Florida and Georgia Leading Workers’ Comp Denial Lawyers
You’ve been injured at work and follow all of the procedures to claim workers’ compensation benefits. You tell your boss, and you go to the doctor, as the insurance company suggests. But then you get a letter saying your claim has been denied. Under workers’ compensation, you are supposed to receive money to pay your bills while you are out with an injury that happened in the workplace.
While the system is supposed to be there to help you, sometimes it fails. Many injured workers in Florida or Georgia have their workers’ compensation claim denied. After a claim denial, the worker is in the uncomfortable position of dealing with the stress of their injury while trying to deal with their medical debt and the additional cost of missing work while filing their claim.
If you’ve been injured on the job, contact the workers’ comp advocates at Farah & Farah. Get your free, no-obligation case review now!
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Reasons Why Work Injury Claims are Denied
There are many reasons why workers’ compensation claims are denied. Getting to the bottom of why your claim was rejected can help you appeal their decision. If you are unsure, the reason for their refusal is usually provided in the denial letter.
Common reasons for denial can include not meeting the eligibility requirements, such as being away from the worksite when the injury happened. But if you are sure their reasons for the denial are inaccurate, you have the right to appeal their decision. Some frequent reasons for workers’ comp denials include:
Work Injury Not Reported Soon Enough
Every state has different laws about workplace injuries. Usually, state laws only allow a brief window after your accident to notify your supervisor. After an injury, you must report it immediately.
Claim Not Filed in Time
In addition to affecting injury reports, state laws also dictate how long you have to file your initial claim. For example, in Florida this period is only within 30 days, but in Georgia it is one year.
Claim Disputed By Employer
While you have a legal right to file a claim, your employer also has a right to dispute it. Employers will often dispute claims if the accident was a result of inappropriate workplace activities like pranks or goofing off. Or if the accident happened outside of work hours.
Work Injury Cannot Be Compensated
Claims for stress-related injuries can be difficult to prove. In many states, these claims are denied because they lack hard evidence of employer negligence.
Not Seeking Medical Treatment
It is challenging to qualify for workers’ compensation without medical records detailing the extent of your trauma. Make sure you see a medical professional after your accident to get official documentation of your injuries.
Not Enough Evidence of Injury Being Work-Related
It can be hard to determine if an injury is work-related. Sometimes getting an additional medical exam can help prove the injury qualifies for assistance from workers’ compensation.
What to Do If Workers’ Comp Denied Your Claim
You should not feel like you have to give up after receiving a workman’s comp claim. Many legitimate claims are denied for false reasons. After a denial, you have a right to appeal your claim denial. But you must act fast because the law provides a short period to appeal a denial.
Before resolving any dispute, try to resolve it by contacting the insurance company. If these efforts are fruitless, then it is time to file a formal appeal.
Starting Your Formal Appeal
The formal appeals process begins when you file your claim with the workers’ compensation board with the Florida Division of Workers’ Compensation or the Georgia State Board of Workers’ Compensation. Be prepared to include vital information about your claim like the nature of your injury, details of your accident, what benefits you’re claiming, and if you have suffered wage loss due to your accident. In order to get the most benefits for your injury, it’s best to file as soon as you are denied.
After receiving your petition, one of these entities will notify your employer and its insurance company. Once your employer has received the notification, they have a little amount of time to either pay your claim or respond.
If the issue is still not reconcilable, your appeal is filed and assigned a unique case number. Before going to court, you will have mediation hearings with the insurance company to resolve your dispute. Mediation hearings are a series of informal conferences with you, the insurance company, and a neutral third party.
If mediation has failed to deliver ideal results, then your case will be assigned to a judge who specializes in workers’ compensation cases. Before your trial, the judge will have a pre-trial hearing to identify your claim and understand its circumstances. During this time, you and the insurance company will exchange evidence and plead your case. Many people submit written statements instead of attending the hearing. After this step, you are ready for the final hearing.
The Final Hearing
After your pre-trial hearing, you will have your final hearing. During your final hearing, you will have the opportunity to present evidence and testimony from witnesses. The insurance company — and their lawyers — will also present their case against your claim. Having a lawyer on your side will help you navigate the expectations for workers’ compensation hearings. The judge will independently review your evidence and case and make their ruling. You will receive a copy of their verdict after your final hearing.
Appealing the Judge’s Decision
You have a legal right to appeal the judge’s ruling. Appealing a judge’s ruling is an especially complicated step, and having legal representation will streamline the complicated filing and procedural requirements for your claim.
We Specialize in Workers’ Comp Denial Cases
Since 1979, Farah & Farah has been dealing with this sort of pushback by the insurance companies. Our staff will deal with your workers’ compensation denial by tackling the reasons for denial one at a time.
We will work as quickly as possible on the appeals process to prove your case and seek what you are entitled to under the workers’ compensation statutes.
When necessary, we will take your case to court by filing a Workers’ Compensation lawsuit. If we find a third party was involved in your injury, or the employer created a dangerous workplace you have every right to find a remedy in a court of law.
Contact Florida and Georgia Workers’ Best Rated Workers’ Compensation Denial Attorney
With your bills mounting up and unable to work, you are already facing monumental obstacles to recovery. Our Florida and Georgia workers’ compensation attorneys will fight for you to obtain what you deserve and need to get on with the business of healing.
You owe it to yourself to contact a lawyer who has successfully helped people get the compensation they deserve for their injuries. Contact Farah & Farah today for a free, no-obligation case review.