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Have You Been Denied Worker’s Compensation Benefits? – (Florida) Work Injury Information

January 9, 2010

The following is an expert answer given by Florida work injury lawyer, Joseph M. Maus, and taken from AllExperts.com, a free Q & A service on the internet:

Question:
I was recently injured at work. I work in a warehouse in Maryland loading and unloading rail cars. I fell out of one of the cars while attempting to put the ramp down between the car and the dock door. I followed all the procedures made by my company and workers comp. I went to the hospital ER and told them that I was having shoulder pain in both shoulders. They told me I had just some pulled muscles.

A week later I went to an occupational health doctor for a follow up. I was asked if I had xrays taken and when they found out I didn’t, they sent me to get them done. It was later found that I have a fractured clavicle. I have since been denied workers comp pay and or coverage for treatment due to the fact that I did not fully describe in the accident report that I had injured my shoulder. That was a month ago. I hired a lawyer shortly after I got denied compensation for care and pay. Does it take this long for a lawyer to get the ball rolling? I haven’t seen a doctor since I was told I had a fracture and was denied care. My position has since been terminated do to me not being at work, and I have bills piling up. He told me he would refer me to to a doctor, and get all the necessary paperwork done so I can receive care and pay for my injury, but nothing has been done as of now and its has been more than a month and a half. My question(s) being is how long does this normally take? Am I entitled to pay while being out of work even though my position has been terminated? Do you believe that this particular lawyer is doing all that he or she can?

Answer:
Since your claim occurred in Maryland, I can’t give you details on how the workers comp system works up there.  I’m a Florida injury lawyer specializing in car accidents, slip and falls, and and Florida work injury (workers compensation) accidents.  Laws vary from state to state, particularly in the area of workers compensation, so you need to speak with the workers compensation attorney you have in MD, or get a second opinion from another experienced workers compensation lawyer.

If Maryland is anything like Fla., the workers comp system moves slowly.  If the insurance company denies your workers compensation benefits, we call that denying compensability.  When compensability has been denied in Florida, we have a form called a Petition for Benefits (PFB) which needs to be filed.  Once a PFB is filed, the State automatically sets down the claim for mediation, and a final hearing date.  A mediation would be an opportunity to negotiate with the work comp insurance company on the issue of compensability, and/or to settle your claim for a lump sum of money.  If no resolution comes from the mediation, your claim is set down for Final Hearing.  A Final Hearing is basically a trial, in front of a judge, who will decide whether you should get the benefits that have been denied.

Florida’s workers compensation laws are spelled out in Florida Statutes. Fla. Statute 440.25 states that once a PFB has been filed, a mediation must be held within 130 days of the filing of the PFB. If the parties fail to resolve the issue at mediation, or don’t settle the claim, a final hearing must be held and concluded within 90 days after the mediation is held.

I don’t know if MD has a process like this, but you should ask your attorney. Even if he doesn’t have actual dates for when a mediation or final hearing are going to take place, he should be able to describe the process to you sufficiently to give you a rough estimate of when you can expect to get your claim in front of somebody that can decide the compensability issue.

Regarding your pay while you are out of work, again, MD is probably different than Florida, but Florida work injury laws state that a person injured at work, who is unable to work due to the injury, is entitled to a portion of their pre-injury average weekly wages while they are out of work.  This would include a situation where a person is injured at work, placed on light duty work capacity by his doctor, but the employer has no light duty work available for the person.

My advice to you would be to ask your workers compensation lawyer to explain the process for obtaining, or at least contesting, your workers compensation benefits, including the timelines for a mediation or trial.  If the lawyer does not explain it to your satisfaction, go speak with another experienced workers compensation lawyer.  In Florida, most experienced workers compensation attorneys will meet with you for a free, no obligation consultation to talk about your case.  If you’re not satisfied with your workers compensation lawyer, you can switch to another.

For more information about a Florida work injury, contact Florida work accident compensation lawyer Joseph M. Maus at 1-866-556-5529 or email him today.

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