Your Tampa workers’ compensation claim may be denied if an employer or their insurance company disputes the validity of a claim, citing reasons such as insufficient medical evidence, missed deadlines, pre-existing conditions or others. Denials are unfortunately common, even in cases where injured workers are rightfully owed workers’ compensation benefits.
However, a denied claim is not the end of the road. Seeking guidance from a workers’ compensation attorney can help you navigate the appeals process and secure the benefits you deserve.
At Berlin Law Firm, we have over 30 years of experience handling workers’ compensation appeals, and our team has also managed the legal department of large Florida workers’ comp insurance carriers.
We fully understand their tactics that aim to reduce their bottom line and are highly knowledgeable when appealing the denial of a workers’ comp claim.
If your claim has been denied, our Tampa workers’ comp attorneys serve as an astute resource and advocate to appeal the denial and get you the benefits you deserve. Contact us today for a free consultation.
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Learn the types of compensation you may be eligible for and have your questions answered. Call today.
Why Do Florida Workers’ Compensation Claims Get Denied?
The most common reasons for Tampa workers’ comp denials include:
- An injured worker did not report the work-related accident to an employer within 30 days after it happened or missed other important deadlines for a successful claim.
- The injured worker’s medical evidence of the injury is incomplete or inconclusive as to the extent of the injury and the limitations it imposes on the worker’s activities.
- The injured worker’s employer or the workers’ comp insurer disputes that the injury happened at work or claims that the injured worker’s limitations result from a pre-existing injury.
- The worker did not seek prompt medical treatment for an injury or failed to follow physician recommendations for treatment and rehabilitation.
- The injury is not covered under the definitions in Florida’s workers’ compensation laws.
In every case, the injured worker’s next step is to appeal the denial. While you can appeal a denial alone, we believe it is highly advisable to retain a specialized attorney who can help you navigate this complex system.
Discuss Your Work Injury Claim for Free
Learn the types of compensation you may be eligible for and have your questions answered. Call today.
How Does the Workers’ Comp Appeal Process Work in Florida?
The two components of every successful appeal are addressing each reason for the denial and adhering to all critical deadlines for filing and prosecuting the appeal.
The appeals process includes the following steps:
- Filing a Petition for Benefits with the Florida Office of the Judges of Compensation Claims (the “OJCC”). An injured worker may have up to two years from the date of an injury to file the petition, but this deadline may vary with the nature of the dispute. Confer with an experienced Florida Workers’ comp lawyer to verify it.
- Mediation is a mandatory step in the appeals process after filing a Petition for Benefits (PFB) with the Judge of Compensation Claims (JCC). During mediation, a neutral mediator (appointed by the state or agreed upon by both parties) facilitates negotiations between the injured worker and the insurance company to resolve disputes without a formal hearing.
- If mediation is unsuccessful, the next step is a hearing before a Judge of Compensation Claims (“JCC”), who will review each party’s evidence and arguments and issue a ruling either reserving or affirming the denial.
- If the judge upholds the denial, you can escalate the appeal to Florida’s First District Court of Appeal.
Appealing a workers’ compensation denial in Florida is a complex process best managed by an attorney with substantial experience with those appeals.
While retaining a lawyer sounds scary, we are here to proudly serve you, protect your job and ensure that any benefits you are rightly entitled to are secured.
Discuss Your Work Injury Claim for Free
Learn the types of compensation you may be eligible for and have your questions answered. Call today.
What Evidence Should You Gather to Appeal a Claims Denial?
Generally, an injured employee will need medical evidence to verify the at-work injury. They will also need an affidavit or other evidence from a medical expert as to the severity of the injury and the limitations it places on the worker’s activities.
It may be necessary to provide other facts and information to conclusively demonstrate that the injury occurred while the worker was performing job-related duties and responsibilities.
To determine the specific evidence you should gather, a Florida workers’ comp lawyer will review your denial notice and prepare an inventory of evidence needed to address each reason for the denial.
When Should You Contact a Tampa Workers’ Compensation Denial Attorney?
In a small number of cases, an injured worker might conclude that the reasons for the denial of workers’ comp benefits are straightforward, and they can respond to those reasons without professional legal assistance.
Other situations where benefits are denied may be more complex, such as when:
- A workers’ compensation insurance company responds with a detailed disagreement about the nature and extent of the worker’s injuries.
- The insurer rejects recommendations from a worker’s physician for medical treatment or rehabilitation of an injury and instead approves a lesser course of treatment.
- The insurer approves only temporary or partial workers’ compensation benefits without properly considering the worker’s limitations.
- The worker suspects that their claim has been denied due to fraud or bad faith on the part of the insurer.
- The worker’s employer has threatened termination or has fired the worker in retaliation for seeking workers’ compensation benefits.
Generally, you will be at a disadvantage if you appeal in these more complex situations without legal representation. Rather than proceeding alone and risking the loss of benefits that you deserve, it’s wise to hire an experienced attorney whose sole job is to protect your best interests.
Contact the Workers’ Compensation Appeal Lawyers at the Berlin Law Firm
The workers’ compensation appeals lawyers at the Berlin Law Firm have represented hundreds of injured workers in and around Tampa in challenges to workers’ comp denials. Save valuable time and financial resources while eliminating the possibility of errors and missed deadlines when you hire our firm to represent you in your workers’ compensation appeal case.
Please call our Tampa office for a free consultation. Since we work on a contingency fee basis, you will not pay attorney’s fees unless we win benefits for you.
Discuss Your Work Injury Claim for Free
Learn the types of compensation you may be eligible for and have your questions answered. Call today.
