What Happens to Medical Bills When Workers' Comp is Denied?
woman sits by couch holding a medical bill and stares into the distance

What Happens to Medical Bills When Workers’ Comp is Denied?

Workers who suffer on-the-job injuries can file a Florida workers’ compensation claim to pay their medical bills and other expenses while they recover.

Frequently, these claims are denied but the medical bills do not simply go away.

Instead, workers will receive a letter explaining the reasons for the denial. To address the issue of denied claims and medical bills, it’s advisable to retain a highly knowledgeable Florida workers’ compensation attorney to aggressively challenge denials and pursue all avenues of appeal.

Our workman’s comp lawyers from Berlin Law Firm can be your most diligent advocate to recover your full amount of worker’s compensation benefits, at no out-of-pocket cost to you.

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Why Do Workers’ Comp Insurers Deny Claims?

The first step toward recovering payments for your medical bills when workers’ comp benefits have been denied–is to understand why.

Some of the common reasons that an insurer might give you include the following:

  • You did not include enough information about your work injuries in your original claim.
  • The accident report on file with your employer includes different information about your work-related accident and injuries than you specified in your claim.
  • You filed your claim too long after the accident or did not promptly pursue medical services.
  • You went to a healthcare provider not on your employer’s approved list of medical service providers.
  • Your employer asserts that your accident is not work-related.
  • Your injuries were too insignificant.

Regardless of how you filed your workers’ comp claim, you will receive a letter explaining their reasons.

Contact our experienced workers’ comp attorneys as soon as possible after you receive that letter to start the appeals process.

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Should You Use Your Personal Health Insurance to Pay Your Medical Bills for a Work-Related Injury?

Your personal group medical insurance policy may reimburse some of your medical bills to treat a work-related injury.

However, that insurance likely includes copays and deductibles that will come out of your pocket. Further, your group policy insurer will probably require you to continue to pursue your workers’ comp claim.

A workers’ compensation attorney at Berlin Law Firm can help you to coordinate claims filed with multiple medical insurance carriers to get you the full reimbursement you deserve.

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What Are Your Options When Workers’ Comp Denies Payment of Your Medical Bills?

Your first step after a Florida workers’ comp insurance carrier denies payment of your medical bills is promptly applying for a claim adjustment with the State’s Workers’ Compensation Commission (WCC).

Because you will probably continue to accrue more bills for medical treatment for your injuries, you should request an immediate hearing before an arbitrator who will be assigned to your case. Once a hearing is granted, the arbitrator should issue a ruling within 180 days.

Suppose the arbitrator continues the denial of payment of your medical bills. In that case, you must file a petition for review no later than 30 days after the arbitrator issues their decision.

When the petition is granted, the WCC Commissioners will allow you to present written arguments and documentation to support your claim for benefits. Your Florida workers’ compensation lawyer will then present an oral argument to advocate for payment of your medical bills.

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Contact Berlin Law Firm for a Free Consultation

When you seek legal counsel from the workers’ compensation appeal lawyers from our firm, we will manage the entire appeals process on your behalf and fight aggressively to recover full compensation.

We will also pursue all other workers’ comp benefits you deserve, including reimbursement for your lost wages while you recuperate from your injuries.

We offer free consultations regarding appeals if you are denied medical payments for workers’ comp claims. Please call our offices in Tampa or Sarasota to speak directly with our Florida workers’ compensation attorneys. You have a short deadline to pursue claims adjustments with the Florida WCC and to appeal the denial of payment for your medical bills.

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