Florida workers’ compensation laws are essential in protecting the rights of employees and employers alike. They ensure that injured or ill workers receive timely medical treatment, wage replacement benefits, and other forms of assistance when needed. The laws also protect employers from being held liable for workplace injuries or illnesses beyond a certain point.
It is important to understand these laws in order to make sure you have the information necessary to handle any situation involving an employee’s health or safety on the job. This article provides ten questions and answers about Florida Workers’ Compensation Laws so that you can better understand your rights, responsibilities, and options under these regulations.
The process for filing and pursuing workers’ compensation in Florida is handled through the Florida Division of Workers’ Compensation, under the Department of Financial Services. The state operates under a no-fault system, which means eligible employees can receive medical treatment and other benefits without having to prove that their employer or any other coworker was negligent. However, there are strict deadlines and procedures to be aware of and comply with, or they risk losing coverage.
Notifying your employer, such as a manager or supervisor, or the human resources department, of a work-related injury or illness promptly is crucial. It is best to let them know immediately, but no later than 30 days from the date of the incident, or the date they knew or should have known of the work-related injury.
Failing to report within the required timeframe can result in a denial of benefits. It is also essential to document the details, such as the date, time, location, and how it happened. Please get everything in writing or via email.
The next step is seeking care from an ER medical provider, an authorized provider authorized by your employer or their insurance carrier. Do not go to your personal doctor unless it is an emergency; if so, seek immediate care at the closest healthcare facility. Emergency care is covered under the plan, but an authorized physician must provide follow-up treatment.
After you notify your employer, they must report the accident and injury to the workers’ compensation insurance carrier within seven days. They may ask you to complete and sign a form for submission and records.
They should provide you with a copy of the form. If they fail to report the incident within the required timeframe, you may contact the insurer directly or reach out to the Division of Workers’ Compensation for assistance.
After the insurance carrier receives the report from your employer, they must send you an information brochure explaining your rights and responsibilities. They have three days to send the packet out.
An adjuster will often contact you within 24 hours to discuss the specifics of the accident and your injuries. They will then investigate and decide whether to accept or deny the claim. If they accept, benefits, including medical care and lost wages, should begin promptly.
If your claim is denied or delayed, the first step is to try resolving it informally by contacting the insurance adjuster or their supervisor. You can also reach out to the Bureau of Employee Assistance at the Florida Division of Workers’ Compensation. You typically have two years from the date of the incident that led to the injuries to file.
If resolving the issue informally is not possible, there are options for dispute resolution and appeals. It is crucial to keep thorough records of all communications, medical visits, and payments, and avoid any delays, as meeting all deadline requirements is critical.
In order to file a workers’ compensation claim in Florida, the injured employee has to tell their employer about the injury or illness within 30 days. The employer then has seven days to submit a First Report of Injury or Illness form to the insurance company. Within 40 days of filing the Petition, the Judge of Compensation Claims (JCC) should issue a mediation order. This must be held within 130 days after the Petition was filed. If an agreement is reached at mediation, then the case is settled.
If you get hurt at work in Florida, you have two years to ask for benefits from your employer. You need to tell your employer that you got hurt or found out that you are sick within 30 days. If you do not ask for benefits within two years, you may not be able to get them. To start the process, you need to tell your employer and the insurance company that you got hurt or sick.
People who work for themselves are not able to get workers’ compensation benefits in Florida. To get these benefits, the worker must meet five things: they must be classified as an employee, the employer must have workers’ compensation insurance, the injury must be from work, the employee must meet reporting deadlines, and the injured worker must go to medical appointments, examinations, and treatments.
Injuries that are covered under Florida’s workers’ compensation laws include those caused by contact with harmful substances, such as asbestosis, mesothelioma, and black lung disease. Some exceptions are injuries resulting from horseplay or failure to follow company procedures. Disability compensation is limited to 100% of the statewide average weekly wage, up to a maximum of $863 per week. Injuries that occur while you are doing your job duties are also covered.
There are some workers that Florida’s workers’ compensation insurance does not cover. This includes people with mental or nervous injuries from stress, fright, or excitement. It also includes corporate officers and LLC owners who have filed for an exemption with the state. And there are certain industries that are not covered, such as construction companies with at least one employee. Workers’ compensation insurance covers medical expenses that come from claims or injured workers. This can include ER visits, surgeries, and drug prescriptions.
In Florida, the amount of workers’ compensation benefits are based on the worker’s Average Weekly Wage (AWW). The benefit is 64% of the AWW, up to $939 per week or $150,000 in total. To get the maximum benefit, the employee would need to make at least $1,455 per week. There are also calculators available online to help with easier computation. Additionally, the percentage of disability assigned by a doctor will also affect the amount of benefits received.
It is illegal for employers to retaliate against an employee who has made a workers’ compensation claim in good faith in Florida. Retaliation can take the form of firing, demotion, or other adverse action.
In Florida, you can ask to change doctors once during your workers’ compensation case. The insurance company will choose the replacement unless it hasn’t assigned you to a new doctor within five days after your request. If you are part of a managed care network, you may select a new in-network provider. However, your initial injury diagnosis and emergency care must be provided by the employer’s chosen doctor.
If you’re in Florida and your workers’ compensation claim is denied, you have to file an appeal with the OJCC (Office of the Judges of Compensation Claims). The appeal needs specific details about what happened and what injuries you have. The EAO (Employee Assistance and Ombudsman) program can help with this process. You usually have two years from the date of injury to file an appeal, but sometimes you have less time if the benefits were denied recently.
In Florida, workers’ compensation benefits last up to 104 weeks, or until the employee can go back to their job. If the employee reaches maximum medical improvement (MMI), then their benefits will end.
Rue & Ziffra has represented many victims of workplace injuries in Orlando, Daytona Beach, Port Orange, Palm Coast, and DeLand as well as the entire state of Florida. If you were injured at work and need to file a workers’ compensation claim, call Rue & Ziffra at 1-800-JUSTICE for a free, confidential evaluation of your case.
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