Was Your Workers’ Compensation Claim Denied?
Suffering an injury at work can be frustrating, as can the process of applying for workers’ compensation benefits. Unfortunately, many initial benefit claims are denied. This can occur even if the claim was valid and thorough. However, this is not the end of your claim.
If you have been denied the benefits you need after a work injury, it is time to enlist the help of an experienced lawyer. Our attorneys at Matheson and Horowitz in Vero Beach, Florida, have more than 60 years of combined experience that they use when handling initial workers’ compensation claims, denials and appeals. Our experience has also allowed us to see how insurance companies deny and minimize claims and how we can fight back on your behalf.
Why Claims Are Denied
There are many reasons a workers’ compensation claim may be denied, such as:
- Paperwork may be missing.
- The application was submitted late.
- There is no medical evidence to show that you suffered an injury.
- Your injury may not be covered.
- You are allegedly responsible for your injury.
- A preexisting condition contributed to your accident or injury.
- No one witnessed the accident.
While these may be some of the reasons the insurer has determined that your claim is denied, this does not mean they are valid reasons for a denial. We take the time to investigate the reasons why your claim was denied, examining all the ways in which we can correct the claim and file an appeal.
Understanding Workers’ Comp Denials In Florida
At our Vero Beach law firm, we understand the frustration and uncertainty of a denied workers’ compensation claim. Many hardworking Florida employees face unexpected obstacles when seeking benefits after workplace injuries. We are dedicated to helping you navigate the complex appeals process and fight for the compensation you deserve.
Workers’ compensation denials happen frequently throughout Florida for various reasons. Insurance companies may claim your injury was preexisting, not work-related or that you failed to report it promptly. Sometimes employers dispute claims to avoid increased insurance premiums. As Vero Beach workers’ compensation attorneys, we have seen how these denials can leave injured workers without necessary medical care and income replacement. Florida law provides specific timeframes and procedures for appealing these decisions, and understanding these regulations is crucial to your case.
The Appeals Process In Vero Beach And Beyond
When your claim is denied, we begin by filing a Petition for Benefits with the Florida Division of Workers’ Compensation. This formal document outlines why you deserve benefits and what specific compensation you are seeking. After filing, your employer’s insurance carrier has 14 days to respond. If they deny, we proceed to mediation – a required step in Florida workers’ compensation cases. Should mediation prove unsuccessful, we represent you at a formal hearing before a Judge of Compensation Claims, presenting evidence and testimony to support your case.
How A Workers’ Compensation Lawyer Can Help
Our Vero Beach attorneys provide valuable assistance throughout your workers’ compensation appeal. We gather medical documentation, interview witnesses, and consult health care providers to build a strong case. We handle all communications with insurance adjusters and your employer, protecting your rights. Our Florida workers’ compensation law knowledge allows us to identify procedural errors in your denial and develop effective legal strategies. Most importantly, we stand beside you through every step, providing guidance and advocacy when needed.
How The Appeals Process Works
Once our attorneys prepare the appeal of your workers’ comp claim denial, the Office of the Judges of Compensation Claims (OJCC) will order a mediation hearing. This is the time for you and the insurance company to attempt to resolve your dispute.
If this process is unsuccessful, the case will proceed and be reviewed by a workers’ compensation judge. Statements will be submitted detailing the dispute. The judge will then review the statements, along with the information provided at a final hearing and issue a decision.
It is possible to appeal the judge’s decision, though this is an even more complex process that goes to the Florida First District Court of Appeal.
Talk To Us About Your Workers’ Comp Claim Denial
Do not be discouraged if your workers’ compensation claim was denied. You have options. Contact our firm online or call our office today at 772-571-4109 and schedule a free consultation.