Workers’ Compensation Appeals

How to Appeal a Workers’ Comp Denial in Florida

If your workers’ compensation benefits were denied, there is a specific process you must follow if you wish to pursue the case. Our attorneys know how workers’ compensation appeals in Florida work and are happy to explain and walk you through each step.

Appealing your workers’ comp claim involves:

Filing a Petition for Workers’ Compensation Benefits

Filing a petition with the Office of the Judges of Compensation Claims is your first step towards resolving a workers’ compensation dispute. Per Florida’s Chief Financial Officer (CFO), you generally have two years to file your petition for your claim to be considered valid.

Florida Statutes § 440.192 states that you must include all of the following information in your petition or else the judge will not consider it:

• Your name, contact information, and Social Security number
• Your job title and job duties, including which task you were working on when the accident happened
• Your employer’s name and contact information
• A “detailed description” of how and when the accident happened and all injuries that resulted from it
• The precise nature of your dispute with your employer, including how long they have withheld benefits and the type and amount of withheld benefits
• The precise nature of your injuries, including their effect on your life and health and what kinds of treatment you need to recover from them

Attending Mediation to Resolve Your Workers’ Comp Dispute

The Employee Assistance and Ombudsman Office may step in to help you resolve the problem, as stated at Florida Statutes § 440.191. You, your employer, and the insurer will each make your case to the Office so that they can try to find common ground.

With any luck, the Office will succeed in mediating a settlement agreement so that you can get your benefits faster.

Attending a Hearing to Explain Your Need for Workers’ Compensation

If mediation is not successful, a judge from the Office of the Judges of Compensation Claims will hear arguments from both you and your employer. You will have to make the most persuasive possible case to show that your employer has unfairly denied you reasonable benefits.

At this stage, there is also the possibility that your employer will give in and pay your benefits without bothering to go through the hearing process. However, you should still be prepared to present your side of the story, as there is no guarantee that they will do this.

Going to Court to Get Your Workers’ Compensation Benefits

If, after the hearing, the judge denies your claim, you can advance your case outside of the workers’ comp system and go to trial. Our workers’ compensation attorneys can prepare your case and represent you in front of the court. This may involve:

• Submitting all of your evidence to the court
• Asking witnesses to testify in person or submit statements
• Collecting additional evidence, such as new medical exams, to bolster your claim
• Making oral arguments in the courtroom

Call Rosenberg & Rosenberg for a free consultation to learn more about how our firm can make the workers’ compensation appeals process easier on you. We have staff members who speak Spanish and Creole.

Why Your Florida Workers’ Compensation Claim Might Be Denied

There are countless reasons why a worker’s claim for benefits might be rejected. Some of these reasons are legitimate, such as if:

• The worker did not submit enough evidence to allow the insurer to properly evaluate their claim.
• The worker’s injury is not tied to their job. Only injuries that occurred while you were engaging in your normal, expected job duties for an insured employer make you eligible for benefits.
• The insurance company genuinely misunderstood or misinterpreted a key piece of evidence. If this is the case, they should reverse their decision once we point out this mistake.

Unfortunately, there are also other, less scrupulous reasons for an insurance company to refuse to offer fair benefits. Insurers want to pay as little as possible, even to legitimate claimants, so they may:

• Falsely claim that the evidence does not support your claim.
• Insist that your injuries do not require the type or amount of benefits you are seeking.
• Blame your suffering on a preexisting condition or a non-work-related event.
• Say that you made a clerical error, such as filing the wrong paperwork or missing a deadline, so they cannot accept your claim.
• Say that you are not an employee and are therefore not entitled to benefits.
• Launch a fraud investigation on illegitimate grounds and accuse you of deliberately faking your injury.

It can be difficult to figure out the true reason for your denial, especially if your employer or their insurer does not communicate openly with you. You may find it helpful to consult with our workers’ compensation attorneys to deal with the insurer for you.

Is Hiring Our Lawyers Necessary to Filing a Workers’ Comp Appeal in Florida?

Only you can decide when and if to hire our law firm. Rosenberg & Rosenberg has more than 50 years of experience behind us, which we put to use on each case we handle. We have been able to recover millions for clients in various Florida cities.

Helping you acquire the compensation you need after a serious injury is our passion. Our attentive and aggressive representation can make the difference for your case because we:

• Evaluate your case for free: We invite all injured workers to call our office and get a risk-free, no-cost consultation from our legal team. Even if you decide not to hire us, this is a golden opportunity to learn more about your case.
• Assist you with all paperwork: As previously stated, the requirements for filing a workers’ comp appeal are very strict and burdensome. Let our Florida law firm help you fill out and review your paperwork before you submit it. This way, you can avoid costly missteps.
• Represent you at all meetings: Facing off against a judge or the insurance company’s representatives can be intimidating. You do not have to go it alone. The workers’ comp lawyers at our office can stand up for you and present your case in a way that the judge may find convincing.
• Help you better understand your rights: We are familiar with all relevant workers’ compensation laws and would be happy to explain the rights and responsibilities that these laws give you. Remember that the vast majority of injured Florida workers, including undocumented workers, deserve benefits.

You Do Not Have to Wait for a Denial to Hire Our Workers’ Comp Attorneys

Rosenberg & Rosenberg recommends that injured workers contact our office as soon as possible, even before they have filed their initial claim. The earlier in the workers’ compensation process you get us involved, the fewer complications you may encounter. This is because:

• We know how to quickly collect and preserve important evidence, including photos of the accident scene and compelling testimony from witnesses.
• We can protect you if your employer tries to retaliate against you for filing a claim. Seeking workers’ compensation benefits is a protected right, and our workers’ comp attorneys can make sure everyone else respects that right.
• Our legal team has decades of experience with dealing with insurance companies and filing injury claims of all kinds. This enables us to navigate the system more smoothly than an injured worker, who may never have had to deal with the workers’ comp process before.

If you want the security of knowing that a large law firm with relevant experience is managing your entire claim, Rosenberg & Rosenberg would be only too happy to help. While we protect your legal rights, you would be free to spend time with loved ones, get the medical treatment you need, and figure out what your life will be like once you have recovered as fully as possible.

Start Your Worker’s Comp Appeal and Move Forward With Your Life

You deserve an advocate who understands procedure, deadlines, and legal strategy if you are hoping to avoid a workers’ comp denial. If your claim has already been denied, then you will want our aggressive, dedicated legal team on your side as you navigate workers’ compensation appeals in Florida.

At Rosenberg & Rosenberg, we work hard to help our clients recover fair compensation so they can receive the care and support they need after an on-the-job injury. Start your appeal today by calling our Florida workers’ compensation lawyers. We are here to speak with you 24/7.