Timelines and Delays in Workers Comp Claims

Workers compensation is a crucial safety net for employees in Boca Raton who suffer injuries or illnesses on the job. However, the process of filing a workers comp claim and receiving benefits can often be complex and time-consuming.

A Boca Raton workers comp attorney can help you file your claim on time and handle the entire process to ensure there are no delays.

The Timeline of a Workers Comp Claim

In Boca Raton, Florida, employers who have four or more employees, whether full-time or part-time, are generally required to carry workers compensation insurance. This is governed by law and  provides benefits to workers who are injured or become ill due to their job. Benefits can include medical expenses, lost wages, and disability benefits.

The timeline of a workers compensation claim in Florida involves several key steps:

Seeking Medical Treatment

When a work-related injury or illness occurs, the first step is to seek immediate medical treatment. It’s crucial to inform the healthcare provider that it’s a work-related injury and provide the employer’s name.

Reporting the Injury

The injured worker must report the injury to their employer within 30 days of the incident or of the discovery of the injury or illness.

Employer Notification to the Insurance Company

Once notified, the employer has seven days to report the injury to their workers’ compensation insurance carrier.

Insurance Company Investigation

The insurance company then has up to 120 days to investigate the claim and decide whether to accept or deny it.

the workers comp process may be delayed by various factors

Filing a Claim

After reporting the injury to the employer, the worker must file a workers compensation claim with the Florida Division of Workers’ Compensation. In Florida, the worker generally has up to two years from the date of the injury to file a workers comp claim.

Payment of Benefits

If the claim is accepted, the insurance company must begin paying benefits within 21 days of being notified of the injury.

Potential Delays in the Process

While the above timeline may seem straightforward, there are numerous factors that can cause delays in the process:

Navigating Complex Processes

One of the most significant challenges in workers compensation claims in Florida is navigating the complex administrative process. The system, while designed to be straightforward, often becomes complicated due to the legal and medical jargon, extensive paperwork, and specific procedural requirements.

Disputes Over the Nature and Extent of Injuries

Disputes frequently arise regarding the nature and extent of injuries. Insurance companies may challenge the severity of the injury or argue that it is not work-related, seeking to minimize their financial responsibility. Such disputes can delay the approval of claims and the disbursement of benefits, placing additional strain on injured workers.

Dealing with Employer and Insurance Company Tactics

Employers and their insurance providers may employ various tactics to deny or reduce claim payouts. These tactics can include disputing the nature of the injury, arguing that the injury did not occur within the scope of employment, or challenging the necessity or cost of medical treatments.

Incomplete or Incorrect Paperwork

Any errors or omissions in the paperwork submitted can cause delays. It’s crucial to fill out all forms accurately and completely.

Legal Appeals

If the claim is denied and the worker appeals the decision, this can add significant time to the process. The appeals process can be lengthy and may require legal representation.

How a Boca Raton Workers Comp Attorney Can Help Overcome Delays

Engaging the services of a Boca Raton workers compensation attorney can be beneficial in navigating the complexities of such claims, particularly when facing delays. Here’s how an attorney can assist:

  • Claim Management: An attorney can manage the claim on behalf of the injured worker, liaising with the employer, the insurance company, and medical providers. This can help to expedite the process and prevent unnecessary delays.
  • Maximizing Compensation: An attorney can ensure that the worker receives the full range of benefits they are entitled to. They can challenge any attempts by the insurance company to minimize payouts, and can negotiate settlements.
  • Legal Representation: If the claim is denied and the worker decides to appeal the decision, having an attorney can be invaluable. The appeals process can be lengthy and complex, and having someone who understands the system can make a significant difference.

If you’re dealing with a workers’ compensation claim and experiencing delays, consider seeking legal advice from Work Injury Rights to ensure your rights are protected and to help expedite the process. Contact us at 954-324-COMP for professional and experienced legal representation.