Workers’ Compensation Resources: Who To Contact After An Injury

Work injuries can negatively affect your career, finances, as well as your overall health. Worker's compensation in Florida is designed to compensate you for some of your losses and assist you in returning to work as soon as possible.

Most employers in Florida must carry workers' compensation insurance, either through a private insurer or through self-insurance with state certification. Workers' compensation claims in Florida are handled by the Florida Division of Workers' Compensation (DWC). No-fault workers' compensation is the law in Florida, as it is in every other state. It is not necessary for you to show negligence on the part of your employer in order to receive benefits. You may be eligible for benefits if your injury occurred on the job or was caused by your work activities.  Workers' compensation claims in Florida are often rejected, while many settlements are much lower than what an injured worker or family member truly deserves.

A workers' compensation attorney in Florida can help. Contact DOCS4PI first for medical attention if you've recently been injured at your workplace. Additionally, the doctors we work with have access to some of the best attorneys in their areas who can effectively assist you with your worker's compensation claims process.

Continue reading to learn about worker's compensation in Florida. In this article we'll cover:

• What is considered a workplace injury?
• How Workers’ Compensation Works in Florida
• Disability Benefits You May be Entitled To
• How to Start a Worker's Compensation Claim
• How to Handle a Denied Worker's Compensation Claim

What is considered a workplace injury?

Most accidents and illnesses resulting from exposure to a work environment are covered by workers' comp insurance. An employee suffering an occupational injury covered by workers' comp insurance must act immediately. There is a limited number of days within which the employee may file a claim for benefits. Injured workers should report occupational injuries to their employers right away. The insurance provider is likely to deny the benefits if a claim is filed late. Depending on the length of the delay, your carrier may think your claim is not valid as well.

Workers' compensation does not typically cover the following:

• Depression, anxiety, or other mental disorders
• Self-inflicted injuries
• Injuries resulting from fighting or horseplay
• Crime-related injuries, injuries caused by drugs or alcohol, and injuries caused by violating company policy

How Workers’ Compensation Works in Florida

If you suffer an injury or illness on the job, your company's workers' compensation insurance can help pay for important benefits like medical care. Treatments for repetitive stress injuries and ongoing therapies, such as physical therapy, are included. If you're out of work due to an illness or injury related to your job, this coverage will assist you in replacing your lost wages. Additionally, you can use it to cover a permanent disability that prevents you from returning to work.

In Florida, the Division of Workers' Compensation assists businesses with workers' compensation programs. Their goal is to help injured workers, employers, health care providers, and insurers comply with Florida laws. They can assist with:

• Obtaining workers' compensation coverage in Florida
• When injured or sick employees are entitled to compensation
• How much should they be compensated

Disability Benefits You May be Entitled To

Temporary Disability

If you are disabled because of a work-related injury or illness, you will qualify for temporary total disability benefits under Florida workers' compensation. This coverage does not apply to the first seven days of your time off unless your injury keeps you out of work for more than 21 days. The amount of temporary total disability benefits is based on two-thirds of your average weekly income just before the accident, up to the annual maximum allowed by law. In 2020, the weekly maximum was $971.

Permanent Impairment

You will be evaluated by your doctor following your medical treatment (or six weeks before your temporary total disability benefits expire if you have not yet reached the MMI stage) to determine whether you have any lasting medical conditions or lost medical function (called an "impairment") due to your injury. The doctor will assign you an impairment rating based on your ability to work, expressed as a percentage. In Florida, a formula determines how long your permanent impairment benefits will last based on this rating. The weekly benefits will be 75% of your temporary total disability amount (up to the same legal maximum), but if you're earning at least the same amount as before your injury, your benefits will be cut in half.

Permanent Total Disability

Your doctor will determine if you qualify for permanent total disability benefits if you cannot perform any work, even passive work. You can receive benefits up to the age of 75 (or for the rest of your life if you aren't eligible for Social Security). Those who suffer severe injuries -- such as an amputation or severe brain injury -- will automatically be considered to be permanently disabled.

Additional Benefits

The Florida workers' compensation system also provides additional benefits, such as: 

• Medical benefits: When a work-related injury or illness is treated on the basis of workers' compensation, the insurance company covers any medical treatment that is prescribed by the treating doctor. The costs of traveling to and from medical appointments and receiving prescribed medicines would also be covered.

• Vocational rehabilitation: It is possible to receive placement services, vocational counseling, and other job placement assistance if you are unable to return to your previous job. Workers' compensation may cover additional training or education for 26 or 52 weeks if needed to obtain a suitable job.

• Death Benefits: Employees who die as the result of a work-related injury or illness may be entitled to death benefits. This benefit is determined by the number of dependents, but cannot exceed two-thirds of the worker's average weekly wage (up to the same limits that apply to temporary total disability benefits) or $150,000 in total. Funeral and burial expenses can also be covered under workers' compensation for up to $7,500.

How to Start a Worker's Compensation Claim

In order to file a workers' compensation claim, you must notify your employer. Injury reports must generally be made within 30 days in Florida. Within 30 days of discovering a connection between your job and a condition or illness, you must inform your employer about it. In the event that you fail to notify your employer within these deadlines, some or all of your benefits may be lost.

Be as detailed as possible when notifying your employer, including:

• when the accident occurred
• how you were injured, and
• any symptoms you may be experiencing.

Upon reporting an injury, your employer should have you see an occupational physician. Unless you need emergency treatment, your employer chooses your doctor. Make sure you give the doctor accurate information about your injuries and symptoms.

Your employer must notify its insurance company within seven days of receiving your notification. Contact the insurer directly if they refuse to report your injury. They will determine whether you qualify for benefits. The insurer may investigate by doing the following:

• requesting medical records
• analyzing your work experience, education, and wages
• ordering a medical examination to assess your condition, and
• requesting a functional capability evaluation (an assessment determining your ability to perform work duties).

Workers' compensation benefits in Florida are either approved or denied quickly by the insurance company. Once your claim is approved, you will begin receiving disability payments and other benefits. Sadly, many workers' compensation claims are rejected by insurance companies.

How to Handle a Denied Workers’ Compensation Claim

The process for appealing a denied workers' compensation claim can be lengthy. Here are three steps in the process:

• Notification of Denial: You will receive a call from your workers' compensation insurance carrier within a few days after the accident report is filed, normally by mail. After investigating the claim, the company will provide a decision within 30 days. In most cases, claims will be denied at first. In the event that your claim is denied, this does not automatically mean the end.
• Appealing a Denied: Claim Injured workers can appeal a denied claim to the Office of Judges of Compensation Claims (OJCC). The insurance company will be forwarded your Petition of Benefits two years from the date of the incident. A response may then be filed by the insurance company justifying its decision to deny the claim. (A company may initially agree to pay benefits but later deny a claim again.)
• Mediation: After mediation is held to resolve any disputes, a judge will make the final decision. During an administrative hearing, an unfavorable outcome can be challenged again. You can present evidence and testimony at the hearing, similar to a trial, to support your claim. A final decision is made within 30 days following the hearing. The First District Court of Appeals can hear appeals of this "final" decision.

Contact DOCS4PI

Each day, thousands of workers are injured on the job. In the event that you have sustained an injury, call 1-888-DOCS4PI for an evaluation. Our network of doctors has partnered with some of the top lawyers in their regions. Not only will they manage your medical care, but they have the experience to document your injuries comprehensively and will cooperate with your attorney.