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When can your workers’ compensation claim be rejected?

On Behalf of | Jul 14, 2022 | Workers' Compensation

Many assume that workers’ compensation benefits are assured after suffering injuries in the line of duty. However, nothing is guaranteed. Your claim may be denied, leaving you to bear the financial burden alone.

It is possible to appeal a claim, but it can be a long dreary wait. Knowing the pitfalls to avoid will boost your chances of a successful claim and save you the trouble of the appeals process.

Ignoring the deadlines

In Florida, you have 30 days to report a workplace accident to your employer. Your claim may be denied unless you have justifiable reasons that prevented you from notifying your employer within the stipulated time. 

Not seeking medical attention

It is necessary to have medical evidence of your injuries, test results and documentation from your doctor. Otherwise, your injuries may be deemed minor to warrant benefits or alluded to pre-existing conditions which are not eligible for worker’s compensation.

Mistakes in the paperwork

If you make errors or provide inaccurate information in the insurance forms, your claim is likely to hit a snag. For a successful claim, you should correctly fill in all the particulars requested. These include dates, medical records, personal details, and other details surrounding your accident.

You were under the influence at the time of your accident

If your initial medical records indicate that you had alcohol or drugs in your system when the accident occurred, the insurance will likely not approve your claim. 

What can you do after your claim is denied?

Fortunately, you can appeal the decision to deny your benefits. Once the insurer provides their reasons for rejecting your claim, usually included in the denial letter, you should be prepared to appeal or file the claim afresh. 

While most appeals sail through, you should not take your chances. Knowing what needs to be done will increase your chances of a successful outcome.