According to the workers’ compensation law in Florida, any employee working for a company with at least three workers, be it full-time or part-time is entitled to compensation if they sustain an injury or fall ill while at work.
This compensation is meant to cover wage loss, medical treatment and other losses. Sadly, some employers and insurance providers can deny the workers’ claims for benefits or even give a lower amount than what the employee requires.
There are numerous reasons for a claim denial or compensation disputes. Some of the most common include making the application too late, the lack of witnesses, the injury or illness wasn’t work-related, the injury or disease was due to horseplay, the injury was due to intoxication or consuming illegal drugs, and even accessing out-of-network medical treatment.
If you find yourself in any of these positions, you can seek help from WorkInjuryRights in Lakeland, Fl. We are a firm with experience in handling workers compensation claims and call make an appeal if your claim is denied unfairly.
Call our Lakeland, Florida office at 954-388-8616 to schedule a free initial appointment to determine the best options for you!
What are the Common Causes of Workers’ Compensation Disputes?
There are many reasons why your claim can be denied and learning why should be the first step in determining the best path forward and also determine whether you head a valid claim to start with. When your claim is denied, you will receive a Denial of Claim letter from your boss or their insurance company stating why it was denied.
That said, here are some of the common reasons for claim denials in Lakeland, Florida:
Employee Status
This is one of the most paramount factors when it comes to determining whether you have a valid claim. In Florida, you are only allowed to seek workers’ compensation benefits if you’re currently employed. Simply put, if you quit your job or were laid off before making a claim, then you are not entitled to benefits.
This is put in place to prevent people who would want to take revenge on their former employers after being fired. If you lose your job, high chances are your former employer or the insurance company will deny your claim for workers’ compensation.
Lack of Causation
Next, there has to be an inherent connection between the injury or illness and your line of work in order to claim to be deemed compensable. This requires proving that the injury or disease was contracted while on duty.
Outside Scope of Employment
For a workers’ compensation claim to be deemed valid, your injury or illness must have happened while doing your duties at work. If it happened outside the scope of your work, then your employer and insurance provider can legally deny your workers’ comp claim.
Missed Deadline
As with all claims, there’s a deadline for filing a workers’ comp claim. This is referred to as the statute of limitations and in the state of Florida, you are required to notify your employer within 30 days of discovering the injury or condition.
For the best chances of receiving compensation, you should provide as much detail as possible including how you hurt yourself, your symptoms and also when the accident occurred.
Once you report the injury, your boss should refer you to an occupational doctor who they chose, unless you require emergency treatment.
Your employer should then report your claim to the insurance provider within 7 days. If they don’t you can contact them directly, but do so in a timely fashion.
You’re Not a Qualified Employer
There are categories of workers who may not be eligible for benefits. These include seasonal workers, domestic workers, independent contractors, farm workers and undocumented workers.
Inadequate Information
In order for your claim to be deemed valid, you are also required to provide as much information as possible to your boss or insurance carrier. Most of the time, claims are denied due to a lack of sufficient information or witnesses.
What Should I Do If My Workers Comp Claim is Denied in Florida?
First, you need a solid reason as to why the claim was denied. The next step should be filing an appeal, which starts by requesting for hearing before the State Board of Workers Compensation or the Industrial Commission. The administrative judge will hear your case and determine if you’re actually eligible for workers comp benefits.
Usually, this hearing happens within two months after filing the appeal.
It is also recommended that you use a lawyer to make things easier and increase the chances of being compensated. A seasoned workers’ compensation lawyer will use their resources and skills to do the heavy lifting and ensure all the paperwork is done in accordance with the law.
Make sure you file the appeal within a year from the date of the claim denial to avoid missing out on the compensation that you deserve.
What are the Different Types of Compensation Disputes in Lakeland?
In the state of Florida, there are two types of compensation disputes that can arise:
Medical Disputes
These occur when the employer or insurance carrier denies the claim on a medical basis. For example, they may claim that your illness was not related to work duties, the injury occurred before the supposed incident or you had an underlying condition.
Claim Disputes
These arise when the employer or insurance company claims that you did not follow the laws and requirement ns stipulated by the Workers’ Comp Law in Florida. For instance, they may say you did not file the claim within the deadline, the accident didn’t happen within the scope of your employment or the accident happened while you were intoxicated, etc.
Hire the Best Workers Comp Lawyer in Lakeland Florida!
An injury or illness that happens while at work can affect your life in many ways including the inability to earn money. If your boss denies your claim, you have the right to make an appeal to protect your rights. The Lakeland team at Work Injury Rights can help you navigate the process.
Call us today at 954-388-8616 to learn more about your legal options.