At South Florida Legal Group, we understand that filing a workers’ compensation claim can be overwhelming for an employee who was injured on the job. The claims process is inherently complex, and insurance companies and employers may try to deny or minimize your compensation, further complicating matters. With extensive experience handling these types of claims, as well as a thorough understanding of workers’ compensation law, our office is dedicated to helping clients overcome any difficulties which may arise with their claims. We have experience successfully advocating for our clients’ right to recover proper compensation through both workers’ compensation claims and third party lawsuits.
If you were injured while working on the job, you may be able to file a workers’ compensation claim to recover damages for your injuries.
How Can a Workers’ Compensation Attorney Help Me File a Claim?
Filing a successful workers’ compensation claim on your own can be difficult; however, hiring a Miami-Dade attorney with an understanding of the claims process can ease your burden and help you recover the benefits to which you are entitled by law. Your attorney can:
In the event your claim is rejected or undervalued, your attorney is in a position to appeal that decision to a higher authority.
It is important to remember that filing a workers’ compensation claim bars you, in most cases, from suing your employer for your injuries. The benefits provided by your employer are intended to reduce litigation and compensate employees for injuries sustained on the job, regardless of fault. However, if a third party is involved, your attorney may be able to seek additional compensation from this individual or entity.
Workers’ Compensation Claims Process
To pursue workers’ compensation benefits, the injured worker must complete the following steps:
Notice: You are required to report your injury to your employer within 30 days of the incident. Your employer then has seven days to report the injury to their insurance company.
Claim and Report: Upon reporting your injury to your employer, you have a limited amount of time in which you may file a workers’ compensation claim for benefits. Your claim should be accompanied by a detailed report of the incident which caused your injury. Your attorney can be a vital asset in gathering and analyzing information, composing the report and ensuring all pertinent information is included. To help create this report, your attorney may review details relating to the on-the-job injury, including time, place, and date of the incident; investigate the cause of the accident; and gather statements from anyone who witnessed the event. To help strengthen your claim, any information relevant to your injury should be included in your report.
Evaluation of the Injury: To evaluate the severity of your injury for insurance purposes, you are required to seek medical attention from an "approved" physician chosen by your employer. Following this evaluation, you are permitted to obtain a second opinion from a physician of your choosing. Both evaluations will be used when calculating the amount of benefits you may receive.
Insurer’s Evaluation: Your employer’s insurance company will review your claim in conjunction with your medical evaluation(s) to determine the benefits you are eligible to recover.
Re-Evaluation: If you believe your claim was undervalued, your attorney may be able to negotiate with the insurer. Your attorney can use your initial claim and independent medical report, if helpful, as leverage when lobbying for a more accurate value of your claim. If negotiations are unsuccessful, your attorney may appeal the decision to higher authorities.
Third Party Lawsuits
If a third party was involved in or contributed to the incident causing your injury on the job, you may be able to seek additional benefits. These lawsuits must be filed in addition to workers’ compensation claims. For example, if a product or tool contained a defect or failed to work as intended, you may be able to file a product liability claim against the product’s manufacturer. Third-party lawsuits may be filed against any party involved in the accident, except for your employer and co-workers.
Denied Workers’ Compensation Benefits?
In some cases, an employer’s insurance company will deny the injured applicant the right to recover any benefits. A workers’ compensation claim may be denied if the insurer accuses the applicant of misrepresenting their injury, blames the injury on a pre-existing injury or denies that the injury was sustained on the job.
During the appeals process, your attorney will be required to file a petition with the Division of Administrative Hearings, where your case will be assigned to a judge who will then schedule a hearing. The hearing provides both sides an opportunity to present information, evidence and witnesses to support their position. The judge will make a decision based on the information presented, which may or may not reverse the insurance company’s decision.
If the judge denies your appeal for benefits, we may file a second appeal with the Florida Third District Court of Appeals, where the information is presented in front of a different judge or panel of judges.
Under Florida workers’ compensation law, most employers are required to carry workers’ compensation insurance for injuries an employee sustains on the job. Carrying workers’ compensation coverage is mandatory if the employer does business in a field other than construction and employs four or more employees. If the employer is engaged in construction and employs one or more employees, workers’ compensation insurance is required.
Only employees are eligible for workers’ compensation benefits. Independent contractors are not considered employees and are generally not entitled to benefits through the employer if they are injured. Employers may try to classify employees as independent contractors to avoid a workers’ compensation claim. Your attorney can help to ensure you are classified correctly.
The employee’s injury must be work-related. At the time of the incident, the employee must have been on the premises during scheduled hours, performing a task for the benefit of their employer, or acting within the scope of their employment.
At South Florida Legal Group, we handle workers’ compensation claims involving injuries including, but not limited to, the following:
If you were injured on the job, you may be able to recover compensation through a workers’ compensation claim or lawsuit against a third party. To have a Miami-Dade workers compensation attorney review your case and discuss your legal options, please contact us for a free consultation
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