If you are injured on the job or while carrying out work-related duties in Florida, you should be able to recover workers’ compensation benefits for your medical expenses and lost wages. However, many injured employees have their initial workers’ compensation claims denied by their employer or their employer’s insurance provider. The good news is, this does not mean you are not eligible to receive workers’ compensation benefits.
If your Florida workers’ compensation claim was denied, you can appeal this decision (and subsequent denials, if applicable) through a series of formal appeals processes. You may need to attend at least one hearing and may be required to appear at additional hearings before a judge; it is strongly recommended that you work with an experienced workers’ compensation attorney if you wish to appeal a denied workers’ comp claim.
Why Do Employers & Insurance Providers Deny Workers’ Comp Claims?
Workers’ compensation insurance providers are often reluctant to pay out claims, particularly when those claims involve serious and/or debilitating injuries that require extensive medical treatment and extended periods of time off work. These insurance providers are primarily concerned with lowering their costs, and denying claims is one of the easiest ways to do this. Often, these companies are not counting on injured workers to continue seeking benefits by appealing denied claims.
Your employer or your employer’s insurance provider may deny your claim by claiming that:
- Your injury was not work-related
- Your injury was caused by a pre-existing condition
- You were engaged in negligent or wrongful behavior (including intoxication) when your injury occurred
- You are an independent contractor, volunteer, or are otherwise not an employee and, therefore, not covered by workers’ compensation
- Your injury/condition is not covered by workers’ comp, according to state guidelines
- You failed to notify your employer and/or file your claim within the designated time limit
- You made mistakes on your workers’ compensation claim documents
Remember, just because your claim has been denied does not mean you cannot receive benefits. The above reasons can be disputed with the help of an experienced and aggressive attorney.