Getting injured at work is never a pleasant experience, especially if you have the unfortunate circumstance of a less than agreeable employer. At Delgado & Romanik, PLLC, our workers’ compensation lawyers frequently receive questions from people who have been hurt on the job and are looking to get the care they need but are unsure about their options. If you or a loved one have been injured at work or hurt while performing a job-related task, we recommend taking a few minutes to go over the following list of workers’ compensation FAQs and their answers.
Workers’ compensation (also called workman’s compensation) is a state-mandated program that provides health insurance benefits to employees who suffer job-related injuries or illnesses. Workers’ compensation law refers to the system of laws which outline the specific benefits that injured employees are entitled to and the legal procedures that must be taken in order to obtain those benefits.
Workers’ compensation insurance is the coverage businesses must carry to provide medical, rehabilitation, and lost wage benefits to employees who are injured or fall ill due to a work-related cause. With a few exceptions, all businesses throughout the U.S. that have employees who are not owners are required to carry workers’ compensation insurance. Fortunately for Florida-based workers, the Sunshine State requires most businesses to carry workers’ comp insurance for employees.
If an employee is injured on the job or develops a work-related illness, workers’ compensation will pay for the most reasonable and necessary medical care they need for their injuries, with the expectation that the injured employee will return to work as soon as they are deemed able by their doctor.
It is your duty as an injured worker to report a point source injury to your employer within 30 days of the incident in order to qualify for benefits. Occupational diseases, on the other hand, can be reported up to 90 days after an occurrence. However, the sooner you report your injury, the better.
Unfortunately, in most circumstances, you may not select your own doctor for treatment if you want your care to be covered by your employer’s workers’ compensation insurance. Unless you’re experiencing a true medical emergency, you should seek treatment through your employer’s workers’ compensation carrier before seeing your regular doctor. Keep in mind, if you choose to see your own doctor afterwards, that the visit will not be covered by workers' compensation benefits.
In Florida, workers’ compensation is essentially a form of wage replacement for employees who are unable to work due to their injuries. As a result, there are many factors that go into how much workers’ comp will pay an individual in Florida, including:
In addition, the maximum workers' compensation rate you may receive may not exceed the Florida State Average Weekly Wage, which (as of January 1, 2019) is $939.00.
Workers’ compensation can provide the following benefits to injured employees:
In most cases, TTD, PPD, and PTD benefits will be equal to 66⅔% (66.67%) of your regular wages. If you are able to return to work, but are unable to earn the same wages that you were earning before your injury, TPD benefits will pay you 80% of the difference between 80% of what you earned before your injury and what you are able to earn now. If your injury left you permanently disabled, impairment benefits will pay you based on your average weekly wage, impairment rating, and other factors.
Under Florida law, when you start receiving workers’ compensation benefits depends on how long you are deemed unable to work by your medical provider. If you are disabled for 21 days or less, you will not receive benefits until the eighth day you miss work due to your injury. However, if you are disabled for 22 days or more, you may receive benefits for the first seven days you missed work. Keep in mind that these benefits will be sent out at a later date, after you have already passed day 22 of disability.
No. However, if you are still receiving care from your authorized doctor and return to work on light or limited duty, you will have to pay taxes on the wages you earn while working.
Your employer must report your injury to their insurance company no later than seven days after receiving notification about your injury. Then, within three days of notifying their insurance company, you should receive an informational brochure from the insurance company that outlines your rights, responsibilities, and other information about Florida workers’ compensation laws.
No. All of your medical visits related to your work injury should be billed directly to your employer’s insurance company, but once you heal as well as you can (reach maximum medical improvement) you must then make a $10 copayment for future doctors' appointments.
It definitely can. Commonly employees need to show that a work accident is the major contributing cause of the need for treatment, however, some types of issues including repetitive trauma and psychiatric needs must be shown by clear and convincing evidence. Depending on your situation, your employer’s insurance company may choose to begin providing medical coverage while simultaneously launching a 120 day investigatory period to determine whether or not your work injury is the largest cause of your need for treatment. If you have a preexisting condition, give us a call at 386-222-6677 to discuss how you should navigate this complex and uncertain legal issue with a workers’ compensation lawyer.
If your workers’ comp benefits have been denied, or if you have experienced any other issues with receiving them, you should consider contacting a workers’ compensation lawyer to help you file a workers’ compensation claim. Workers’ compensation lawyers can help you gather evidence, negotiate with the workers’ comp insurance company, write your settlement agreement in a way that helps you avoid any unintended consequences, and meet all of the critical deadlines for your legal paperwork. In some cases, they can also help you change which doctor you see for your medical treatments. In addition, if an agreement cannot be made with the insurance company, a workers’ comp lawyer can help you prepare for and represent you at trial to pursue the benefits you deserve.
Our firm partner and Board Certified Expert in Workers’ Compensation Law, Matt Romanik, has written a variety of useful and informative material that provides even more information about Florida’s workers’ compensation laws. Here are some informative blogs you may want to check out:
Our personal injury and workers’ compensation cases are always contingency-based, meaning you will pay no fees or costs unless we recover for you. We use the standard contingency fee agreements approved by the Florida Supreme Court wherever applicable. That being said, our legal fees are often payable over and above what our clients’ awards are, and clients are typically able to pocket their entire award while we recover our fees and costs (in addition to the award) from the defendant.
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