How Workers’ Compensation Works in Florida

How Workers’ Compensation Works in Florida

Like other U.S. states, Florida provides protection for employees through workers’ compensation insurance. You may nonetheless want to know how workers’ compensation works in Florida. If you are injured (or ill) due to a job-related condition or circumstance, you are entitled to no-cost medical treatment, partial wage replacement, and, in extreme cases, permanent benefits.

Under workers’ compensation law, you are not normally considered responsible or “at fault” for your injury, so adjusters do not generally consider causation. This protects the employer as well; unless the situation is unusual, you cannot sue the company for negligence while receiving workers’ compensation.

Workers’ Compensation in Florida

In Florida, any business with four or more employees (full- or part-time) is required to carry workers’ comp coverage. All Florida construction industry employers are required to carry workers’ comp, as are government employers and farmers using the services of 6+ workers (or 12 seasonal employees).

If you believe you have a Florida worker’s comp claim, you are required to report your injury or symptoms to your employer within 30 days. This means 30 days from the date of injury or the day a doctor tells you your condition likely stems from a workplace task or hazard.  Seek medical care right away in an emergency, but you must use a workers’ comp-authorized physician for continued treatment.

Your Florida employer should provide you with paperwork to sign and is obligated to report the claim to the carrier within seven days. Be sure to follow-up with the insurance company to verify that your claim was reported. The workers’ compensation insurer should affirm your claim in writing within 30 days.

Claim Denials

For various reasons, many workers’ comp claims are unexpectedly denied. If your Florida claim is denied, know that you  have the right to pursue an aggressive appeal. To appeal a denied claim, you must petition the Office of Judges of Compensation Claims (OJCC) within two years.  If the insurance company still denies the claim at that point, the dispute goes to mediation. The judge’s mediation decision can be further appealed in an administrative hearing, where you (or your attorney) have the opportunity to provide evidence and testimony to support your claim.

A “final” decision will be issued in 30 days. However, if it is a denial, this can be further challenged in the U.S. District Court of Appeals.

Florida Workers’ Comp Benefits

For an approved claim, your potential benefits under workers’ compensation include:

  • Medical Care – At no cost to you, you are entitled to treatment, medical devices, medication, and rehabilitation services.
  • Wage Benefits – If your ability to work is affected, you can receive Temporary Partial Disability or Temporary Total Disability payments.
  • Re-employment Services – To transition to a new career, you can receive vocational counseling, training, and placement services.
  • Permanent Disability Benefits – For a permanent injury, you can receive lifetime payments or a lump-sum settlement.
  • Death Benefit – When a worker is killed, the spouse and children are entitled to survivor benefits.

Discuss How Workers’ Compensation Works in Florida with an Attorney

An experienced workers’ compensation attorney can help ensure you receive all benefits to which you are entitled. Depending upon your individual circumstance, you may need help with your initial claim or to pursue justice through the appeals system. Sometimes, there will be a third-party claim for a traffic accident or equipment malfunction. Rarely is it in the employee’s best interest to pursue a negligence claim instead of workers’ comp.

If you have questions about a Florida workers’ comp claim, contact Feldman Legal Group today.