In Florida, the odds of winning a workers comp case are pretty high. Based on statistics, about 99% of workers comp claims filed in the state for the past ten years have been granted benefits. More than 32% of which were settled out of court.
Compared with the rest of the country, injured workers in Florida have it good. Estimates from insurance groups show that up to 25% of workers comp claims are denied in the first round. Though a Lockton study suggests that 67% of initially denied claims were eventually approved for benefits.
Though the statistics look promising, your chances of winning your workers comp case still boil down to the circumstances of your case. To help you figure out whether you’ll get benefits or not, here’s a quick guide on how to increase your odds of winning your workers comp case.
Why Workers Comp Claims Are Denied
Workers comp claims get denied for a variety of reasons. Some of the most common ones include:
- Doubts on whether the injury is work-related. For an injury to be compensable, the law requires that it must be work-related. But since there is a certain ambiguity on what constitutes a work-related injury, insurance companies often use it as an excuse to deny claims.
- Missed deadlines. States like Florida have set time limits on when you should report your injury. If you missed the said deadline, your insurance carrier can use it to deny your benefits.
- Insufficient evidence. If you don’t have enough evidence that your injury prevents you from working, then your claim can easily be denied.
- Your doctor isn’t accredited by your insurance provider. To receive medical benefits, your treating doctor should be accredited by your insurance provider.
- Your injury doesn’t meet your state’s requirements. There are certain medical conditions that aren’t considered compensable in some states. Stress, for instance, isn’t compensable. Though serious mental health issues might be eligible for benefits as long as they’re work-related.
How to Increase Your Odds of Winning a Workers Comp Case
As mentioned, the odds of you winning your workers comp case depends on the circumstances of your case. But in general, the following tips will help you increase your chances:
1. Report your injury as soon as possible
Many states have set time limits when it comes to reporting a work injury. In Florida, you need to inform your employer about your injury within 30 days after the accident or after you’ve known of it.
Your employers, in turn, must inform your insurance provider as soon as possible. State laws only give employers 7 days to report a work-related injury. Failure to do so can lead to a denial of your benefits.
Unfortunately, it’s not uncommon for employers to refuse to report a work injury. The more work injuries they have, the higher their premiums will be. So after reporting your injury, make sure that your employer informs the insurance company about it too.
2. Hire a good lawyer
We can’t emphasize this enough but having a good workers compensation attorney fighting for you can significantly increase your chances.
An experienced workers comp lawyer like Victor Malca knows the ins and out of the workers comp system like the back of their hand. They know what evidence to produce and how to argue your case before a judge if it goes to trial.
Also, contrary to popular belief, workers comp lawyers don’t get paid unless you win the case. And even then, it’s only a considerably small percentage of your benefits. So if you’re putting off hiring a lawyer because of the fees, you can put those reservations to rest.
3. Gather as much evidence as you can
Having strong evidence will obviously make your case stronger. So gather all the evidence you can. This includes medical records, witness statements, and accident reports. Depending on the circumstances of your case, you can also present surveillance videos, expert testimonies, and employment records.
If you have a workers compensation lawyer, they can help you get the necessary evidence to prove your claim.
4. Read up on your state’s workers comp laws
One of the reasons why injured workers don’t get the benefits they deserve is because they don’t know their rights. So if you have the time, familiarize yourself with your state’s workers comp laws.
Know your rights as well as the benefits you’re entitled to. Even if you have a workers comp lawyer, it still helps if you know a bit of the law yourself. It helps you avoid getting sidelined by the insurance company or settling for an amount that’s way below what you’re really entitled to.
VICTOR MALCA – Florida Workers Compensation & Social Security Disability Attorney
Victor Malca P.A. has over 27 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. His experience and continued success when fighting for his clients puts him among the most trusted workers’ compensation attorney’s in Florida. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits.
Book a free consultation today. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida.
About The Author
Judy Ponio is a writer and editor for the Victor Malca Law P.A. website and blog. She enjoys helping people in need with questions about social security disability and workers compensation law. She has a passion for helping those in need and the elderly with accurate legal information that can make a positive difference in their lives.