In theory, getting benefits through your employer’s workers’ compensation insurance after a workplace accident should be as simple as telling your supervisor how and when you were hurt and keeping up with doctors’ appointments while you recover. In practice, though, the insurance companies providing workers’ comp coverage are for-profit enterprises like any other insurance company. That means they will often do everything in their favor to minimize their financial liability at your expense.
Fortunately, you can appeal a workers’ compensation claim denial in Florida with help from a dedicated workers’ compensation attorney. From negotiating with insurance adjusters directly to guiding you through every necessary step of a formal appeal, your Pensacola workers’ compensation appeals lawyer from Emmanuel Sheppard & Condon can assist you through every stage of this often lengthy process.
When Is It Possible to Appeal a Workers’ Comp Rejection?
Insurance companies deny workers’ comp claims in Florida for one of two reasons: because they believe the applicant did not follow proper procedures for filing their claim or because they believe the applicant did not prove they have valid grounds to file a claim. With that in mind, a workers’ compensation appeal is to confirm that you were injured as claimed under the circumstances you stated and followed the necessary procedure to apply for benefits.
In some situations, it is possible to accomplish this without formally filing an appeal and discussing things privately with your employer and their insurance provider. A Pensacola work injury appeals attorney can provide valuable help during these negotiations, as can the Bureau of Employee Assistance and Ombudsman within the Workers’ Compensation division of the Florida Department of Financial Services.
Basic Steps in the Work Injury Claim Appeals Process
If a formal appeal of a workers’ comp denial is the only way forward, the first step is filing a Petition for Benefits with the Office of the Judges of Compensation Claims (OJCC). Once the OJCC processes the petition and notifies your employer and their insurance provider, the parties have 14 days to either accept your claim or respond to the OJCC explaining their rejection. If the parties reject the claim, the OJCC will set up third-party mediation between the opposing parties, followed by a hearing before a judge if mediation does not result in an agreement.
If the hearing has an unfavorable result, the claimant can continue their appeal to a Florida Court of Appeals and potentially to the Florida Supreme Court. However, cases that progress this far are costly and have relatively low chances of success, making it especially important for you to have help from an experienced work injury compensation appeals lawyer in Pensacola.
Get Help from a Pensacola Workers’ Compensation Appeals Attorney
Appealing a workers’ compensation denial can be intimidating and high-stakes, especially if your injury prevents you from working for months at a time. It is vital to know that it is possible to get favorable results from such proceedings, and that guidance from capable legal counsel can make all the difference in your outcome.
Our team of professionals at Emmanuel Sheppard & Condon knows how to handle situations like yours effectively, efficiently, and with your best interests at the forefront. Call today to learn how a seasoned Pensacola workers’ compensation appeals lawyer can assist you.
