If your workers compensation claim has been denied, the Kissimmee, Florida Workers Compensation Disputes Lawyers at Work Injury Rights are here to assist you.
In Florida, any employee who sustains an injury while on the job may be entitled to workers’ compensation benefits to cover medical expenses and a portion of lost wages during recovery. However, some employers and insurance companies may dispute valid claims, leaving workers without the support they need.
At Work Injury Rights, our team of attorneys in Kissimmee has extensive experience handling denied workers’ compensation claims. We have successfully represented workers whose claims were rejected and have effectively appealed cases in higher courts.
If you have questions about your denied claim and how we can help, contact us at 954-833-5226 today to speak with an attorney. We are here to advocate for your rights and pursue the compensation you deserve.
Causes of Workers’ Compensation Disputes
One common cause of workers compensation disputes arises when there is a disagreement over the employment status of the injured worker. Employers may claim that the worker was an independent contractor rather than an employee, which can complicate the process of receiving benefits. Understanding the laws surrounding independent contractors is crucial for resolving such disputes and ensuring that injured workers receive the benefits they deserve.
Outside Scope of Employment
Disputes may also arise if there is uncertainty about whether the injury occurred within the scope of the worker’s employment. Workers compensation typically covers injuries that occur while an employee is performing job-related duties. Injuries sustained during breaks or outside of work hours may not be eligible for compensation.
Lack of Causation
Workers’ compensation benefits may be denied if the employer or insurer believes that the injury was not directly caused by work-related activities. For example, if an employee was intoxicated at the time of the accident, the claim may be denied on the grounds that the intoxication contributed to the incident.
In Florida, workers are required to report work-related injuries or illnesses to their employer within 30 days. Failure to meet this deadline could result in a denial of benefits. It is essential to act promptly to ensure that all necessary paperwork is submitted on time to avoid potential disputes.
Employers may dispute workers’ compensation claims if they believe there is insufficient evidence to support the injury. This could include inconsistencies in witness statements, missing medical records, or discrepancies in the worker’s account of the incident.
To prevent misunderstandings and inconsistencies, it is advisable to limit discussions about the accident to those directly involved in the claims process and to allow a qualified workers’ compensation lawyer to represent you in dealings with your employer and the insurance company.
What To Do If Your Workers Comp Claim Is Denied In Florida?
If your workers compensation claim in Kissimmee, Florida is denied, it doesn’t mean the end of the road. You have options to appeal the decision and pursue the benefits you rightfully deserve. Here’s what you can do:
Request a Hearing Before the Industrial Commission
If your claim is denied, you have the right to request a hearing before the Industrial Commission. To initiate this process, you may need to file a Petition for Benefits within two years of the accident. A judge will be assigned to your case, and they may suggest mediation or other dispute resolution methods to attempt to reach a settlement.
If mediation fails to resolve the dispute, you can proceed to a hearing at the Office of the Judges of Compensation Claims (OJCC). The judge will review the evidence and testimony presented during the hearing and issue a decision on your workers compensation benefits within 30 days.
If you disagree with the judge’s decision, you have the option to file a petition with the state’s First District Court of Appeal within 30 days of the ruling.
Contact an Attorney
When your workers comp claim is denied, it’s crucial to seek legal representation from an experienced attorney. A Kissimmee workers compensation dispute attorney at Work Injury Rights can advocate on your behalf, negotiate with the insurance carrier, and fight to ensure that you receive the benefits you deserve. Don’t hesitate to reach out to us for assistance in navigating the appeals process and protecting your rights.
Types of Workers Compensation Disputes
Following a workplace injury in Kissimmee, your employer’s insurance provider is responsible for covering your medical expenses. However, disputes may arise when they deny coverage based on medical grounds. They may argue that you had pre-existing conditions, previously suffered similar injuries, or attribute your injuries to other factors unrelated to work.
Claim disputes occur when your employer and their insurer reject your workers compensation claim, alleging non-compliance with Florida’s workers compensation laws. This could involve missing deadlines for claim submission or failing to meet other regulatory requirements outlined in the statutes.
Workers Compensation Dispute and Appeals Process in Florida
If your workers compensation claim is denied in Kissimmee, you have the option to appeal the decision. Here’s how the appeals process typically unfolds:
- File a petition with the Division of Administration hearings.
- You will receive a conference date from the Judge of Compensation Claims.
- Attend the pretrial hearing where you must present evidence of your injuries.
- Participate in Alternative Dispute Resolution (ADR), such as mediation, to attempt to reach an agreement with your employer.
- The final hearing is scheduled within 90 days of the mediation and no later than 210 days after filing the Petition for benefits.
- If both parties reach a voluntary resolution before the Final Hearing, they will draft and sign a stipulation or agreement outlining the agreed terms.
Allow Us to Assist You with Your Workers’ Compensation Appeal
When faced with a denied workers compensation claim, having a skilled attorney by your side who is well-versed in Florida’s legal system is crucial. Understanding the intricacies of deadlines, procedures, and legal tactics involved in appealing a workers comp denial is essential, and our team at Work Injury Rights is here to provide you with expert guidance every step of the way.
With our assistance, you can navigate through these challenging times and pursue the maximum compensation available for your case. Our goal is to ensure that you receive the necessary support and care following a workplace injury or illness. Contact Work Injury Rights now at 954-833-5226 to arrange a consultation with a Kissimmee, Florida Workers Compensation Disputes attorney.