Florida Workers’ Compensation: Was Your Claim Denied?

We spend most of the hours of our day at work.  Many of us identify ourselves with the job we do.  Work is a source of income, to be sure.  Yet, it is also a source of personal growth, of intellectual stimulation, and of pride.  We care deeply about what we do because we typically spend at least eight hours each day doing that job.

So, when misfortune comes and an accident happens at work, it can be a scary and uncomfortable place to be.  Not only do you likely have to deal with various doctors, intrusive medical tests, and the stress of recovery, but also you have lost your routine and the comfort that comes with having a job to go to every day.

Even worse, imagine if you are injured on the job and your employer does not compensate you for your injuries.  A denial of a workers’ compensation claim can add a whole new level to the stress and frustration that you already feel.  In that case, it is always better to have an advocate by your side, helping you along the way.

You cannot find a better advocate when injured on the job than an attorney who has a wealth of experience with the Florida Workers’ Compensation Act.  That is why you should consider contacting the professionals at Doolittle & Tucker, P.A., Attorneys at Law today.  We at Doolittle have decades of experience handling all types of cases involving the Florida Workers’ Compensation Act.  We have helped countless clients, just like you, maximize their workers’ compensation benefits in Florida more than they could have ever imagined.

We at Doolittle understand the many aspects of the Florida Workers’ Compensation Act that injured workers or even less experienced attorneys would not understand.  It is that type of experience that will help you get the best outcome.  Call us today at 904-396-1734 to find how we can help you with your workers’ compensation case.  We are passionate about protecting and defending the rights of injured workers.  Let us focus our efforts on you.  Contact us today.

First Things First – Finding Out Why Your Claim Was Denied

If you have been injured at work in Florida, then you are likely entitled to workers’ compensation benefits.  However, it is possible that your employer’s insurance company may deny you benefits or only pay partial benefits after you make an initial claim.  If that occurs, then your first order of business is to find out why your claim was denied.

Typically, your employer’s insurance company will send you a letter indicating the reasons for a denial.  You should read that notice carefully.  There can actually be many reasons why a claim is denied.  Here are just a few reasons:

  • Off the Clock. It is common for your employer to claim that the injury is not work related because you were “off the clock” when the injury occurred. For example, injuries resulting from horseplay or practical jokes at work may be viewed by your employer’s insurance company as non-work-related activities.  As another example, injuries that occur when traveling to and from work are not covered by workers’ compensation in Florida.  That said, if you are traveling as part of your job duties, then any injury will likely be covered.  Obtaining the assistance of an attorney may help a great deal when faced with a benefits denial, alleging that your injuries resulted from somewhere outside of work.
  • Existence or Severity of the Injury. Another common reason an employer’s insurance company will deny benefits is if there is something to lead the insurance company to believe that there is no injury, or that it is not severe. A medical evaluation is typically necessary to demonstrate your eligibility for workers’ compensation benefits.  Moreover, your employer’s insurance company may deny a claim, stating that the injury is a pre-existing condition and was not caused by the work accident.  Workers’ compensation benefits may still be provided at least partially, however, if a work accident aggravates a pre-existing condition.
  • Technical Error With Your Claim. Many times, a denial notice does not result from anything having to do with your injuries. Rather, it is because you missed a deadline or improperly filled out a form for your claim.  For example, in Florida, workers have 30 days within which to report the accident.  If you miss that window, it is very possible that your claim will be denied.
  • Failure To See An Approved Medical Professional. Once you report a work-related accident, your employer will provide you with a list of approved medical providers for treatment. If you do not go to any of the providers on the list, that may result in a denial of benefits.  By the same token, if you do not obtain medical treatment at all, then you are likely to get a claim denied.  Having a medical professional note your injuries is typically the starting point to proving your eligibility for benefits.

The Next Step – Appealing the Denial

Once you have received a notice of denial and read the reason provided for the denial, then the next step is to challenge that denial.  It may be worthwhile to seek a quick resolution through informal negotiations.  Having an experienced workers’ compensation attorney on your side could make such negotiations much easier for you, with a likely better outcome.

If negotiations are unsuccessful, then you need to file what is called a Petition for Benefits.  That Petition will trigger the Florida Workers’ Compensation Office to have a judge assigned to your case.  At that point, the judge will direct you to try to mediate the case first.

If mediation does not resolve your case, then you will have a trial-like hearing before the Office of the Judges of Compensation Claims.  Following that hearing, the judge will make a decision on benefits.  The next step is to appeal that decision to the First District Court of Appeals in Florida.

Florida Workers’ Compensation Attorneys Are In Your Corner

In sum, if your claim is denied early on, then the path you must walk to get the compensation you deserve is increasingly difficult.  That is why you would be well served by obtaining the services of the workers’ compensation experts at Doolittle & Tucker.  We are lawyers who will help you get compensation benefits, and we will advise you all along the way.  Call today at 904-396-1734.