If you filed a Florida workers’ compensation claim that was denied you may be wondering what the appeals process looks like. If you have a dispute with the outcome of your Florida workers’ compensation decision, there is a way that you can find a resolution. When you submit your Florida workers’ compensation claim, the insurance provider your employer uses has up to 120 days to give you a decision, even if it is a denial. 

The appeals process can take a very long time and be quite stressful. To avoid unnecessary strain and to reduce the amount of time that it takes to come to a conclusion, working with a Flordia workers compensation attorney is a good choice. Choosing the right Florida workers’ compensation attorney that has the experience necessary to ensure you obtain your full benefits is also important. Stephen M. Andrews is a Tallahassee workers’ compensation attorney with more than 35 years of experience helping injured workers obtain fair settlements after their workplace accident.

What Steps are Involved in a Florida Workers’ Comp Appeals Process?

The following steps outline what happens in the appeals process for Florida workers’ compensation benefits:

1. Contact the Florida Employee Assistance Office. The EAO will work with your employer’s Workers’ compensation provider to figure out a way to resolve your denial and secure some amount of benefits for you. If the EAO is able to come to a resolution for benefits you will receive them,  your case will close, and you can move on. Often though, the EAO is ineffective in getting the insurance company to go back on denial and provide benefits.
2. When the EAO’s efforts are unsuccessful, you will then file a “Petition for Benefits” with the Office of Judges of Compensation Claims. The OJCC will begin scheduling a meeting between the insurance company’s representatives and yourself. This process could take up to 40 days. It is highly advisable to have an attorney with you when you meet with the insurance company because they will surely have theirs at the meeting.
3. Once a meeting has been scheduled, mediation will ensue. In mediation, you and your legal counsel as well as the insurance company and their legal counsel will meet with a neutral third party. Many times, the third party is another workers’ compensation attorney or someone who was previously a judge. You will be in one room and the insurance provider will be in another, the third party will be the go-between during the negotiations. If both sides are willing to work together to come to an agreement, you can settle your case. About half of all cases will be resolved in mediation.
4. If mediation is unsuccessful you will have a worker’s compensation hearing with the OJCC. Within 90 days after your mediation meeting, you will have a hearing before a judge with no jury. The judge will hear both sides and make a decision. If both sides are agreeable to the decision the case is closed and you will get your settlement.
5. The final appeal will take place in the First District Court of Appeal if both sides don’t’ agree with the judge’s decision during the workers’ compensation hearing. This is a long process that can run in excess of over a year. Any outcome could happen here so it is important to be ready.

Take Your Case to a Florida Workers’ Compensation Attorney

As you can see, the Florida workers’ compensation process is intricate, has many steps, and can take a while to come to a conclusion. Working with a Florida workers’ compensation lawyer will help you navigate the process much more efficiently. Schedule your free consultation with Stephen M. Andrews, a resourceful Florida workers’ comp and SSDI attorney at (850) 906-9599.