When someone sustains a severe workplace injury, a workers’ compensation claim is one of the only ways to continue to earn money. Unfortunately, many people apply for workers’ compensation only to face a denied claim. However, a denied claim doesn’t have to be the end of the road.
Before we talk about what to do with denied claims, we need to identify why insurance companies deny claims in the first place.
Why Insurance Companies Deny Claims
There are several reasons why a Florida insurance company may deny a workers’ compensation claim. Let’s take an in-depth look at each one.
Statute of Limitations
A statute of limitations is a time limit for making claims. If someone fails to make a claim before the statute of limitations timer is over, an insurance company could deny the request.
In Florida, the statute of limitations is generally two years from the date of injury. However, it’s important to note that it’s two years from the discovery of the injury. Therefore, if someone doesn’t discover an injury until weeks after its occurrence, the injured has two years to file from the date of discovery.
Injury Report
Insurance companies can deny claims if the injured fails to report the injury-in-question promptly. In Florida, injured workers must report their injuries to their employers within 30 days of the accident.
Similar to the statute of limitations, the 30-day cutoff is based on the initial discovery of the injury. Therefore, if a doctor identifies a work-related injury, then the injured has 30-days from the doctor’s visit to apply for workers’ compensation.
Employer Dispute
Although it’s an employee’s job to file a workers’ compensation claim, the worker’s employer can review and dispute the claim. In some circumstances, the injured worker’s employer may argue that the employee injured himself outside of work, which means the employee doesn’t qualify for workers’ compensation.
In other circumstances, the employer may argue that the employee’s injuries were a result of intoxication from drugs or alcohol. Additionally, an employer may say that the employee intentionally injured himself to apply for worker’s compensation.
Injury Is Not Compensable
Insurance companies can argue that their workers’ compensation contracts do not cover the injuries the employees are applying for. In this circumstance, the employee will have to argue that the agreement covers his or her wounds.
As you can see, there are many reasons why insurance companies deny insurance claims. Unfortunately, it’s difficult to obtain justice for your case if you don’t understand Florida workers’ compensation laws. For this reason, it’s wise to reach out to a trusted Hialeah workers’ compensation attorney about your case.
Talking to a Workers’ Compensation Attorney
An experienced workers’ compensation attorney can review the facts of your denial to determine next steps. In some circumstances, you may only need to refile your claim with additional information, but sometimes, you may need to go to court to fight for just compensation.
That’s why it’s time to talk to a Hialeah workers’ compensation attorney about your case.
Regardless of the needs of your case, Morales & Cerino, P.A. is here to help! Our firm walks people through the process, helping them refile or dispute denied claims.
Additionally, if it comes to it, we are prepared to argue denied claims in court. All the while, our clients can sit back and relax, knowing we are doing everything we can for their cases.
We’d love to hear about your denied claim to determine if we can help you get the compensation you deserve. Ready for effective representation for your denied claim? Call (305) 340-2630 now for a free consultation for your case!