Types of Workers Comp Disputes

Workers compensation should cover your medical bills and lost wages if you get hurt on the job. But, disputes between employees and employers or insurers can arise. As you’ll see in this article, several common types of workers comp disputes exist.

Understanding the basics can help you advocate for your rights and find the right workers comp attorney in Brandon, Florida, if you ever suffer an on-the-job injury.

Denial of Benefits

Don’t lose hope if your workers comp claim is denied. Many disputes over benefits are resolved. You just have to go through the proper steps.

Maybe the insurance company says there isn’t enough evidence your injury happened at work or is work-related. Provide additional evidence like witness statements, photos, or reports from your doctor connecting your injury to your job.

Ask your doctor to submit a letter of medical necessity explaining how your work caused or aggravated your condition.

The insurer may argue your injury was due to a pre-existing condition or circumstance outside of work. Have your doctor evaluate all possible contributing factors and determine if work was the major cause.

Your doctor’s opinion, supported by objective medical evidence, can help prove your case.

Medical Treatment Disputes

When an injured worker requires medical care for a work-related injury, disputes can arise regarding the appropriate treatment.

As the injured party, you want to receive the care you need to recover, while the employer and insurance company want to minimize costs. Finding the right balance can lead to disagreements.

You and your doctor may feel certain procedures, therapies, or medications are necessary for your recovery, but the insurance company disagrees. If denied, you have the right to appeal.

Your doctor can provide documentation explaining exactly why the recommended treatment is needed.

The insurance company may require you to undergo an independent medical exam (IME) with a doctor of their choosing. The purpose is to determine if your injury is work-related, if you need further treatment, and when you can return to work.

the workers comp insurer will try to deny your claim

Disability Rating Disputes

When you’re injured at work in Brandon, Florida, your disability rating directly impacts the benefits you receive. The rating indicates the severity of your injury and how much it impacts your ability to work and earn an income.

Disputes over disability ratings are common, and it’s important to understand the process.

The disability rating process starts with medical exams by doctors approved by the workers’ compensation insurance company. They will evaluate the severity of your injury and how much it limits your physical abilities and range of motion.

They assign a percentage that indicates your level of disability, from 0% (no disability) to 100% (totally disabled).

If you disagree with the rating the insurance doctors give you, don’t panic. You have the right to appeal their decision and provide opinions from your doctors.

Your doctors can examine you, review your medical records, and determine an accurate disability rating based on your injury.

Fraud Allegations

Injured workers or employers may accuse each other of fraud to try and gain leverage in a workers comp dispute. Employers want to pay as little as possible in premiums and benefits.

Some may underreport employee wages or improperly classify jobs to lower costs, but they face hefty fines and legal consequences if caught.

Some injured workers may exaggerate the severity or cause of an injury to gain higher benefits or settlement amounts. However, falsely claiming an injury or disability is illegal, and if discovered, the worker may face criminal charges, legal fees, and loss of benefits.

Most workers compensation claims are legitimate, but fraud occurs on both sides. If you suspect fraudulent activity, report it to the authorities. They have the expertise to investigate the situation properly.

If You Are Facing Any Workers Comp Disputes, Contact a Brandon Attorney

If your claim has been denied, we will review the reasons for the denial and all evidence in your case. Often, claims are denied improperly due to lack of investigation, incorrect facts, or failure to consider key details.

We know Florida workers’ compensation law inside and out and have a proven track record of overturning unjust claim denials.

Call us today at (786) 249-7999 for a free consultation with a Brandon workers compensation attorney. We’re here to help you navigate the system, solve any workers comp disputes, and get the benefits and justice you deserve.

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