Why Was My Florida Workers’ Compensation Claim Denied?
You reported your injury, saw a doctor, and filed your Fort Lauderdale workers’ compensation claim. Then the denial letter arrived. Getting denied benefits is frustrating, confusing, and scary, especially when you are still hurt, out of work, and bills are piling up. Fortunately, it’s not the end of the road. In fact, it’s often just the beginning.
You have the right to appeal the insurer’s decision, and understanding why your claim was denied matters. Our experienced Fort Lauderdale workers’ compensation lawyer explains the most common reasons and what you can do about them.
Common Reasons For Denied Fort Lauderdale Workers’ Compensation Claims
When on-the-job injuries in Fort Lauderdale happen, benefits are available through the Florida Division of Workers’ Compensation (DWC). However, they are paid out by insurance companies, which are quick to deny claims.
Among the most common reasons for denied Fort Lauderdale workers’ compensation claims include:
- Late reporting: Under Section 440.185 of the Florida Statutes, you must report a workplace injury within 30 days.
- Disputed causation: The insurer may argue that your injury isn’t work-related, or that a pre-existing condition is responsible.
- Lack of medical evidence: Your records may not connect your diagnosis to a specific workplace incident or the physical demands of your job.
- Independent medical examination conflicts: The insurer’s hired physician concluded that your injury does not require the treatment your own doctor recommended, or that your condition is not work-related at all.
- Employment classification disputes: Your employer claims you were an independent contractor rather than an employee, placing you outside coverage.
Knowing exactly what factored into the insurer’s decision helps you and your lawyer know where to focus.
What To Do If You Receive a Florida Workers’ Compensation Claim Denial
Getting a denial letter does not mean giving up. Under Florida workers’ compensation laws, you have the right to appeal the insurer’s decisions. Here’s what to do next:
- Carefully read the denial letter, noting the reasons for the insurer’s decision.
- Keep getting medical care as needed, and make sure your doctor continues documenting the connection between your symptoms and your workplace injury.
- Gather evidence that directly addresses the reason for the denial, such as witness statements, incident reports, employment records, or prior medical records.
- File a Petition for Benefits through the Office of the Judges of Compensation Claims, which is the formal step that puts your dispute into the legal process.
Keep in mind that firm deadlines apply. To get the maximum amount you are entitled to in a Fort Lauderdale workers’ compensation claim, get professional legal help as soon as you receive a denial letter.
Denied Benefits? Contact Our Experienced Fort Lauderdale Workers’ Compensation Lawyer
Insurers are quick to deny workers’ comp claims. Our experienced Fort Lauderdale workers’ compensation lawyer has extensive experience dealing with these companies and fights for the benefits you are entitled to. To request a consultation at our Sunrise, Fort Lauderdale, or West Palm Beach office, contact The Law Offices of David M. Benenfeld, P.A., today.
Source:
myfloridacfo.com/division/wc/employee/frequently-asked-questions https://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0440/Sections/0440.185.html