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 for 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 pre-existing condition contributed to your accident or injury.
- No one witnessed the accident.
While these may be some reasons the insurer has determined that your claim is denied, it 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.
How The Appeals Process Works
Once our attorneys put together the appeal of your workers’ comp claim denial, a mediation hearing will be ordered by the Office of the Judges of Compensation Claims (OJCC). This is the time for you and the insurance company to attempt to work out a resolution to 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.