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What to do when your workers’ compensation claim gets denied

On Behalf of | Aug 6, 2018 | Employment Law |

Suffering an injury at your job can be angering and debilitating. A workplace injury affects your daily life in terms of your health and finances. The aftermath of an occupational accident is even worse when the insurance company denies your request for compensation.

You may not know what to do next after you receive a notice of denial. Thankfully, you may be able to appeal the decision and receive your benefits. Here are the next steps you should take.

Read the letter thoroughly

The first thing to do is understand why the insurance company is denying your claim. Here are some common reasons why claims get rejected:

  • Late reporting: Florida workers compensation laws require you to report your injury within 30 days of your accident. 
  • Late filing: Your employer must report the injury to the insurance company within seven days of learning about it.
  • Your injury is not eligible for benefits: There are certain injuries that workers’ compensation laws do not cover.
  • Your employer disputes your claim: Your boss may say your injury is not work-related or occurred because you were partaking in horseplay. 
  • Insufficient evidence: The insurance company may say it does not have enough medical records to believe your claim.

When you figure out why you received a denial, you can take further action.

Appeal the denial

If you believe you deserve benefits, you should pursue an appeal. You will need to fill out a Petition for Benefits. In general, you have a two-year period to appeal the claim, but you should do it as soon as possible for the best chances of winning your case. However, before you complete this document and submit it, you may want to get another medical exam to prove your injury. You may also want to seek legal assistance because appealing a claim can be a complex process.

Do not give up on receiving benefits just because you get a denial the first time around. 

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