If you’re injured or develop an illness because of your work, you may be covered by the Florida workers’ compensation system. Workers’ compensation replaces some wages, pays for medical care and may provide additional financial assistance for workers who qualify for coverage.
To receive benefits, you must report your illness or injury to your employer in a timely manner and meet other requirements. Understanding Florida’s workers’ compensation procedure is vital for ensuring that you get the benefits to which you’re entitled.
Who Is Covered Under Workers’ Compensation?
Florida businesses that have four or more employees usually are required to provide workers’ compensation insurance. In the construction business, employees with just one worker must carry workers’ comp.
In Florida, the workers’ compensation system is defined as “no-fault,” meaning you are not required to demonstrate that your employer acted in a reckless manner in order to qualify for benefits. If your injury happened at your workplace or resulted from your work, you likely will have eligibility to receive benefits.
Notifying Your Employer
The workers’ compensation process begins with notifying your employer. In Florida, most injuries or illnesses must be reported within 30 days. However, if your illness or injury has developed over time, you should make your employer aware of the situation within 30 days of determining the link to your work.
If your injury or illness requires emergency treatment, you should let your employer know as soon as possible after seeking medical care.
Failing to notify your employer within the 30-day workers’ compensation timely filing limit may result in loss of some portion or all of your benefits. When you provide notice to your employer, you should give as much detail as you can, including:
- The date, time and location of your injury.
- How the accident or injury occurred.
- The symptoms you’re experiencing.
- Details of medical treatment, if you sought emergency care.
You also can report your injury directly to the carrier of your employer’s workers’ compensation insurance. After you report your illness or injury, your employer or the insurance company should give you the needed forms for filing your claim. You also can get the required forms from the state’s Division of Workers’ Compensation.
Claim Review by the Insurer
Your employer should report your injury to the insurance company no more than seven days after receiving notice. The insurance company then is required to send you information outlining your rights within three days.
If your employer fails to inform the insurance carrier, you can do so yourself. After the report, the insurer analyzes your claim, which may include:
- Reviewing your education, wages and work experience.
- Collecting and reviewing your medical records.
- Asking you to undergo a medical exam.
- Asking you to undergo an assessment of your capacity to perform your duties at work.
Florida law requires that the insurer approve or deny your workers’ compensation claim promptly.
If the insurance company approves your claim, you will begin to receive benefits, which may include:
- Payments for your loss of wages.
- Impairment benefits if you have suffered an amputation or a permanent impairment.
- Coverage of medical care.
- Rehabilitative education of training for new work, if necessary.
The amount you’re paid for disability will vary according to how state law defines your specific situation. You should receive your initial check within a 21-day period following your report of the illness or injury to your employer.
Medical Treatment Under Workers’ Compensation
Florida law requires that your employer pay for medical care to treat an illness or injury you’ve suffered due to your work. Covered medical care may include visits to doctors or hospitals, prescription drugs, physical therapy, and tests to assess your condition. You also may receive mileage reimbursement for your travel to and from medical appointments.
You should not have to pay medical bills related to the workplace injury or illness; each medical provider should submit their bills directly to the workers’ compensation insurance company for reimbursement. Under Florida law, you have the right to choose the pharmacy you use. However, your employer can choose the doctor that treats you unless you require emergency treatment.
Filing A Petition For Workers Comp Benefits
If your employer’s insurer denies your claim or any benefits, you’ll need to file an petition. In general, your petition must be filed within two years of your injury or illness, or within one year of your latest medical payment or indemnity payment.
Filing a workers’ compensation petition for benefits can be a complex process, and your employer’s insurer will have legal representation. A qualified workers’ compensation attorney can assist you with meeting all requirements, filing the necessary paperwork and taking legal action if necessary to recover the compensation to which you are entitled.
To schedule a free consultation with a workers’ compensation attorney, please contact Kaire & Heffernan, LLC.