What to Do When Workers’ Comp Won’t Pay

Workers Comp Not Paying Medical Bills | Workers Compensation Insurance Companies | LaBovick Law Group

Sustaining an injury on the job is nerve-racking, stressful, and even frightening. Not only are you contending with physical pain, but you also are not able to work, earn the income you need to make ends meet, support yourself and/or your family, to pay for the mounting medical bills, therapies, and medications.

Workers’ compensation is designed as a safety net for employees; it is intended to bridge the gap and provide essential funds when they are unable to work due to an employment-related injury. Is your workers comp not paying medical bills and other expenses? Here’s what to do if that safety net fails you.

Workers Comp Not Paying Medical Bills and Other Expenses?

Your worker’s compensation benefits application may be denied if:

  • You missed the window of time in which to notify your employer. In Florida, you have 30 days from the day you were injured or 30 days from the day you were diagnosed with a work-related illness to inform your employer.
  • You did not file a workers comp claim within the required period of time. Under Florida law, you have two years in which to file a workers’ compensation claim. It is best to file as soon as possible after you are injured/made ill at work.
  • You were not injured on the job. Typically, your injury must have occurred while performing duties at the worksite or offsite while performing a task assigned by your supervisor/employer. But it can get tricky: what if work-related stress significantly contributed to a heart attack, for example? In Florida, you may be entitled to receive benefits. If you are not sure, contact a workers comp attorney to get the clarification you need.
  • You were under the influence of drugs or alcohol. If drugs or alcohol contributed in any way to your injury, your claim will most likely be denied. If legally prescribed medications contributed, you may also be denied.
  • Your injury isn’t “serious” enough. To receive workers comp, your injury must limit or prevent you from doing your job.
  • Your employer disputes your claim. They may say that it is a non-work injury, that it is the result of a preexisting condition, or that you are not injured at all. Here, the burden is on you to prove you are injured. When it comes to workers compensation, insurance companies often try to deny or significantly reduce benefits. Seek medical help to begin documenting your condition, and if your employer and their insurer drag their feet, consult a lawyer.

What If Your Workers Comp Claim Is Denied?

If you are unable to work at full capacity (and earn full income), having a workers compensation claim denied is not just frustrating: it can be devastating. Do not give up. You can appeal this decision.

First, many people try to resolve their issues with the worker’s compensation insurance companies. We recommend that you consult a qualified attorney at this point. They have the experience and insight you need to negotiate with these entities. If that does not work to your satisfaction, you can file a formal appeal.

To do this, you must file a Petition for Benefits with the Offices of Judges of Compensation Claims. There is a two-year statute of limitation in which to file. The Judge will then schedule a mediation conference within 40 days, and it must be held within 130 days of filing the petition. You may have to provide more documentation of your injury and, in some cases, undergo a physical evaluation.

The mediator’s job is to help you and your employer/insurance company reach a settlement. If this is not successful, a final hearing will be scheduled. This will be held within 90 days of the mediation session.

If you must have a final hearing, you have the chance to present evidence and testimony from witnesses (e.g. your doctor). From there, the Judge will make a final decision within 30 days.

An Advocate During the Workers Comp Process

Workers comp not paying medical bills and other expenses? Remember that, if your claim is denied, if your employer and their insurance company are refusing to move ahead with your benefits, you should consult an attorney immediately. Your rights are on the line, and you need a legal representative with the expertise and experience necessary to ensure you receive just compensation for your injury.

If you have any questions or need assistance, please contact LaBovick Law Group& Diaz for a free consultation.

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