Most Common Reasons Your Workers Compensation Claim May Be Denied

When you get injured at work, you expect that your employer will take care of you. You naturally assume that they’ll cover any medical bills you incur as a result of your workplace accident. You also expect that you’ll receive replacement wages while you’re at home on workers comp. Unfortunately, there’s no guarantee that your workers compensation claim will be approved. Between your employer and their insurance carrier, they may decide to deny your claim. If this happens, you should contact a Tampa workers comp lawyer as soon as possible.

A workers comp attorney will find out why your workers compensation claim was denied, help you file an appeal, and file a lawsuit against your employer if need be.

Here, we will discuss the main reasons why your employer may deny your workers compensation claim. Regardless of the reason, your workers compensation attorney in Tampa will do their best to get your claim approved. Sometimes it’s just a matter of showing the insurance company that you’re willing to press the issue. Once they find out that you’ve hired an attorney, they may change their attitude and be willing to negotiate a payment of your workers compensation claim.

If you have questions or concerns about your workers compensation claim, feel free to give us a call. We can always schedule your free, initial consultation right over the phone. Or you can go online and visit our website to schedule your initial consultation.

Did You File Your Workers Compensation Claim on Time?

One of the reasons your employer may deny your workers compensation claim is because it wasn’t filed on time. According to Florida law, workers have 30 days from the date of their injury to report the accident to their employer. If you fail to file your claim within this time, your employer has the right to deny your claim.

It’s important that you understand the difference between filing your workers compensation claim and filing a workers compensation lawsuit. While you only have 30 days to file your claim, the law gives you two years to file a worker’s comp lawsuit. Ideally you won’t have to do this. However, if the insurance company denies your workers compensation claim, you’ll have no choice but to take legal action. Our workers compensation attorneys in Tampa will have no problem filing suit on your behalf.

Perhaps You Didn’t Meet the Requirements for Workers Comp in Florida

Another reason why your employer may have denied your workers compensation claim is because you don’t meet the requirements for workers comp in Florida. Our Tampa workers comp lawyers meet with clients all the time who were told that they didn’t meet the basic criteria to receive workers compensation benefits. These include:

  • Your accident took place on company property. If you don’t work on site, you’ll have to prove that the injury took place while you were acting within the scope of your employment.
  • You must show that the accident took place on company time. If you are a salaried employee, you will have to show that you were doing official business at the time of your injury.
  • You also have to report your injury to your employer within that 30-day time frame.
  • You must submit to a drug test prior to receiving treatment.
  • You must have agreed to be treated by a state-approved workers compensation doctor.
  • You must comply with your treatment plan.
  • You cannot be under the influence of alcohol or drugs at the time of your workplace accident.
  • You may not work for any other employer while collecting workers comp.

If you meet these basic criteria, you should be entitled to benefits. However, if your employer feels there’s a reason to deny your workers compensation claim, they have the right to do so. Once your workers compensation attorney in Tampa finds out why your claim was denied, they will get started on your appeal.

Tampa workers comp lawyer

Your Tampa Workers Comp Lawyer Can Appeal Your Claim

Once our Tampa workers comp lawyer finds out why your claim was denied, they can start the appeals process. The first thing you must do is file a petition with the Office of the Judges of Compensation Claims in Florida. In your petition, you must include the following information:

  • Explain how the accident occurred
  • Describe any injuries you suffered
  • State the amount of money you have lost in wages thus far
  • Mention the specific benefits you are demanding in your appeal

Once your appeal has been filed, your employer or their insurance company has 14 days to respond. It is very rare that they would not respond to a position of this type. If your attorney and your employer cannot come to terms with an agreement, there will be an official hearing before the OJCC. After the hearing, the panel will make a decision regarding your workers compensation claim and notify both parties. If their final order indicates that your claim has still been denied, you’ll have to decide whether you want to file suit.

Your Workers Compensation Attorney in Tampa Will File Suit on Your Behalf

If need be, your workers compensation attorney in Tampa will file suit for you. They’ll name your employer and their insurance carrier as defendants in the complaint. They’ll demand that your medical care be covered and that your replacement wages be paid for the period you were out of work. There’s a good chance that your case will settle out of court. Since trials are expensive and time-consuming, it’s doubtful that either party will want to proceed to the point of a trial.

Meet with a Workers Compensation Attorney in Tampa Right Away

You should be entitled to workers compensation benefits if you have recently been injured in a workplace accident. However, if your workers compensation claim has been denied for any reason, you should call a Tampa personal injury lawyer. Our attorneys have been handling workers compensation cases for years and are familiar with the legal process. They also have a lot of experience dealing with the insurance adjusters. Their goal is to get you the benefits you deserve, and make sure you don’t pay out of pocket for any of your medical care.

We recommend that you contact our office as soon as possible after your injury. Since we offer you a free consultation, you have nothing to lose. In fact, you don’t pay us a dime until your case settles.