On-the-job injuries require the workers’ compensation program in Florida to provide you with benefits related to medical care and time missed at work through your employer’s policy. In accidents involving loss of life, surviving family members can receive death benefits for their emotional and financial losses.
However, the Division of Workers’ Compensation may deny you from receiving partial or total coverage. You do not have to accept their denial-of-coverage on services and benefits to which you are entitled.
You Do Not Have to Go Against Workers’ Compensation on Your Own
Instead of going against a government-run system on your own, you can hire a Fort Lauderdale work accident lawyer to assist you during the appeals process. Insurance companies are in a unique position where they understand the intricacies of the system where most well-meaning workers do not.
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Call Hancock Gaeta, P.A. for an Initial Consultation
If you Florida workers’ comp denied you benefits, contact Hancock Gaeta, P.A. for a consultation regarding the details of your case. Our legal team has the knowledge and strategies necessary to fight back against a state-run system that limits how much they spend at every turn.
Request an initial consultation with Hancock Gaeta, P.A. today by calling (954) 281-2231 or sending a message via our online contact form.
Hancock Gaeta, P.A. Helps Fight Denied Claims
It is essential to understand that a workers’ compensation adjuster has two primary functions. First, he or she can only authorize necessary medical treatment and benefits. Second, he or she exists to minimize the insurance company’s financial exposure.
As you can see, there may be room for interpretation under these terms. However, they do provide valid reasons for denial of coverage, which your attorney can dispute if their opinion differs from reality.
Some objections from the adjuster may include:
- The accident injury did not occur during work hours
- The insured employer denied the claim
- The employee did not report the injury within 30 days
- The employee did not follow his or her doctor’s medical advice
Since the adjuster’s intent is different from your own, it is surprising to discover that they may deny the treatments that your doctor deems necessary. Shifting focus from your health to fighting with an insurance company is challenging at best.
If you believe that you qualify but did not receive compensation for your injuries, Hancock Gaeta, P.A. can help. A Fort Lauderdale work accident lawyer on our team is ready to pursue the coverage you deserve.
Contact Hancock Gaeta, P.A. for a case evaluation today by calling (954) 281-2231 or sending a message via our online contact form.
The Florida Division of Workers’ Compensation Has a Duty to Employees on the Job
Since Florida state laws automatically require your employer to provide insurance, you must first ensure that your injury qualifies for coverage. The two-part eligibility requirement states that you must be a qualified employee injured while performing work for the company.
It’s as simple as that. Workers’ compensation must pay for your care if it meets the following criteria:
Requirement 1: Be an Eligible Employee for a Florida Employer
Qualified employees covered by workers’ compensation insurance are eligible to receive benefits. This coverage applies to full-time, part-time, and seasonal employees. Insurance policies often begin from your date-of-hire.
Workers’ compensation does not apply to independent contractors, such as consultants and vendors. Contract position employees should supply their insurance policies. Workers’ compensation does not cover volunteers.
Requirement 2: The Injury Must Have Occurred While Working
Aside from being an eligible employee, the injury claim must have also occurred during the course and scope of work. Injuries that occur during commutes and lunch breaks do not qualify for workers’ compensation benefits.
If you were ‘on the clock,’ insurance will cover your work-related injuries. There may be a question as to what the scope of work entails, which means that having a Fort Lauderdale work accident attorney helps determine your classification and status under Florida statutes.
We Represent Multiple Injury Types Covered by Workers’ Compensation in Florida
Workers’ compensation insurance covers almost any injury or illness that occurs while you are working. Qualifying injuries can be related to your physical or mental well-being. Hancock Gaeta, P.A. will work with you to get you the coverage you deserve.
Our legal professionals can help you get coverage for the following types of injuries:
- Muscle sprains and strains
- Pinch and crush injuries
- Slip and fall accidents
- Exposure to toxic substances
- Repetitive stress injuries
- PTSD, mental anguish, and depression
- Exacerbated pre-existing conditions
- Pain and suffering
- Wrongful death
- And more
Since each case is different, a Fort Lauderdale work accident lawyer can help you determine what should be covered by workers’ compensation. He or she can also help determine the best course-of-action family members can take if their loved one lost his or her life in a work-related accident.
The legal team at Hancock Gaeta, P.A. is here to help you throughout the entire process. We make sure that your rights remain protected, and the insurer stays true to its word in the coverage policy.
Our Fort Lauderdale Work Accident Attorneys Work to Get You Benefits
Every approved workers’ compensation claim is eligible to receive fair compensation. Covered employees can obtain medical, lost wages, or death benefits. However, workers’ compensation uses computer algorithms and opinions of the assigned insurance adjuster to approve or deny every line item.
Therefore, they may miss critical information or have a malformed opinion on the matter. Hancock Gaeta, P.A. can help you pursue the following types of compensation available under the program:
Workers’ compensation insurance covers the treatments prescribed by your doctor as a medical benefit. The doctor you choose must be authorized by the Division of Worker’s Compensation to perform diagnostic tests and subsequent treatments.
Workers’ compensation covers the following services from authorized providers:
- X-ray and MRI examinations
- Emergency room services
- Laboratory tests and blood work
- Medical treatments for your injuries
- Current and future rehabilitation
- Prescribed drugs and medical devices
Overall, your necessary medical expenses are covered by insurance. You can also receive reimbursement for gas mileage and vehicle maintenance related to your travel for doctor’s visits.
Even if you are receiving authorized treatment, it’s critical to keep in mind that the reimbursement can be denied later. This reason is one of many that makes having a legal professional, like Hancock Gaeta, P.A., essential to the strategy of your approach.
Lost Wages and Other Monetary Compensation
Injured employees receive cash benefits to supplement lost wages. Medical treatment is crucial during this period.
Keep in mind that the adjuster wants to limit losses to medical necessity while getting you back to work as quickly as possible. Disability benefits compensate you for the time you missed due to the injury that made it impossible for you to work.
There are four types of disability and lost wage benefits that workers’ compensation pays to qualified employees:
- Temporary total disability: This coverage is for individuals who have a favorable long-term prognosis but must spend some time away from work. Temporary total disability ends upon your doctor’s medical opinion.
- Temporary partial disability: You can receive this benefit if you cannot participate in some work activities as usual but can reasonably perform other tasks. For example, your doctor may advocate that you can work for a certain number of hours a day or perform non-manual labor under temporary partial disability.
- Impairment income benefits: If a doctor believes your condition will not improve, he or she may evaluate you for work restrictions and impairment on your future ability to work.
- Permanent total disability: This form of coverage is for workers who sustained injuries so significant that they are unable to perform as in the past. In general, you do not have to be impaired entirely to receive benefits under permanent total disability.
As you can probably see, there is room for interpretation in the area of disability. The responsibility primarily lies within your doctors’ opinion.
Hancock Gaeta, P.A. will work with your medical provider to understand the unique details of your case to ensure that your assessment is in accordance with the medical duty of care standard.
The accidental death of an employee means that surviving family members may be able to pursue workers’ compensation benefits. Death benefits claims are permitted under the premise that the deceased employee contributed financially to the household.
Now that he or she is gone, your entire family suffers as a result. The maximum death benefit for a deceased employee is $150,000.
Surviving family members can expect to receive reimbursement for funeral expenses as well for up to $7,500. A surviving spouse may also receive educational benefits since he or she can no longer rely on the earning capacity of his or her loved one.
Hancock Gaeta, P.A. Effectively Responds to Denied Claims
Collecting workers’ compensation in Florida requires you to give notice of your injury to your employer and make a claim for benefits using the First Report of Injury or Illness Form. The Division of Workers’ Compensation has a hotline to help you complete your form.
If they denied your workers’ compensation claim after filing the form, you have the right to challenge that decision. Your first step after a denial is to contact the insurance company with an informal dispute.
Tell them why your coverage should be available and work with them in good faith to resolve the matter. A second denial-of-coverage leads you to the formal appeals process. It’s at this point that working with a Fort Lauderdale work accident lawyer is essential.
The Formal Workers’ Compensation Appeals Process
Initiating the appeals process starts with the legal team at Hancock Gaeta, P.A. filing a Petition for Benefits to the Judges of Compensation Claims office.
The form asks us to provide them with detailed information about your claim, including:
- the details of your accident
- the nature of your injury
- whether you have sustained lost wages
- specific benefits for which you are claiming
The deadline for formally appealing a workers’ compensation claim is one year. You can avoid missing out on this critical opportunity by filing the petition as soon as reasonably possible.
Once the compensation claim’s office reviews your petition, it will notify your employer and the insurance provider. They must either pay your application or respond to the appeal within 14 days of receiving notice.
From there, your Fort Lauderdale work accident lawyer can negotiate on your behalf and request additional hearings to prove your accident injury claims. At Hancock Gaeta, P.A., we exhaust every possible route to get you the coverage you need.
You Have Options If Your Employer Does Not Have Coverage
There are a few reasons why a Florida employer may not have workers’ compensation coverage. For example, you may not qualify as a coverable employee if you are a contractor. Some industries and companies are exempt from having insurance coverage as well.
However, there are times where an employer skirts the law and doesn’t provide coverage even when they are mandated to do so. It is alarming for employees to discover that their employer does not carry the mandated workers’ compensation insurance.
When an employer has the available coverage, employees cannot file a personal injury lawsuit against the employer in general. However, this requirement is waived if the employer does not provide workers’ comp coverage.
Since you have multiple options available, it’s critical to consider your next move carefully since it can have long-lasting repercussions. Working with a Fort Lauderdale work accident lawyer will respond on your behalf using the most advantageous strategy for your case under these circumstances.
Contact Hancock Gaeta, P.A. for a Denied Workers’ Compensation Claim in Florida
Your health and well-being take priority when covering from a work-related injury. There are several aspects of an appeal to consider when pursuing fair compensation.
Consider working with a Fort Lauderdale accident lawyer to help you through the process. He or she can take on your denial-of-coverage claim with the experience and subject-matter knowledge in the complicated area of handling a Florida Division of Workers’ Compensation claim.
Call Hancock Gaeta, P.A. today at (954) 281-2231 or by completing our online contact form for an initial consultation. We will work with you in a dedicated and empathetic manner that ensures you feel protected at every critical point.