Company owners can be resistive when an employee seeks workers’ comp benefits. The most common argument is that the injury did not actually occur on the job, or that it is less severe than the injured worker claims.
Workers’ compensation insurance is expensive for employers, and if claims are filed, premiums go up. An employer may make it standard practice to dispute claims, creating real problems for a worker who is living with an injury that renders him or her unable to work.
Recent changes in the law have resulted in reductions in the amount and duration of workers’ compensation benefits. Our Morgan & Morgan attorneys at St. Augustine office are dedicated to helping you get all the benefits you deserve. You may assume that after years of working, that you will be treated fairly, and that you will be paid workers’ comp benefits while you recover.
Unfortunately, many employees are left struggling to survive, with a valid claim denied, or delayed due to a challenge from an employer and the insurance company.
Workers’ Comp Benefits: Your Rights
Workers’ compensation benefits are paid to employees injured while performing work duties. You will be required to go to the doctor or clinic selected by your employer or their insurance company. On-the-job injuries include traumatic physical injuries, repetitive motion injuries, conditions from toxic exposure, occupational diseases, and fatal injuries. In cases of a work-related fatality, the family of the person has the right to seek benefits through the Florida system. All of these issues should be handled by an attorney who is very familiar with the system, the agency, and has a record of favorable results.
The benefits paid can include:
- Medical treatments and testing
- Physical therapy
- Death benefits for next of kin
- Compensation for missed work
- Permanent or partial disability compensation
What Do I Have to Do to Receive Workers Compensation?
Because worker’s compensation is a no-fault system, you are not required to prove fault for injuries to receive benefits. The injured party does have responsibilities, however. These include:
- You must report the injury to your employer within 30 days of the occurrence. This report should include full data including witnesses, location, cause, and the time it occurred.
- Regardless of when you report the incident, you should get an immediate medical evaluation of your injury. This must be provided by a medical provider chosen by your employer. If you need a second opinion, you have this right.
- You must file a claim within two years of filing your injury report.
Our workers’ compensation attorneys understand this complex government system, and can help you avoid the pitfalls – and there are many. As the insurance company or employer has chosen the doctor or clinic, the doctor may have a vested interest in minimizing the degree of your injuries. If you were injured and are being asked to return to work before you have recovered, we can help. If the physician has misrepresented the degree of your injuries, we will help you seek a doctor who to fully evaluate your condition.
How Do I Appeal a Denied Claim?
If the insurance company denies your claim and says that it did not occur on the job, accuses you of misrepresentation, or blames the injury on a preexisting condition, we know what to do. We are very familiar with the appeals process.
- You can file a petition with the Division of Administrative Hearings (DOAH) who will assign the case to a judge for a hearing, which must occur within 40 days.
- At the hearing, your attorney will present evidence proving that you deserve benefits. The evidence will include all the original data from your report, and records regarding your medical condition and treatment. Our skilled workers’ comp lawyer will make the extent of your injuries clear. We can also help prove a direct relationship between your injury and work duties to dispute the claim that the injury was related to a previous medical or physical condition.
- Medical experts may be called upon to substantiate your claims.
In some cases, mediation can achieve a more favorable outcome, agreed upon by both the worker and the company. In mediation, it is vital that you have legal representation, as the insurance company typically has legal counsel present.
We only wish that getting workers’ comp benefits paid without hassle was how the process works – but that is rarely the case. We can help you fight for the benefits you deserve – contact us today.