Having questions about your workers’ compensation claim process in Melbourne is understandable given their confusing wording and changing regulations.
You may be wondering whether your injury will be covered or how to begin the filing process. We’re here to provide you with some simple answers to these important questions.
The workers’ compensation attorneys working at the Workers’ Compensation Lawyers Coalition Florida have plenty of experience representing clients like yourself. We keep up with the growing list of statutes used to determine eligibility and benefit amounts.
And we’re more than happy to share what we know to help our client’s receive compensation.
If you find yourself in a situation where the insurance provider does not want to provide compensation for your injury, then we advise contacting our legal team immediately. Call us any time you’re in need at 954-448-7355 for a free claim review.
How Can I Know If My Injury Will Be Covered By A Workers’ Compensation Claim?
Many insurance providers will do their best to find exceptions and loopholes that prevent employees from receiving their full benefits. Fewer benefits for you means less money taken from their business.
But just because an insurance provider says you are ineligible doesn’t mean you should believe them.
Instead, it means you should contact a workers’ comp lawyer to review your case. We’ll work you with to find out whether you truly qualify and then fight for your rights as a Florida citizen.
It helps to have a basic understanding of workers’ compensation guidelines and what it takes to receive coverage. You can use these basic guidelines to determine for yourself whether you are eligible to receive benefits.
The following work-related injuries are covered by Florida workers’ comp policies:
- Any illness or injury that is the result of repetitive action
- Any injury that resulted from operating machinery
- The aggravation or acceleration of a pre-existing medical condition
- Any injury that resulted from a slip, trip, or fall
- Any injury caused by a vehicular accident while performing your job
- Any illness caused by exposure to hazardous chemicals, materials, fumes, or mold
Florida is considerably more lenient than many other states when determining whether an accident can be covered by workers’ compensation. For example, the injury does not necessarily need to be the result of an unforeseen accident.
Injuries caused by repetitive motions and stress are covered even if they are part of your normal work routine. There are some cases where a claim will always be denied.
They include:
- Any injury where more than 50 percent of the injury occurred outside of the job
- Any injury that is self-inflicted or obtained intentionally to receive workers’ compensation
- Any injury that occurred while intoxicated or under the influence drugs
- Any injury that occurs because the employee refused to follow known safety protocols or where available safety equipment
How Long Do You Have To File A Workers’ Compensation Claim In Florida?
It is imperative that you begin the filing process as soon as possible. Your employer, a supervisor, an HR agent should be notified of your injury immediately. You have 30 days from the time of the injury to report it to your employer.
If you do not report the injury within this time, then your benefits will be denied.
A workers’ compensation claim, also known as a petition for benefits, must be filed within two years of the injury or you will be ineligible to proceed with the claim.
How To File A Workers’ Compensation Claim In Florida?
Filing a workers’ compensation claim doesn’t need to be a complex process. Minor injuries with small payouts are often handled swiftly by both parties. It is the larger claims with severe injuries that tend to get slowed down with legal obstacles.
Here is the standard process for filing a workers’ comp claim in Florida.
Report The Injury
Remember, you have only 30 days from the time of the injury to file a report with your employer. We do not suggest waiting for nearly this long. The sooner you file your report the sooner you can move forward with receiving your benefits.
You’ll likely want to have them available as soon as possible to cover upcoming medical bills.
If the injury does not require emergency care, then take the time to find out which medical providers are covered by your company’s workers’ comp insurance policy. The insurance policy will only cover health care that is received from an authorized provider.
Of course, in emergency situations, you will not be able to wait for this information.
Injury Is Reported By Employer
The First Report of Injury is filed by your employer within seven days of receiving a notification of injury. The employer files their report with their insurance provider and they will send you an information packet within three days.
That packet will contain your copy of the report as well as additional legal information.
Claim Is Accepted Or Denied
If the process goes smoothly, then the insurance provider will accept the claim and you will receive your first benefit check within 21 days. The amount of the check depends on the severity of the injury.
During this time frame, injuries may be classified as Temporary Partial Disability(TPD) or Temporary Total Disability(TTD).
The amount is provided is taken as a percentage of your average weekly wage for the 13 weeks prior to the accident with a weekly maximum that is established annually.
An insurance provider can wait up to 120 days to declare that they have denied a claim. You can now begin the tedious work of disputing the claim and filing petitions with the Office of the Judges of Compensation Claims.
It’s at this point that you’ll want to contact our law offices. We will work with you to ensure the correct evidence is collected and available at all times.
Call Today for Help with the Workers’ Compensation Claim Process in Melbourne
We hope that your Florida workers’ compensation claim goes smoothly. But know that we are here to fight for your rights in any scenario.
You should expect your benefits to begin arriving within a month’s time if the insurance provider does not intend to dispute or deny the claim. If it takes longer, then it’s a good indicator they are going to resist making payments.
If you’re worried about your claim or the eligibility of your injury, then call our expert workers’ comp attorneys at Workers’ Compensation Lawyers Coalition Florida today by calling 954-448-7355.
