When injured on the job in Orlando, Florida, you may be entitled to workers’ compensation benefits. These benefits can cover the cost of medical treatment, lost wages, and other expenses related to your injury. However, not all workers’ compensation claims are approved. There are several reasons why your claim may be denied, including failure to report the injury on time, failure to seek medical treatment, or the injury not occurring while on the job.
In this article, we will explore some of the common reasons why Orlando workers’ compensation claims are denied, so you can be better prepared and know what to expect in case you need to file a claim. You can also seek assistance from an Orlando workers’ comp lawyer who can help you better understand your rights and options.
There are several common reasons why an Orlando workers’ compensation claim may be denied:
Failure to Report the Injury on Time
A workers’ compensation claim may be denied in Orlando if the injured worker fails to report the injury on time. Florida law requires workers to report their workplace injuries to their employer within 30 days of the injury.
Failure to report the injury on time can result in the employer denying the claim. It makes it difficult to verify the injury and may indicate that it is not severe enough to warrant medical attention.
Additionally, suppose the injured worker delays reporting the injury. In that case, the employer may have difficulty conducting a thorough investigation into the cause of the injury, which could lead to a dispute over whether the injury is work-related. Reporting the injury promptly can help ensure that the claim is processed efficiently and that the injured worker receives the compensation they are entitled to.
Failure to Seek Medical Treatment
A workers’ compensation claim may be denied in Florida if the injured worker fails to seek medical treatment for their injury. To receive workers’ compensation benefits, the injured worker must demonstrate that the injury occurred due to their work and that it required medical attention.
Failure to seek medical treatment can make establishing a connection between the injury and the work-related activity difficult. It can cast doubt on the severity of the injury.
Additionally, seeking medical treatment immediately after the injury can help prevent the injury from worsening and ensure that the injured worker receives appropriate treatment. If the injured worker delays seeking medical attention, the employer or insurer may argue that the injury is not severe enough to require compensation or was caused by something other than work-related activity.
To ensure their claim is successful, injured workers in Florida should seek medical treatment immediately after an injury occurs.
The Injury was Caused by Drug or Alcohol Use
In Florida, a workers’ compensation claim may be denied if the injury was caused by drug or alcohol use. This is because, under Florida law, workers’ compensation benefits are only provided for work-related injuries arising out of the course and scope of employment.
If the injury was caused by drug or alcohol use, it might be argued that it did not arise out of the course and scope of employment. Therefore, the injured worker may not be entitled to workers’ compensation benefits.
Additionally, drug and alcohol use can impair an individual’s judgment and coordination, making them more prone to accidents and injuries. Employers may also have policies that prohibit drug or alcohol use in the workplace. If the injured worker violated these policies, it might be argued that they were engaging in behavior outside their employment scope.
Even if the injured worker was under the influence of drugs or alcohol at the time of the injury, they might still be eligible for workers’ compensation benefits. However, this is only possible if they can demonstrate that their injury was not caused by drug or alcohol use but rather by a work-related activity. However, this can be difficult to prove.
The Injury was Intentional
A workers’ compensation claim might be denied in Florida if the injury was intentional. If an injured worker intentionally caused their injury, they may not be entitled to workers’ compensation benefits.
This is because workers’ compensation benefits are intended to compensate workers who are injured during their employment due to accidents or incidents that are outside of their control.
If an injured worker intentionally caused their injury, it may be argued that they were engaging in behavior that was outside the scope of their employment and that the injury did not arise out of the course and scope of their employment.
Additionally, intentionally causing an injury may violate workplace policies and procedures, impacting the injured worker’s eligibility for workers’ compensation benefits.
If an injured worker’s intentional actions were the result of mental illness or another medical condition, they might still be eligible for workers’ compensation benefits. However, they must demonstrate that their work-related activities caused their condition.
The Injury was Not Severe Enough
In Florida, a workers’ compensation claim may be denied if the injury is not severe enough to require medical treatment or result in a disability. Workers’ compensation benefits are intended to compensate workers for injuries that result in a disability or the need for medical treatment. If the injury is not severe enough, it may be argued that the worker is not entitled to benefits.
Additionally, if the injury is minor and does not require time off work, the employer or insurer may argue that the injury did not impact the worker’s ability to perform their job duties, and therefore, the worker is not entitled to compensation.
Even if the injury is not severe enough to require medical treatment or result in a disability, injured workers may still be entitled to compensation for other expenses related to the injury, such as travel expenses or out-of-pocket medical expenses.
The Claim was Not Filed in Time
A workers’ compensation claim may be denied in Florida if it is not filed within the statutory time limit. In general, injured workers have two years from the date of the injury to file a workers’ compensation claim. If the claim is not filed within this time period, the injured worker may lose their right to pursue a claim for benefits.
Failing to file a workers’ compensation claim within the statutory time limit can result in the employer or insurer disputing the claim because it is untimely. This can be particularly challenging for injured workers who may not realize the full extent of their injuries until some time after the injury occurred.
Injured workers must report their injury to their employer immediately and file a claim for workers’ compensation benefits within the statutory time limit. Doing so can help to ensure that the injured worker’s claim is processed efficiently and that they receive the compensation they are entitled to.
Your Rights to Workers’ Compensation Benefits
It is important to note that you have the right to appeal the decision if your claim is denied. It is recommended that you seek the assistance of an experienced workers’ compensation attorney to help you with the appeals process.
