What Happens if You’re Denied Workers’ Compensation After a Work-Related Injury in Florida?
Florida requires virtually all businesses with four or more employees to carry workers’ compensation coverage. Workers’ compensation is designed to cover medical expenses and lost wages when employees are injured while on the job.
It is no-fault coverage meaning that coverage applies any time there is a workplace injury — the worker does not need to prove that the employer created unsafe conditions, was negligent, or was otherwise responsible for the injury.
To receive benefits, a worker must report the injury to the employer within 30 days. Once that report is made, the employee has two years to make a claim against the workers’ compensation policy. This gives the employee time to receive full treatment and to become aware of any lingering injuries such as back pain.
The initial report should contain details of the injury including when, where, and how it occurred. It should also include the names of any witnesses to the injury. The employee should also request that any security camera footage that may have caught the injury be preserved.
Although an employee has 30 days to make the report, a fast report helps preserve evidence and alleviates concerns that the injury occurred outside of the workplace.
Common Reasons Claims are Denied
After an injury is reported, the employer will usually require the employee to undergo a medical evaluation. Claims are commonly denied after this evaluation when the doctor says the injury was due to a pre-existing condition or that the employee is exaggerating or making up the injury.
Claims may also be denied where the employer suspects they occurred outside of the workplace — for example, a delayed report may lead the employer to claim that the employee was really injured at a sporting event or while working on their own home.
What to Do if Your Claim is Denied
An employee whose claim is denied should immediately seek an evaluation from their own doctor. They should also preserve any correspondence with their employer and request in writing that the employer preserve any evidence, including video footage, of the injury.
Often, the employee will be able to get the employer to reverse their decision once additional documentation is provided. If not, they may file an appeal to the Division of Administrative Hearings.
At the hearing, evidence including medical records, witness testimony, and video footage may be presented to the judge. The process is similar to a trial, although it is slightly less formal. After hearing the evidence, the judge will decide whether workers’ compensation benefits should be awarded.
To ensure that evidence is properly presented, that the legal burden of proof is met, and that other legal procedures are followed, hiring a workers’ compensation attorney can be very beneficial.
Get The Help & Resources You Deserve
If you or a loved one is injured in an accident, contact Florida Personal Injury Lawyer at Glotzer & Kobren, P.A. at 561-300-6900 to discuss your rights. Serving Boca Raton, Delray Beach, Boynton Beach, Deerfield Beach & throughout Florida.