied? The good news is that you do not have to accept a denial. You have legal options and the Orlando workers’ compensation appeals attorneys at Van Dingenen Law help.

We have devoted our entire practice to helping injured and ill workers who are entitled to workers’ compensation benefits. If your workers’ compensation claim was denied, let our experienced and dedicated Orlando workers’ compensation appeals attorneys help you appeal that denial to get you the benefits to which you are entitled. For a consultation with one of our workers’ compensation appeals attorneys, contact us online or call (407) 967-5377. We will sit down with you and review your case to determine why your claim was denied and discuss the prospect of appealing your denial.

Why Was My Orlando Workers’ Compensation Claim Denied?

Despite the intended simplicity of the workers’ compensation system, some claims are still denied. An attorney will need to review the unique facts of your case to determine why your claim was denied; however, common explanations given for the denial of a workers’ compensation claim include:

  • Lack of evidence proving the injury/illness is work-related. Workers’ compensation covers an injury or illness that is work-related. Typically, it is easy to prove that an injury/illness is work-related, but if there is any question about the nexus between your job and the injury/illness, your claim might be denied.
  • You failed to timely report the injury/illness. The workers’ compensation rules require a worker to report injuries and illness immediately. If you waited to file a report, that delay could cause your claim to be denied.
  • You missed the filing deadline. Along with reporting an injury/illness in a timely manner, you are also required to file a claim within the allocated time limit. In the State of Florida, workers only have 30 days “after the date of or initial manifestation of the injury” to file an official workers’ compensation claim.
  • You had a pre-existing injury. If you had a similar or related pre-existing injury/illness at the time of the incident in question, your claim might be denied on that basis.
  • You caused the injury. If your own negligence caused or contributed to your injury or illness, workers’ compensation insurance is not responsible for covering your medical treatment or wage replacement. The most common example of this is when a worker was under the influence of drugs or alcohol at the time of an injury.
  • Your employer disputed the claim. An employer has the right to dispute any workers’ compensation claim. While most employers choose not to do so, some employers routinely deny claims in the hope that workers will give up and not pursue the claim.
  • Lack of evidence regarding medical treatment. Even if your injury/illness appears to qualify for workers’ compensation benefits, your claim could be denied if there is no evidence that you are receiving treatment from a qualified healthcare professional.

What Should I Do If My Orlando Workers’ Compensation Claim Was Denied?

It can be extremely disheartening to suffer a work-related injury or illness and then find out that the workers’ compensation benefits you were counting on have been denied. Nevertheless, it is important to remember that you have legal rights, including the right to appeal a denial of your claim. Having one of our Orlando workers’ compensation appeals attorneys on your side is the key to increasing the likelihood of prevailing on appeal. A workers’ compensation appeal will typically go through the following steps:

  1. Filing of the petition. The first step in the appeals process is the filing of a Petition for benefits with the clerk of the Office of the Judges of Compensation Claims (OJCC). This sets forth the details of your claim and denial and explains the benefits you are requesting.
  2. Employer response. After the OJCC receives your Petition, they will notify your employer that you are appealing the original denial. Your employer then has 14 days to either approve your claim or file a response with the OJCC.
  3. Mediation. If your claim was not approved after filing the Petition, your case will be assigned to mediation within 130 days from the time you filed your Petition. A neutral third-party mediator will assist both sides to try and resolve the dispute.
  4. Pre-trial hearing. If mediation fails to resolve the dispute, your case will be set for a pre-trial hearing in front of the OJCC. At the pre-trial hearing, both sides will exchange information and/or evidence. The hearing also serves to give the judge an idea of the contested issues in the case.
  5. Final hearing. Within 90m days after the pre-trial hearing, you will have a final hearing. At the final hearing, both sides will officially present their case to the OJCC judge who will release a ruling within 30 days after the hearing.
  6. Appeal. If you receive an unfavorable ruling from the OJCC, you have the legal right to appeal that ruling to the First District Court of Appeals; however, you must file a notice that you intend to appeal within 30 days of the OJCC decision.

How Can the Orlando Workers’ Compensation Appeals Attorneys at Van Dingenen Law Help Me?

If you were injured or became ill while on the job, you are entitled to benefits, including medical treatment and wage replacement, from the workers’ compensation insurance system. Receiving a denial of your workers’ compensation claim can be upsetting; however, do not give up. At Van Dingenen Law we are committed to fighting for Florida workers who suffer workplace injuries or illnesses. Let us put our vast experience and resources to work appealing your denial of claim. We have recovered hundreds of millions of dollars in benefits and tax-free settlements for Florida’s injured workers and their families and we will fight to get your claim approved. If your Orlando workers’ compensation claim was denied and you would like to learn more about your legal options, get in touch with Van Dingenen Law today for your free initial consultation by calling 407-976-5377 or contacting us online.

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