Appealing a Florida Workers' Compensation Denial
Understand the steps to be taken when appealing a workers' comp denial in the state of Florida.
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Every employer in the State of Florida is required by law to carry workers’ compensation insurance to cover lost wages or medical costs due to injuries sustained on the job. Only employers with less than four employees are exempt from this law. The deputy commissioners who oversee workers compensation claims in Florida are called “Judges of Compensation Claims” (JCC). If the claimant is denied benefits, they can file a dispute. Workers compensation appeals in Florida must be made to the First District Court of Appeal (DCA), which has statewide jurisdiction over all claims.
The Appeals Process for Claims in Florida
Nearly 100,000 people in Florida become injured on the job each year and file for workers compensation benefits. When an employee becomes injured, they are required to provide written notice of the injury to the employer within 30 days from the date of injury, or they risk their claim being denied. If your claim for benefits is denied, you must file a petition with the Division of Administration hearings. The Judge of Compensation Claims will schedule a conference to take place within 40 days. During this time, you may be required to submit further evidence regarding the claim or agree to undergo an Independent Medical Examination (IME).
- The Pretrial Hearing - During the pretrial hearing, evidence can be presented showing the extent of the claimant’s injuries and why he or she should be given benefits. Expert testimony may be given by healthcare professionals, such as doctors or physical therapists who can attest to the extent of the injuries and how much time recovery may take. The judge will issue a decision within 30 days, and if benefits are denied, the next step is to file an appeal with the First District Court of Appeals.
- Alternative Dispute Resolution (ADR) - The claimant may be able to settle the dispute through mediation to facilitate a mutually acceptable resolution for all parties. This process allows more creative solutions and remedies to be obtained. For instance, in addition to being a dispute resolution system, ADR can also authorize a modified job assignment, or a light-duty position whereby the injured party does not have the physical strenuous of their previous position.
Hiring a Florida Workers’ Compensation Attorney
If your claim gets denied and you appeal the ruling to the District Court of Appeals, you will need to have a qualified attorney represent you. New evidence is not allowed to be presented during this hearing, but your lawyer can argue that the Administrative Law Judge misinterpreted Florida’s workers’ compensation laws.