Where Does My Claim Go When Workers’ Compensation Insurance Won’t Pay?

WLRN reported that Florida’s First District Court of Appeal recently issued an important decision for workers’ compensation claims. The Court held in favor of the insurance company in deciding that it should not have to pay a claim under a policy that was written after the claimed work injury. The policy in the case was written a few hours after a piece of machinery ran over a construction worker’s foot on a job site. In so ruling, the Court held that workers’ compensation law cannot be extended to require new insurers to cover losses previously known to the insured.

This case will be important for future workers’ compensation claims in Florida, as insurers now have a new legitimate basis on which to deny claims. Insurers will now be able to assert, in denying a claim, that the injury occurred prior to the policy, therefore justifying its denial. And as almost 35,000 workers’ compensation claims have already been filed so far in 2018, this has the potential to affect many Floridians. However, this is just the latest in an array of reasons that insurers use to deny a claim – sometimes legitimately but often because the company does not want to pay. Receiving a notice of denial can be very confusing and frustrating, especially when you are already dealing with mounting bills and your own injuries. An experienced workers’ compensation attorney can help you with the process of navigating through your appeal.

My Claim Was Denied. Now What?

Unfortunately, you have found out that your workers’ compensation claim was denied. Your next step is to file for an appeal to begin the process of trying to reverse your denial. In Florida, workers’ compensation appeals must be filed initially with the clerk’s office in the lower court or tribunal where the order denying your claim was issued. The lower court or tribunal then certifies the notice of appeal to the First District Court of Appeal. While injured parties may appeal denials without counsel, they are still required to comply with Florida appellate law and court orders, and for this reason alone, hiring an experienced workers’ compensation attorney is highly recommended. Attorneys are also more experienced with the hearings and oral arguments that a workers’ compensation appellate claim can contain.

How Long Do I Have to Appeal My Denial?

Typically, an injured party who wants to appeal a denied workers’ compensation claim has thirty days to file a notice of appeal. It should be noted that the thirty days does not begin when you received your notice of denial, but instead begins to run with the date that the denial decision is rendered. This is one reason why it is so important to quickly retain an experienced workers’ compensation attorney as soon as you find out that your claim has been denied. This deadline is extremely important as the denial of your claim can become finalized if you wait too long to appeal it.

Has Your Claim Been Denied? Contact Us Today.

If you or someone you love has been legitimately injured at work, you should not attempt to appeal your workers’ compensation claim alone. The Miami workers’ compensation attorneys at Payer & Associates have significant experience helping people like you bear some of the burden you have been placed under and obtain the compensation you are entitled to. Begin by contacting us today to schedule a free consultation.

Resources:

wlrn.org/post/court-says-insurer-can-t-be-saddled-known-loss

1dca.org/faq.html

secure.fldfs.com/wcapps/claims_research/Stats_Results.asp