Injured on the Job: What if I’m Denied Workers’ Compensation Benefits?

By: Admin

Workers' Compensation

Mr. Wieland and Mr. Hilado handle workers’ compensation claims based on injuries caused in places of work. Oftentimes, these injuries occur because of an unsafe workplace, the negligence of a co-worker or the negligence of a third party.

Florida workers’ compensation law and statutes provide a strict liability of compensation for injured workers. This means that, essentially, if you are injured while at work, you are entitled to recover workers’ compensation benefits, regardless of who is at fault. In exchange, the injured worker is generally prevented from bringing a negligence claim against his or her employer or co-workers. Only in rare instances is an injured worker able to collect workers’ compensation benefits and successfully bring a negligence lawsuit against his employer.

However, what if someone is injured on the job and the injured worker is denied workers’ compensation benefits? At this point, can the injured worker sue the employer for negligence?

The answer is “yes” depending on the reason for the denial.

In one recent Florida case, a worker was exposed to hazardous materials and eventually died. The workers’ compensation insurance company denied his claim, stating, “…the entire claim is denied as the worker’s employment was not the major contributing cause of his death.” The appellate court allowed the negligence lawsuit case to continue because the denial was determined to be too vague. If the insurance company’s denial would have clearly stated that the injured worker indeed suffered a compensable workers’ compensation claim specified that their denial was based solely on medical causation or major contributing cause, the injured worker would not have been able to successfully bring a negligence claim against his employer. In this scenario, the injured worker’s only remedy would be to bring a workers’ compensation claim and litigate the medical causation issue through the workers’ compensation system.

However, if the denial of the workers’ compensation claim specifically stated that the claim was being denied because the accident did not occur while in the course and scope of his/her employment, or that there was no employment relationship, the employer would be prevented from asserting a workers’ compensation immunity defense and a negligence lawsuit against the employer could proceed.

The decision over whether an injured worker can successfully bring a negligence claim against his or her employer for a job-related injury is often times determined by the reason for the denial filed by the workers’ compensation insurance carrier.

At Wieland Hilado & DeLattre, we have represented many clients that have been injured on the job and have been able to collect workers’ compensation benefits while bringing a negligence claim against a third party. A very common example is when the injured worker slips and falls at work due to the negligence of an outside floor cleaning company.

In this scenario, the injured worker collects and recovers his or her workers’ compensation benefits and then brings a negligence claim against the outside cleaning company. The outside cleaning company is not immune from liability since they are not connected or related to the employer.

If you, a friend or a loved is injured on the job or should you have any questions, do not hesitate to contact Wieland, Hilado & DeLattre, P.A. at (407) 841-7699. For additional resources, keep checking our blog, LIKE us on Facebook and follow us on Twitter for more helpful hints and to always be informed about best practices in law.

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