Experienced Workers’ Compensation Lawyer, West Palm Beach
In theory, claiming workers’ compensation benefits should be a fairly easy and straightforward process if you have suffered a clear on-the-job injury or occupational disease. Unfortunately, workers’ compensation insurers increase their own profits by minimizing or rejecting claims. Therefore, they often look for reasons to deny claims rather than reasons to accept them. As a result, it’s generally a good idea to speak with an experienced workers’ compensation lawyer West Palm Beach residents trust before submitting your workers’ compensation claim. Working with the team at Franks, Koenig, & Neuwelt will help to ensure that your legitimate claim is accepted the first time around and that you receive the total amount of compensation you’re entitled to. With that said, if you have already submitted a claim and it has been rejected, know that you’re not out of options. Our West Palm Beach experienced workers’ compensation lawyer team can help you to appeal the rejection of your claim.
When preparing for a consultation with our firm, it may be helpful for you to review some of the common reasons claims are rejected. That way, you’ll be in a more informed position to ask questions about your legal situation when we speak. Some common claim rejection reasons are as follows:
Rejection on Procedural Grounds
These are some of the most frustrating and common reasons that valid claims are rejected. The workers’ compensation insurer may deny your claim because you failed to follow proper procedure (often by accident or circumstance). Some examples include:
- You failed to report your injury to your employer in time. In Florida, you must report your injury within 30 days of the accident or within 30 days of being told by a doctor that you are suffering from a work-related condition. Reporting in writing (or via email) is the safest way to ensure that there is evidence of compliance.
- You failed to file a workers’ compensation claim in time. This is different from reporting the injury. Florida law generally gives you just two years to file a workers’ compensation claim. After that, you are forever barred from seeking benefits for that injury.
- You failed to attend required medical appointments. You must typically have your claim verified by a doctor in an independent medical exam. You may also be required to periodically attend appointments as part of ongoing benefits. Failure to do so could result in rejection of a claim or loss of benefits.
Worker Deemed at Fault
Claims are sometimes denied because employers/insurers claim that you are responsible for your own injuries in ways that invalidate eligibility for coverage. Here are some examples:
- The insurer alleges that you intentionally inflicted your own wounds as an attempt to file a fraudulent claim
- You are allegedly responsible for your own wounds because you started a fight with another employee (or some similar circumstance)
- You were allegedly willfully negligent by coming to work intoxicated, ignoring important safety rules, etc.
- You were allegedly injured while “goofing off” or engaging in “horseplay”
Difference of Opinion or Interpretation
Your employer/insurer may deny your claim because they disagree about what happened, how it happened or how significant your injuries are. These are some of the most complex case scenarios. Thankfully, our West Palm Beach experienced workers’ compensation lawyer team can help you to gather the proof you need to substantiate your claim. Examples include:
- The cause of your injury cannot be determined, even though it occurred at work (such as suffering a heart attack).
- Your injury cannot be causally linked to your job. It is not clear that it arose “out of and in the course of employment”
- Your injury is allegedly less significant than you claim it is, especially as it relates to your return-to-work timeframe
Contact Us to Learn More
Our firm is dedicated to helping injured Florida workers collect the workers’ compensation benefits they are entitled to. For answers to your questions and help filing or appealing your claim, please contact us to speak to an experienced workers’ compensation lawyer West Palm Beach trusts.