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Denial of Workers’ Compensation Claims in Florida

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The workers’ comp process can be overwhelming and confusing without skilled attorneys by your side. Additionally, if your claim is denied you may be unsure about what to do next. Fortunately, if an insurance company denies your claim for benefits, our workers’ compensation denial lawyers could help. The dedicated workers compensation attorneys at Kogan & DiSalvo could work to ensure that you receive the compensation to which you may be entitled.

Why Might a Claim Be Denied?

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To be approved for a claim, the injured person must be employed by a company with workers’ comp insurance, and they must have suffered injuries at work or as a result of job-related duties. However, meeting these two requirements may not automatically lead to someone’s claim acceptance.

Because there are many reasons why an insurance company may reject an injured employee’s claim, it is important to hire a workers’ compensation denial attorney who could help you get the full workers’ comp benefits you deserve. The Department of Labor may deny a claim if the:

  • Injury in question did not happen at work
  • Claimant failed to notify their employer in a timely manner
  • The injured employee was intoxicated or under the influence of drugs at the time of the injury
  • The worker failed to treat their injuries with a certified doctor
  • Injured claimant failed to receive any medical treatment
  • The employee did not file the required forms before their deadlines
  • Injuries in question were caused by inappropriate workplace behavior
  • Injury was caused by a preexisting condition
  • Injury in question disputes the employee’s claim

How Can an Attorney Help When an Insurance Company Denies a Claim?

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Florida lawyers with experience in handling workers’ compensation claim denials could guide an injured employee through the appeal process. The first step in the appeals process is to complete a Petition for Benefits form and submit it to the Office of the Judges of Compensation Claims (OJCC). Once a claimant notifies their employer of the petition, they must either pay the claim or respond to the petition within 14 days.

If an employer fails to pay a claim, the case may go into mediation. Mediation is an informal process where a neutral third party may help resolve a claim between the injured worker and their employer’s insurance company.

If mediation is unsuccessful, a judge may hear the case. During these hearings, the Kogan & DiSalvo workers’ compensation denial attorneys in Florida could present evidence on a claimant’s behalf and work to get them the compensation they deserve.

After the trial, the judge makes a written decision. It is important to note that the injured employee has an opportunity to appeal this decision and should do so with help from a legal professional.

Ensuring Future Medical Treatment

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After an employee’s benefits are approved, they should follow up on their doctor’s treatment plan until they reach maximum medical improvement (MMI). During treatment, the injured worker should not pay for anything related to their medical care. After a physician places a claimant at MMI, they may continue to treat but may have to pay a copayment for each doctor visit.

An injured employee should know that they may be entitled to continue to receive future medical treatment so long as their workplace injury remains the major contributing cause of their need for more medical care. If a worker does not need to treat their injuries at least once a year, their claim may be closed, and the statute of limitations may bar them from making a claim for that accident again.

Speak with a Florida Workers’ Compensation Attorney Today

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If an insurance company has rejected your claim for workplace injuries, you should speak with the Florida workers’ compensation denial lawyers at Kogan &DiSalvo as soon as possible. Our attorneys could explain why your claim may have been denied as well as how to receive approval. To learn more about your legal options, schedule a free case consultation.

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