The laws regarding workers’ compensation benefits vary from state-to-state. In Florida, the vast majority of employers are required to obtain workers’ compensation coverage for their employees. This means if you are injured at work in the state of Florida, you are most likely entitled to workers’ compensation benefits.
But it is not always easy to obtain workers’ compensation benefits even though you are entitled to them by law after suffering a work-related injury. In fact, many injured workers are denied the workers’ compensation benefits they deserve. What are some of the most common reasons why workers’ compensation claims are denied? How can a Tampa workers’ compensation attorney help you win benefits? Keep reading to learn the answers to these questions and more.
You Missed the Deadline to File A Claim
There are certain deadlines that you must meet in order to obtain workers’ compensation benefits for your work-related injuries. If you have suffered a work-related injury, you must notify your employer within 30 days from the date the injury was sustained or the date you were informed by a doctor that your injuries are work-related. If you miss this deadline, the insurance company could deny your claim, which means you could lose the right to obtain benefits.
Even though the law gives you 30 days to notify your employer, it’s best to do it as soon as possible after suffering an injury. This way, you can make sure you don’t accidentally miss the deadline.
Furthermore, the insurance company cannot start to process your claim until your employer has been notified of your injuries. This is another reason why it is so important to notify your employer as soon as possible. The sooner you report your injury, the sooner you can obtain workers’ compensation benefits.
Your Injuries Are Not Work-Related
The workers’ compensation system only provides benefits to workers who have suffered work-related injuries or illnesses. If the insurance company believes your injury or illness is not work-related, they will deny your claim for benefits.
The laws regarding what injuries are covered by the workers’ compensation system are complex. But in general, injuries sustained “by accident arising out of and in the course of employment” are covered by the workers’ compensation system.
For example, say you suffer an ankle injury after slipping and falling in the workplace. In this case, the ankle injury would be covered since it was sustained in a workplace accident.
The workers’ compensation system also provides benefits to workers who are suffering from occupational diseases. Examples of these diseases include asbestosis, mesothelioma, and silicosis.
You may also be entitled to workers’ compensation benefits if you aggravate a pre-existing injury while performing your job duties. But in this case, the workers’ compensation system will only cover the aggravation of the pre-existing injury, not the injury itself.
You Are Not Covered Due to Your Employment Status
Your workers’ compensation claim could also be denied if the insurance company determines that you are not covered due to your current employment status.
In Florida, most employers with at least four full- or part-time employees are required to obtain workers’ compensation coverage. But employers are only required to provide this workers’ compensation coverage to employees.
In other words, if you are classified as an independent contractor, you are not entitled to workers’ compensation benefits for your work-related injuries. However, your employer cannot classify you as an independent contractor just to avoid having to compensate you for your work-related injuries. You must meet the legal definition of an independent contractor.
Drugs or Alcohol Were Involved
If you have suffered a work-related injury, the workers’ compensation insurance company may ask you to submit to drug or alcohol testing. Why? The insurance company can deny your claim if it is determined that you were intoxicated or under the influence of drugs not prescribed by a doctor at the time you were injured.
For example, say you are involved in a slip and fall accident in work that results in a serious back injury. This injury would typically be covered by the workers’ compensation system since it was sustained in a workplace accident. But if the insurance company discovers that you were under the influence of illegal drugs at the time of the accident, they may deny your claim.
This is because the accident may not have occurred if you were not under the influence of drugs, so the insurance company is no longer obligated to compensate you for your injuries.
You Intentionally Injured Yourself
Some workers’ compensation claims are denied because the insurance company believes that the worker intentionally injured themselves in order to collect benefits.
The law states that an employee is not entitled to benefits for injuries that were intentionally caused. If the insurance company has proof that you acted intentionally, they may deny your claim for benefits.
Seek Legal Representation From A Workers’ Compensation Attorney
Have you suffered a work-related injury or illness? If so, it’s important to seek legal representation from the skilled workers’ compensation attorneys at Carlson Meissner Hart & Hayslett as soon as possible. Since 1971, our team of attorneys has been committed to helping the injured in the greater Tampa Bay area obtain the benefits they deserve. We will work tirelessly to ensure you are fully compensated for your work-related injuries.
If your claim has already been denied, don’t hesitate to contact our law office right away. It is possible to appeal the insurance company’s decision and continue fighting for the benefits you deserve. But you shouldn’t face this fight alone—turn to our attorneys for help at once. We aren’t afraid of going head-to-head with a workers’ compensation insurance company to protect your rights and help you secure benefits.
Learn more about how we can help by scheduling a free consultation. To schedule your free consultation, call our law office today.