Workers’ compensation is supposed to be there for you after any kind of workplace injury. The fact remains, however, that employers are reluctant to pay claims because it raises their insurance rates. Insurers, for their part, don’t want to pay claims because it lowers their profits.
You can bet, then, that your employer or their insurer will look for any possible way to challenge the basis of your workers’ comp claim. One of the favorite modes of attack is to challenge the idea that your job was a major contributing cause of your impairment.
What’s the rule on major contributing causes?
Human bodies are prone to problems, especially as they age. There are very few workers out there over the age of 30 that have never experienced any kind of health problem or prior injuries.
When you suffer a work-related injury, however, you can generally expect the insurance company to start to ask, “Is this injury really more related to your work than not?” The reason they ask is simple: In Florida, your work activity has to be 51% (or more) the cause of your condition in order for workers’ comp to cover it.
If, for example, you slip a disc in your back lifting boxes at work, the insurance company may pore over your medical records for signs that your injury is related to anything but your job. They may point to the fact that you were diagnosed years ago with osteoarthritis and claim that’s the greater cause of your problems. Or, they may say that your back injury is merely a recurrence of an old injury from last decade’s bike wreck.
When your workers’ comp claim gets complicated, get help
Denials based on major contributing causes are very common in Florida workers’ comp claims. You can (and should) mount a challenge when your claim has been unfairly denied.