Four Top Reasons Claims Are Denied
Some employers and/or their insurance carriers will do anything to get out of paying for your workers’ compensation benefits. Sadly, most companies care more about maximizing their profits than they do about their employees. As such, many injured workers are unfairly denied medical benefits or wage replacement benefits by their insurers or employers. In other cases, a simple clerical error was made by the employee when filing their claim. No matter the case, an experienced Fort Lauderdale workers’ compensation attorney can help you reverse the denied claim.
Insufficient Medical Proof of Injury
You need to have substantial medical evidence of your injury or illness in order for a workers’ compensation claim to be proven. Sometimes, claims are denied even when there is medical proof. Or, an employer may force you to seek an independent medical examiner before you are provided your benefits. One problem with an independent medical examiner is that they are not actually independent—they are an in-network provider, who essentially works for, and is paid by, your employer/workers’ compensation insurance carrier.
Employer Claims the Injury Happened Outside of Work
A common excuse made by employers is to claim that the injury happened outside of work. In some cases, it is easy to prove your employer wrong. Video surveillance, eye witnesses, medical examinations, clock-in and out records, and other evidence may be relevant to your case.
Failure to Notify Employer of the Injury Within 30 Days
According to Florida statute 440.185, you have 30 days from the date of the workplace accident to notify your employer of your injury. Or, if the injury or illness was caused over time, you have 30 days to notify your employer from the date you realized that the overuse injury or illness was caused by work. There are exceptions to the 30-day rule, however. These exceptions include:
- Your employer had actual knowledge of your injury;
- The cause of the injury could not be identified without a medical opinion, in which case the employee has 30 additional days from that medical appointment to tell the employer;
- The employer failed to put their employees on notice of this rule by failing to post the notice pursuant to s. 440.055; and
- Other exceptional circumstances arose.
You Are Misclassified as an Independent Contractor
If your employer claims that you are not technically an employee because you are classified as an independent contractor, you are not alone. This happens to many workers all over the country; it is a tactic used by employers to get out of having to pay higher workers’ compensation premiums. An attorney can help you fight this.
Reach Out to a Fort Lauderdale Workers’ Compensation Attorney
Being denied workers’ compensation benefits is beyond frustrating—it can be downright terrifying, especially if you have mounting medical bills that you are expected to pay yourself, all while receiving reduced wages, or no wages at all. You were injured during your line of work, helping your employer’s profits all the while. You deserve to be compensated for your injuries. Call the South Florida workers’ compensation attorneys at the Law Offices of David M. Benenfeld, P.A. today at 954-807-1334 to schedule a free consultation.