Workers’ Comp Attorney for Denied Claims in Orlando, Central Florida
My Workers’ Comp Claim was Denied. Now What?
Being denied workers’ compensation benefits for a workplace injury or illness can be devastating. Without proper medical care and financial compensation for your losses — how are you expected to get better or pay the bills?
Fortunately, under Florida law, you have the right to challenge the insurance company’s decision to deny your workers’ comp claim. However, it’s best not to tackle this feat on your own. The appeals process requires extensive knowledge of workers’ compensation law including which forms to file, how to gather and interpret medical evidence, and how to present a persuasive case before a judge.
For the best chance at winning an appeal, you need an experienced workers’ compensation lawyer on your side. The Law Firm of Marshall S. Adler, P.A. is prepared to help you fight to get the justice you deserve. Workers’ comp attorney Marshall Adler understands the tactics employers and their insurance companies use to deny, suspend, or terminate benefits and can prevent you from getting taken advantage of.
Call 407-648-5523 to receive a free consultation.
Common Reasons Insurers Deny Workers’ Comp Claims in Florida
The first step in disputing a denied workers’ comp claim is to determine why the claim was denied in the first place. You should have received an official letter or Notice of Denial informing you of the precise reasoning as to why you have been deemed ineligible to receive benefits.
It’s possible that your employer and their insurance company cited one or more of the following reasons:
- your injury occurred “off the clock”
- your injury is not serious enough for coverage
- you failed to promptly notify your employer of your injury
- there is insufficient evidence to prove your injury is work-related
- technical errors were made or incomplete information was given during the application process
- the injury is a pre-existing condition that was not caused by work
- you received medical treatment from an unauthorized medical provider
- you were under the influence of alcohol or drugs when you’re injured
- you failed to use safety devices required by the employer during work activities (seat belts, safety harnesses, goggles)
Workers’ Comp Appeals Process
Negotiate quick resolution: Before the formal appeals process begins, Mr. Adler may attempt to negotiate with the insurance company out of court to settle the claim quickly and fairly. If an agreement is reached that meets your needs, we will submit it to a workers’ comp judge to be approved.
File a petition for benefits: If a resolution cannot be reached outside of court, the next step is to file a petition for benefits with the Clerk of the Offices of the Judges of Compensation Claims (OJCC). This must be filed within two years from the date of your accident. Once the OJCC has received your petition, they will notify your employer and their insurance company. The insurance company has two weeks to decide whether to pay your claim or reject it once again.
Mediation: If the insurance company refuses your petition, the OJCC will order mediation which involves informal conferences designed to help you and the insurance company reach a settlement using the help of a neutral third party mediator.
Pretrial Hearing: If an agreement is not made in mediation, a pre-trial hearing is scheduled within 90 days. During this hearing, Mr. Adler can make a compelling argument before a judge that proves why you should receive workers’ compensation benefits. Mr. Adler can present evidence such as your medical records, expert testimony on your medical condition, as well as testimony from family and friends. Once the judge hears all the evidence they will make a ruling in your case within 30 days.
District Court Appeal
If the judge does not rule in your favor, we will an appeal at the First District Court of Appeals. The appellate court will either affirm the OJCC’s decision or reverse it and send it back for more proceedings.
Contact a Workers’ Compensation Lawyer to Appeal Your Denied Claim
If your workers’ claim has been denied, don’t wait to get help. The Law Office of Marshall S. Adler is prepared to help you fight to get the benefits you deserve. We have been serving injured workers and their families in Florida for over 20 years. Schedule a free consultation with our office today 407-648-5523.