If you’re injured on the job, you may be eligible for benefits under Florida’s workers’ compensation system. This state-mandated insurance covers medical care, loss of wages, and other harm incurred by workers who suffer illnesses or injuries related to their work.
The Florida state statutes provide a detailed description of workers’ compensation law and all related issues, including who is covered, the circumstances under which employers must provide benefits, and procedures for hearings, mediation and settlement of workers’ compensation cases.
Workers’ Compensation Requirements for Employers
Most Florida employers are required by law to provide compensation or benefits to employees who suffer accidental injury or death.
To receive benefits, the employee — or the employee’s workers’ compensation lawyers — must establish that the injury or illness happened as a result of required work duties. In addition, medical evidence of the injury or illness, along with any resulting disability to the worker, must be established.
Employers with fewer than four employees can elect not to carry workers’ compensation insurance and not to pay benefits if an employee is injured. However, employers who opt out of the system must provide notice — posted in a highly visible location at every work site — that workers are not entitled to workers’ compensation benefits.
Payments to injured employees under the workers’ compensation system typically include an “exclusive remedy” provision. Under exclusive remedy, injured workers agree not to seek additional compensation in civil court once they’ve reached an agreement with the employer for workers’ compensation benefits.
In 2015, the Florida Supreme Court issued a ruling that affirmed the exclusive remedy principle. The ruling followed a court challenge by an injured worker’s widow who had filed an additional civil claim after reaching a settlement with the employer’s insurer.
Responsibilities of Injured Workers
Under Florida law, injured workers also must uphold certain responsibilities to receive compensation. Workers are required to notify their employer as soon as possible — and no longer than 30 days — after suffering an injury or illness on the job.
Injured workers must see a doctor that the employer or the employer’s insurance company chooses. Usually within 24 hours, an insurance claim adjuster contacts the injured worker to explain the workers’ compensation claim process along with the worker’s rights and responsibilities.
Florida law also includes some restrictions that can prevent you from receiving compensation if you’re injured on the job. If you have both a work-related injury and a pre-existing condition that combine to cause your disability, the work injury must account for more than half of the cause of your disability.
If you’re injured while under the influence of alcohol or illegal drugs, you may not receive compensation for any resulting disability. In addition, the court will deny workers’ compensation claims that are filed with the intent to commit fraud. Benefits also are denied to employees who willfully try to injure themselves or someone else.
Intentional refusal to use safety equipment and observe safety rules at a job site can result in a 25-percent reduction in workers’ compensation benefits.
Workers’ Comp Mediation and Settlements
In Florida, workers’ compensation judges consider claims only after they have gone through mediation. If you file a workers’ compensation claim, you can choose to go through the court-sponsored mediation process, or you can agree to private mediation.
After mediation, you still may request a trial with a judge. Any information disclosed in mediation is private and confidential, and it cannot be used against you should your case go to trial. Regardless of the outcome of mediation, a final hearing is held in which the judge of compensation claims enters a final order.
In most cases, injured workers and insurance companies reach a settlement for benefits during the mediation process. However, cases that seem to be settled through informal negotiations in mediation still can end up in court because of disputes over details and specific legal language.
Get Assistance From Experienced Workers’ Compensation Lawyers
After an injury at work, you may not know where to turn for unbiased advice on your case. By working with an experienced workers’ compensation attorney, you take an important step to protect your rights and make sure you receive the compensation you deserve. To consult with an attorney at no cost to you, please contact Kaire & Heffernan, LLC.