When you suffer an injury at work in Ormond Beach, you more than likely deserve workers’ compensation benefits. Sometimes, though, insurance companies attempt to deny claims or minimize them to limit their payouts. They know that the Florida workers’ comp system is confusing and complex, and that you might not truly know the value of your claim.
Although rare, your claim may be denied unfairly because of the following:
- Your employer is disputing that your injury occurred on the job.
- The insurer blames your injury on a pre-existing condition.
- Your employer says you didn’t notify management within the proper timeframe.
Contesting the Denial of Your Workers’ Comp Claim
If a workers’ comp adjuster denied your work-related injury, you shouldn’t accept this decision as the final answer. You may appeal this decision by filing a Petition of Benefits with the Florida Division of Administration Hearings. When you begin the appeals process, the law requires that you attempt to resolve your dispute with the insurer through mediation. During the time you are awaiting your mediation hearing, the other side might ask you to undergo an independent medical exam.
Once mediation begins, the other side will present its information to support their case. You are also entitled to present evidence and expert testimony to strengthen your claim and show why you are entitled to benefits. This is why it is essential that you have legal representation. If the issues are not resolved during the mediation hearing, you are entitled to pursue a hearing in front of a Judge of Compensation Claims.
A judge will hear the evidence presented from both sides and will make a final decision within 30 days of that hearing. Even if your case is denied at that hearing, you have the right to appeal your case all the way to the Supreme Court of Florida. Because workers’ comp cases can be complex, it is in your best interest to have legal representation. An experienced lawyer can walk you through the process, advise you along the way, and represent you in front of a judge.
If your employer and its insurer are refusing to cover your medical expenses or have denied your claim for workers’ compensation, you should consider appealing this decision to make sure you are compensated fairly. To learn more about your rights, you can download a free copy of our book, It’s Not Rocket Science, It’s Workers’ Comp: A Simple Guide Through Florida’s Not So Simple Workers’ Compensation System.