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Workers' Compensation Process in Florida

Workers' compensation in Florida is meant to ensure that injured workers get quick and efficient delivery of disability and medical benefits. For the employer, it's intended to get their workers back on the job at a reasonable cost. Furthermore, the Florida workers' compensation system is intended to protect both sides equally and fairly and not give either side an undue advantage over the other.

You should know that after being injured on the job or developing a work-related illness, you have the right to pursue a workers' compensation claim whether your employer wants you to or not. It's not up to them to decide your rights. If you're researching the subject, you may be wondering, what is the workers' compensation process in Florida? That's where we come in. Contact us right away if you're experiencing difficulties getting your claim approved or being intimidated by your employer for filing a claim. Here is our helpful guide on everything you need to know about filing a successful Florida workers' comp claim.

What are an employee's responsibilities after being injured at work?

Report your injury to a supervisor or HR department as quickly as possible. You are required by Florida law to report your injury within 30 days of its occurrence or within 30 days of being diagnosed by a doctor with a work-related injury.

When you report the injury, you have to use a doctor approved by your employer or their insurance company.

Suppose you need medical treatment immediately and your supervisor isn't available to direct you to a preferred doctor. In that case, you may go to the nearest emergency room. Report the injury to your employer as soon as you are able.

Employers are required by Florida law to report your injury or illness to their insurance company within seven days of the injury occurrence. If they do not do this and are giving you excuses as to why not, you can contact the Workers' Compensation hotline or contact one of our workers' comp lawyers to help you because it's likely they're up to something fishy.

Once your employer contacts their insurance company, you'll likely be contacted by an insurance adjuster quickly afterward. Be sure to return their calls promptly to get the quickest medical treatment.

Within 3 to 5 business days after your employer or you have reported the incident, you should receive a full brochure explaining your rights and responsibilities and will include a copy of the accident report or First Report of Injury or Illness, which you will need to verify for accuracy. You will also be required to sign a fraud statement. Failure to do so will mean your benefits will be withheld. Furthermore, you'll need to sign and return a release for your medical records.

What to do when seeing a doctor after being injured at work

When you see a doctor, be sure to give them a detailed account of the accident or how you were injured. Make sure that the doctor or any staff helping you understand you were injured on the job and request that they include that in your medical files. You'll be required to answer any questions about and current or past medical conditions or injuries. Ask the doctor when they think you'll be able to return to work and any instructions they have about what you can or cannot do at work. Be sure to show up to all medical appointments as benefits may discontinue if you fail to do so.

What to do after seeing a doctor after being injured at work

Quickly contact your employer after seeing the doctor and explain to them what, if any, restrictions you have to return to work. If you have to be admitted to the hospital, ask someone to contact your employer and explain the situation if you're unable to do so, and be sure to get a copy of the doctor's note to them. When talking to your employer, ask if they have tasks for you to do that will not go against the official medical recommendations. If they do have work that fits your limitations, ask when you can report to work. If not, let them know to contact you as soon as something comes up.

Next, contact the insurance company and relay what the doctor has to say about your injuries and whether your employer has work available within the doctor's recommended restrictions. Keep communications open with both your employer and the insurance company while you recover.

What kind of benefits can I receive for a workers' comp claim in Florida?

Indemnity benefits: If you're unable to return to your job for more than seven days, you should get money to partly replace your wages for the time you were not able to return to work. The compensation rates vary for every calendar year and the number of dependents you have. Generally, they are about two-thirds of your average weekly wage with caps for high-earning workers.

Temporary total disability: When your doctor says you cannot work at all, you can qualify for about two-thirds of your weekly wage starting on the 8th day you're unable to return to your job. The first seven days are only paid if you're temporarily disabled for more than 21 days. When critically injured, you could be eligible for up to 80% of your regular wages for as long as six months after the accident. You max out at 104 weeks for temporary total disability or temporary partial benefits.

Temporary partial disability: You may be eligible for a portion of the difference in wages should you be able to return to work but cannot earn the same wages as before you were hurt with a maximum of 104 weeks of compensation.

Impairment benefits:  Say you have recovered as well as your doctor can expect. That is called Maximum Medical Improvement. Yet, you may have permanent work restrictions and a permanent impairment rating. In that case, you could be eligible for money based on that rating.

Medical expenses: Your employer is responsible for your medical expenses, including therapy and treatments. However, it's important to note here that you must use doctors authorized by the insurance company, not your own doctor. 

What to do if your workers' comp claim is denied in Florida?

If the insurance company flat out denies your claim, you have legal recourse. After making a good faith effort to resolve a benefits dispute and still being denied, your next step is to file a Petition for Benefits with the Office of Judges of Compensation Claims. At this point, it's highly recommended to have one of our workers' compensation lawyers represent you.   

The dispute process can be arduous and lengthy. That's why if you feel your benefits have been denied unjustly, our lawyers can save you time and stress. The insurance company has 14 days to deny an indemnity request and medical within 3-10 days. If you refuse to accept their denial, the next step is filing a Petition for Benefits which must be done within one year of the last payment of indemnity or furnishing of remedial treatment. The insurance company must either pay or respond to the Petition within 14 days of receiving it. Next comes the mediation phase, which is held within 130 days of filing the Petition.

From there, if the claim is not settled, it goes to a Workers' Compensation Judge, and you'll get a Pre-Trial Hearing. Then a Final Hearing within 90-days of the Pre-Trial Hearing. If your benefits are still denied, you can file an appeal within 30 days, which goes to the 1st District Court of Appeal.

How can Morgan & Morgan workers' comp lawyers help me?

After having the question, "what is the workers' compensation process in Florida," answered, you may feel overwhelmed, especially if you've been denied your rightful benefits. Unfortunately, it's not uncommon for insurance companies to routinely deny valid claims. After all, it's their business to make a profit. Here's how our Florida workers' comp attorneys can help you.

Communicate with the insurance company on your behalf: The appeals process is complicated, and it's possible to negotiate a settlement at any time during the process. We understand the tricks of the trade, and yes, there are many. From low ball offers to fake "final settlement offer" threats, we've seen it all. In almost all cases, you have a greater chance of a favorable settlement when represented by one of our attorneys. While judges must approve a workers' comp settlement, we can persuade them to take into account all of your future medical requirements and ensure your paperwork accurately reflects the true value of your claim.

Compile persuasive evidence: One of the most common reasons workers' comp claims are denied is insufficient medical evidence. That's why, as your legal team, we will work to gather vital medical records and talk to your doctors to document recommended treatments and therapies. To bolster medical evidence, we may acquire testimony from experts about the physical requirements of your job. Furthermore, we can interview witnesses to the accident and investigate whether injuries are a common occurrence at your place of work.

Represent you during hearings and a trial if necessary: Perhaps one of the most important things is to have a dedicated lawyer represent you during official court appearances and manage court documents. Deadlines are critical, and if you miss one, your entire claim could be in jeopardy. In court, we present our legal arguments and make objections when the insurance company does something that is wrong. Finally, if the claim is still denied, we represent you through the appeals process.

Whether you have serious injuries, your employer denies you were injured at work, your claim is denied, or you're not sure whether to accept an offer, we can help. Contact us today for a free, no-risk case evaluation. Our services are free unless we win.

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