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What Happens If My Florida Workers’ Compensation Claim Is Denied?


After suffering a work-related injury or illness in Florida, you have the right to file a workers’ compensation claim and recover workers’ compensation benefits. For many employees, the workers’ compensation claim process goes smoothly. On the other hand, some workers experience a difficult time after filing a workers’ compensation claim. There are even times when a workers’ compensation claim can be denied. So, why would a workers’ compensation claim be denied? And what happens if your Florida workers’ compensation claim is denied? Keep reading to find out.

Why Would a Florida Workers’ Compensation Claim Be Denied?

After filing a workers’ compensation claim, no one wants to receive a Notice of Denial. However, it is not uncommon for workers’ compensation claims to be denied. If you receive a Notice of Denial after filing a workers’ compensation claim, it generally means that your eligibility and entitlement to workers’ compensation benefits have ended.

Employers and insurance companies deny workers’ compensation claims for various reasons. An employer or an employer’s insurer can deny a workers’ compensation claim for either legitimate or illegitimate reasons. Some of the legitimate reasons workers’ compensation claims get denied include;

  • Submitting misleading or false information with your claim
  • Failure to submit your claim on time
  • Failure to see the doctor chosen by your employer or employer’s insurer
  • Not being able to provide enough medical evidence to prove your injury or illness is work-related

Unfortunately, employers and insurers often deny workers’ compensation claims for illegitimate reasons. If your employer or employer’s insurance company denies your workers’ compensation claim for illegitimate reasons, an attorney can help you overcome the denial. Depending on your case, an attorney can even help you overcome a legitimate denial.

What To Do if Your Florida Workers’ Compensation Claim Is Denied

If your workers’ compensation claim is denied, you can work with your attorney and employer or the insurance company to overcome the denial through informal negotiations. However, working with an employer or their insurer directly to overcome a workers’ compensation claim denial is not always easy. If it proves impossible to work out things with your employer or the insurance company, you will need to take formal legal action.

In Florida, the legal process of challenging a workers’ compensation claim usually begins with an employee filing a petition for workers’ compensation benefits with the Office of the Judges of Compensation Claims (OJCC). Once you file your petition, the OJCC will likely order you and your employer or employer’s insurance company to participate in mediation. If you reach an agreement, the process will end there.

However, if you cannot reach an agreement, your claim will continue through the OJCC process, which involves a pre-trial and a final hearing. Fortunately, if the decision made during the final hearing is still not in your favor, you can appeal the decision to the First District Court of Appeals with the help of an attorney.

Contact a Key West & Marathon Workers’ Compensation Lawyer

The process of challenging a workers’ compensation claim denial can be complex and lengthy. Therefore, it is vital for you to hire an attorney if your claim is denied. In fact, you should hire an attorney the moment you suffer a work-related injury to help you file your workers’ compensation claim.

Our Key West & Marathon workers’ compensation lawyers at Florida Keys Injury are here to help you with your Florida workers’ compensation claim. You can reach us at 786-605-8500.

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