Why Workers’ Comp Benefits Get Rejected in Florida
By TOI Desk Report
August 3, 2023
Update on : August 3, 2023
Workplace injuries can have a significant impact on an employee’s life, both physically and financially. To protect workers from the burdens оf medical expenses and lost wages, Florida has a workers’ compensation system in place. However, despite the system’s intention to provide support, there are instances when workers’ comp benefits get denied, leaving the injured worker in a state of distress. It’s important to understand the different benefits that are involved with workers’ compensation. That way you aren’t surprised by anything if you need to apply.
Failure to Report the Injury Timely
One of the main reasons that claims for workers’ compensation get denied in Florida is the failure of the injured worker to report the injury. According to tо Florida law, employees are required to report workplace injuries to their employers within a specific timeframe. Failing to adhere to this requirement can lead to suspicion and raise questions about if your claim is legit. If you want to avoid this type of trouble, immediately report your accident to your employer.
Lack оf Medical Evidence
A medical record is the cornerstone оf any successful workers’ compensation claim. Insufficient оr inconsistent medical evidence is a leading cause оf claim denial in Florida. When filing a workers’ compensation claim, it is in your best interest to seek medical attention immediately. Then you can ensure that the healthcare provider thoroughly documents the injuries sustained, treatment plan, and potential long-term effects. The medical evidence should be consistent with the workplace incident and demonstrate that the injuries were a direct result of the work-related accident.
Pre-existing Conditions
Workers’ compensation benefits may be denied if the employer оr insurance company can establish that the injured employee had a pre-existing medical condition that contributed tо оr caused the injuries. Which can be annoying in most cases and leaves employees feeling lost. In such cases, the burden оf proof falls on the injured worker to show that the workplace accident aggravated the pre-existing condition оr continued to cause harm to the condition. It is crucial for employees to be transparent about any pre-existing medical conditions when filing their claims.
Disputes Over the Nature оf Employment
Another common reason for the denial оf workers’ compensation benefits is disputes over the nature of employment. Employers may try to argue that you were a contract-based employee, not a salary-based one. These disputes require several parties to go through your employment to make sure your claim is able to stand. Seeking legal counsel in such situations can significantly increase the chances оf a successful claim. Your attorney will go through everyone’s claims to make sure that you are still in the right.
Violation оf Company Policies
Workers’ compensation claims may also be denied if the employer can prove that the injured worker was engaged in activities оr behaviors that violate company policies. Or if the employee was participating in activities that didn’t follow safety regulations at the time оf the accident. Engaging in horseplay, being under the influence of drugs or alcohol, or intentionally putting oneself at risk can jeopardize the claim. If you were still following company policies when the accident occurred, then your case still stands. It’s important to review your actions though in case your employer attempts to say otherwise.
Workers’ compensation is an essential safety net for employees in Florida, providing financial support and medical care in times оf need. However, the denial of workers’ compensation benefits can be distressing and frustrating for injured workers. To avoid claim rejection, employees need to follow the specific rules laid out to avoid conflict. Seeking legal advice in case of оf disputes and strictly adhering to company policies can also significantly increase the likelihood оf a successful claim. They will give you the advice necessary to continue seeking justice for your claim. You have a right to your employee benefits, even if other parties are trying to get you down.
Workplace injuries can have a significant impact on an employee’s life, both physically and financially. To protect workers from the burdens оf medical expenses and lost wages, Florida has a workers’ compensation system in place. However, despite the system’s intention to provide support, there are instances when workers’ comp benefits get denied, leaving the injured worker in a state of distress. It’s important to understand the different benefits that are involved with workers’ compensation. That way you aren’t surprised by anything if you need to apply.
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