If the carrier disapproves the workmans comp claim, the claim can be arbitrated before the workers compensation board (depending on the state, it may also be called "the industrial commission).
If the workers compensation board or industrial commission denies the workmans comp claim, it can, typically, go to court for resolution. To find out if your workers comp claim will be accepted contact a workers compensation lawyer in Orlando.
Typically, the following jobs will not be covered by workers comp:
- part-time domestic employees in private homes
- newspaper carriers
- real estate sales agents
- some agricultural workers
- casual workers*
- unpaid volunteers (who are not considered employees in the first place)
- sole proprietors
- partners
To avoid a suspicion or accusation of f-r-a-u-d regarding a workmans comp claim, a worker should be mindful of the following factors:
- If no one witnessed the injury or accident, this may cause the worker's compensation carrier to have suspicions regarding the claim. For this reason, a worker will certainly want to present a list of witnesses to the accident.
- If the employee's story regarding the accident changes, this may cause suspicion as well. For this reason, a worker filing a workers compensation claim should be very clear in their own mind regarding the details of a work accident or injury.
- Finally, if there is an unusually protacted length of time between the occurrence of the work injury or work accident and the time that it is reported as a compensable workers compensation claim, a carrier may suspect that the claim is not wholly legitimate. For this reason, among others, a work accident or injury should be reported promptly and immediately to one's employer, typically to someone in a supervisory capacity.
