Workers’ Comp Claim Denied. What Should You Do?

Post on behalf of Thomas J. Ueberschaer PA on Tuesday March 26, 2019

Workers’ compensation protection typically covers injuries received while at work. In Florida, construction companies and non-construction companies with more than four employees must carry workers’ compensation coverage. If you or a loved one were injured at work, the injury may be covered as part of a workers’ compensation claim.

Despite this broad protection, however, claims are often wrongly denied. Once a claim has been denied, an appeal may still be available in your case.

Why Workers’ Compensation Claims May Be Denied

Workers’ compensation claims may be denied for a number of reasons. Most of these reasons revolve around the employer’s claim that the activity that resulted in injury was not part of the injured person’s work. This means that the employer claims that the injury occurred while their employee or contractor engaged in activities outside of the scope of their employment. Other common reasons an employer may deny a workers’ compensation claim may include:

Claim of no medical treatment required.

Workers’ compensation claims often require medical treatment. If no medical treatment was sought or if the injury required no medical treatment, an employer may deny a claim.

Claim that workers’ comp claim was not reported or filed by deadline.

Some states require filing a workers’ comp claim by certain deadlines. In Florida, that limit is generally two years from the date of the injury. A number of exemptions exist, however, for this deadline. These exemptions may include:

  • The employer deceived their employee about their benefits,
  • The injured person is mentally incompetent,
  • The injured person is a minor.

Claim that injury was not work related.

Employers may dispute that the injury did not occur as a result of their employee’s job. This dispute can take many forms including claiming that the injury resulted from horseplay, stress, or that the evidence does not clearly prove that the injury was caused in the course of the employee’s employment.

This list is not exhaustive and there are a number of other reasons why an employer may deny a claim. If you believe that your or your loved one’s claim may have been wrongly denied, contact our law firm.

How to Appeal a Workers’ Compensation Claim

If you believe that your claim was wrongfully denied, you may want to consider filing an appeal. In many states, once notified of the denial, strict requirements govern how long how long you have to file an appeal.

It is important to act quickly as this deadline is important to adhere to. Filing an appeal will initiate a complicated legal process. You should consider consulting a licensed attorney to assist you with your claim.

Do not give up on your claim that your workers’ compensation claim is valid. Collect all medical records related to the injury and contact an attorney as soon as possible to discuss your workers’ compensation appeal.

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