What to Do if Your Workers’ Compensation Claim is Denied in Florida
If you’ve been injured at work and your workers’ compensation claim was denied, you may feel frustrated, confused, or even hopeless. But a denial is not the end of the road. In Florida, you have the right to appeal the decision and continue pursuing the benefits you need to recover and move forward.
Here are the steps to take if your claim has been denied:
1. Review the Denial Letter/Pleading Carefully
Your denial letter/pleading should explain why your claim was not approved. Common reasons include missed deadlines, insufficient medical evidence, disputes about whether the injury was work-related, or whether the injury qualifies under Florida law. Understanding the specific reason for your denial will help you determine your next steps.
2. Gather Documentation
Start collecting any documentation that supports your case, including:
- Medical records and reports from your doctor
- Witness statements from coworkers
- Accident reports filed with your employer
- Any communications between you and your employer or insurance company
These records can help demonstrate the seriousness of your injury and that it occurred during the course of your employment.
3. File a Petition for Benefits
In Florida, if your claim is denied, you must file a Petition for Benefits with the Office of the Judges of Compensation Claims (OJCC). This is a formal request to have your case reviewed by a judge. The petition must be filed within two years of the date of accident or one year of your last received authorized benefit, whichever is later.
4. Attend Mediation and a Hearing
After you file the petition, your case must go through mediation, where you and the insurance company try toreach a resolution. If mediation doesn’t resolve the issue, your case will be scheduled for a hearing before a judge, who will review the evidence and make a decision.
5. Consult an Experienced Workers’ Compensation Attorney
The appeals process can be complicated, with strict deadlines and legal requirements. Having a knowledgeable attorney on your side can make a significant difference. An attorney can help you gather evidence, represent you in mediation and hearings, and advocate for your rights throughout the process, always following the procedures which must be followed to get evidence to be reviewed.
At De Cardenas Freixas Stein & Zachary, P.A., we are committed to protecting your rights and helping you secure the benefits you deserve. Call us today at 305-377-1505 for a complimentary consultation. Our bilingual team is ready to provide personalized guidance and support every step of the way. Let us help you navigate the complexities of your case and pursue the compensation you need to move forward with confidence.
