If you experience a work-related injury, you may file for workers’ compensation benefits to cover medical expenses and lost wages. However, the insurance company might attempt to deny your claim, leaving you without the support you need.
When a workers’ compensation claim gets denied, an appeal may be the next step.
Steps to appeal a workers’ compensation denial
Appealing a workers’ compensation denial in Florida begins by filing a Petition for Benefits with the Division of Administrative Hearings. You must file this petition within two years of the date of injury or within one year of the last payment for benefits, whichever is later. This petition should include details about the injury, the benefits requested and any reasons for the denial of the original claim.
Once you file the petition, your employer’s insurance company has 14 days to respond. If the insurer denies the claim again, the case will proceed to mediation. Mediation is a required step where both sides try to settle the case before going to a hearing. This process can help resolve disputes more quickly and cost-effectively.
Attending a workers’ compensation hearing
If mediation does not resolve the issue, the case will go to a workers’ compensation hearing. This formal hearing occurs before a Judge of Compensation Claims. This is your chance to present evidence, including medical records and expert testimony, to support your workers’ compensation claim. The insurance company can also present its evidence and arguments.
After reviewing the evidence, the judge will issue a decision, either granting or denying the requested benefits. If the judge denies the benefits, you can file an appeal with the First District Court of Appeal in Florida.
Appealing a workers’ compensation denial in Florida requires timely action and detailed preparation. Failing to meet deadlines can result in losing the right to benefits altogether. Understanding the appeal process and gathering strong evidence are key to securing the compensation you need after a work-related injury.
