Florida state laws protect the livelihoods of injured workers in Orlando. If an individual is hurt on the job, either through a one-time industrial accident or the development of a condition over time, they are eligible to receive workers’ compensation benefits to pay for medical treatment and lost wages. Unfortunately, greedy workers’ compensation claims adjusters often deny legitimate claims, leaving workers needing to file Orlando workers’ compensation appeals.
Although it is a state-mandated right that workers injured on the job are eligible for medical treatment, rehabilitation, and lost wages, some workers may unfortunately be denied valid claims. Hiring an Orlando workers’ compensation attorney to help handle appeals and advocate for the injured worker’s rights should be an important consideration for workplace injury victims.
Workers’ Compensation Appeals Process
Common reasons to have a claim denied by insurance claims adjusters include the insurance company denying the injury took place on the job, alleging fraud on the injured worker, or blaming the injury on a pre-existing condition. Much speculation exists as to why an insurance claims adjuster would deny a valid claim, but reasonable people may surmise the rejection of a claim may involve placing the insurance company’s bottom line before the needs of injured workers and their families.
Injured workers whose claims are denied are allowed to file appeals with the Florida Division of Administrative Hearings to show that a workplace injury claim is genuine and compensation is warranted. Injured workers have a two-year window after their accident to file appeals for their claims.
Once an appeal is filed, the case is assigned a hearing date in front of an appeals judge within 40 days. At the hearing, both sides will present evidence about the case. Details about the injury, including medical evaluations and expert opinions, will be presented at the hearing. Insurance companies have droves of attorneys, claims adjusters, and their own medical experts who may aggressively defend their decision to reject what may very well be a legitimate claim.
Because workers’ compensation appeals are precarious situations, it is imperative injured workers consider hiring an Orlando workers’ compensation attorney to help handle their claims. Experienced attorneys have the legal training necessary to collect medical records and acquire expert testimony to ensure the injured worker’s case is given the credence it deserves.
After the workers’ compensation appeal, a decision will be handed down by the judge within 30 days. Judges may uphold the claims denial, reverse the decision, or reach some sort of compromise between the two sides’ demands.
Can I File a Workers’ Compensation Lawsuit?
Under Florida law, the workers’ compensation claims process is an exclusive remedy. This means workers must work within the prescribed system and are barred from filing civil lawsuits against their employers.
However, even if a workers’ compensation appeal is denied, injured workers may file a second appeal, which will be heard by the Florida Court of Appeals. The stakes are often high in workers’ compensation appeals hearings and it is strongly advised injured workers seek experienced and qualified Orlando workers’ compensation attorneys.
Do not risk you and your family’s well-being; speak to an attorney about your case at the onset of the injury and give yourself the best chance to have your claim approved.