If you recently had your claim for workers’ compensation benefits denied, you are not alone. While workers’ comp is supposed to cover all work-related injuries and illnesses automatically, it is common for workers’ comp claims to be denied for various reasons, some of which can be difficult to address on your own.
Help from an experienced workers’ compensation attorney can be essential to overturning a claim rejection. Once retained, a Pensacola workers’ compensation denial lawyer from Emmanuel Sheppard & Condon can take the lead in investigating the reason(s) for your denial and work towards getting you the benefits you need.
Understanding Why Workers’ Comp Claims May Be Denied
Workers’ comp claims are sometimes denied due to minor errors or omissions in forms submitted to an employer or insurance company. However, most often, claim rejections stem from one or both of those parties believing—or at least claiming to believe—that you do not legally qualify for benefits. The point of contention is usually either that:
- You were not actually injured while performing work-related tasks
- The injury you suffered at work is not as serious as you are claiming
In the former scenario, you may need to provide additional information proving that you were injured during your employment or that you were not engaging in horseplay or otherwise acting irresponsibly in a way that contributed to causing your accident. In the latter scenario, you may need to present substantial medical documentation to illustrate the physical effects of your injury and prove it was not a pre-existing condition. A Pensacola workers’ compensation denial attorney can help build a strong counterclaim in either situation.
Options for Resolving a Workers’ Comp Rejection
Sometimes, it is possible to convince an employer to cover a work-related injury by giving them additional evidence or fixing a mistake in a previous application. Usually, though, you will need to formally appeal your rejection by filing a Petition for Benefits with the Florida Office of the Judges of Compensation Claims. You have two years from the moment you were first hurt or from the moment you discovered you were harmed to submit your appeal.
Most cases will go through at least one round of third-party mediation between you as the claimant and the employer or insurance company contesting your claim. If mediation does not lead to a satisfactory agreement, you can continue the appeals process by requesting a hearing before a workers’ compensation judge. A well-practiced workers’ comp denial lawyer in Pensacola can help you prepare for this important hearing.
Seek Help from a Pensacola Workers’ Compensation Denial Attorney Today
The appeals process can technically continue past a workers’ compensation hearing if the judge rules against the claimant; however, claim denials are generally resolved through the steps listed above.
If you have further questions about what to do following a claim rejection, a Pensacola workers’ compensation denial lawyer can answer them in detail during a confidential consultation. Call Emmanuel Sheppard & Condon today to schedule a meeting with our team of skilled legal professionals.
