Workers Compensation

6 Main Reasons Why Your Workers’ Compensation Claim Could Be Denied In Florida

injured employee whose workers comp claim was denied

Sustaining work-related injuries can be traumatizing. The physical pain aside, medical bills and lost wages can cause lots of emotional distress and a total disruption in your everyday life. In Florida, fortunately, most employers are required by law to carry workers’ compensation insurance. That means you may qualify to collect workers’ compensation if you suffer job-related injuries. In some instances, however, your Florida workers’ compensation claim could be denied. Below are six reasons why you may not receive your workers’ comp benefits after a workplace injury.

Reason 1: You are not legally eligible to collect benefits

In Florida, your eligibility to collect workers’ comp benefits after a workplace injury will largely depend on the industry and the number of employees in your company. 

If you work in an agricultural sector, for example, your employer must have not less than six regular employees or twelve seasonal workers working for a minimum of 30 days per season for you to collect benefits.

Reason 2: Late application

When seeking workers’ comp benefits, there are strict guidelines that you must adhere to, as stated by Florida worker’s compensation laws (§ 440.185). For instance, you must notify your employer or supervisor within 30 days from the date of manifestation of the injury. Failure to do this may deny you the right to collect the benefits you deserve.

Reason 3: A pre-existing condition

Insurers and employers may deny workers comp benefits due to a health problem an employee had before the date of the injury. For example, an employer may argue that your injury happened because you had a limp in your leg when a slip-and-fall accident occurred.

If this happens to you, it would be best to enlist a lawyer’s services. The right Florida workers comp lawyers will help you prove that your injury has nothing to do with an underlying condition. 

Reason 4: Your injury is not work-related

Florida statute 444.02(19) stipulates the conditions under which an employer is obligated to compensate an injured employee. According to the statute, you are entitled to compensation only if death or injury happens in the course of employment and is work-related. 

If a claim fails to meet the statutory definition, your employer or insurer may not take responsibility. An excellent example is if you took some time off work to attend to some private task and sustained an injury. In such a case, your employer is under no obligation to compensate for the injury sustained and your workers compensation could be denied.

Reason 5: No medical evidence

Every worker compensation claim filed must be accompanied by medical evidence. This includes all the necessary medical records, doctor’s notes, and medical test results related to your injury. The medical reports play a crucial role in determining the extent of your injury and the damages you qualify to collect. 

If your medical report has flaws and does not support your claim clearly, your employer or insurer may cite the lack of evidence as the reason to deny your Florida workers’ comp benefits.

Reason 6: Lack of witnesses

When filing a workers’ compensation claim, a witness’s testimony is essential. Without a witness, it may be challenging to prove your case as your employer and insurer will have to depend on your word and the doctor’s report, which may not be adequate. 

Consult with a team of reliable workers’ comp lawyers in Florida

If you had your workers’ compensation claim denied in Florida, there’s no need to panic. It happens all the time and that may not be the end of the road for you. Talk to our Florida workers’ comp lawyers today to learn whether you qualify to collect these benefits and how we can fight for you.

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