Workers’ Compensation Lawyers Boca Raton
433 Plaza Real
Boca Raton, FL 33432
Phone: (561) 617-8802
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¡LOS ABOGADOS DE COMPENSACIÓN LABORAL HABLAN ESPAÑOL!
The Workers Compensation Program in Florida is administered by the Division of Workers Compensation, Department of Financial Services. Workers compensation is mandatory for all businesses in Florida, although some waivers are permitted. The benefits under the Workers Compensation Policy are not paid by the state but by private insurance carriers or groups of employers. All employees, including those working in construction businesses, non-construction business, agricultural operations and domestic employees qualify for Workers Compensation. However, in the case of construction companies, employers with one or more full-time or part-time employees are required to get coverage. Non-construction employers with four or more full-time or part-time workers and agricultural businesses with five or more regular employees and 12 or more seasonal employees are required to provide coverage for their employees. For domestic employees, employers are permitted to provide voluntary coverage.
The premium rates for workers comp are regulated by the Department of Insurance as long as they abide by the Insurance Code and are not excessive, inadequate or discriminatory. All insurers that write workers comp in Boca Raton, Florida are required to have their rates approved by the Department of Insurance before using them. Workers Compensation insurers in Florida are required to be members or subscribers of the National Council on Compensation Insurance which is the only licensed rating organization in Florida. Self-insurance funds are also required to file their rate the same way, but individual self-insured employers are not subject to this filing or approval. Their rates are primarily determined through the claim of the worker, job classification and the size of the payroll.
Types of Injuries that are Covered by Workers Comp
All injuries that are sustained in the workplace premises or any other location where the employee is acting within the course and scope of their employment will be covered under the Workers Compensation Policy. Specifically, the injuries that are covered include:
- Injuries sustained in a road accident while the employee was using the vehicle for work purposes irrespective of whether he was using his vehicle or the employer’s vehicle. This does not include any accidents that the worker may sustain while driving to and from work
- Injuries sustained while working
- Injuries sustained due to workplace violence
- Injuries sustained during a terrorist attack on the workplace
- Injuries sustained from natural disasters while in the workplace
- Illnesses or occupational diseases contracted as a direct result of the employment
Types of Workers Comp Benefits in Boca Raton
The types of benefits included in Workers Compensation include:
- Medical Benefits – all medical bills are covered under the Workers Compensation Act. Once the maximum medical improvement is achieved, there is a $10 patient co-payment that is required for any additional medical services.
- Temporary Total Disability Benefits – these are paid at the percentage rate of 66 2/3 of the worker’s wage. The employee will receive payments for a maximum of 104 weeks. The minimum weekly amount is $20, and the maximum amount is $783. All payments under the Workers Compensation Policy are subject to offsets from Social Security and Unemployment Insurance benefits.
- Permanent Total Disability Benefits – these are paid at the same percentage of 66 2/3 with the same minimum and maximum amounts. However, the duration of payments is dependent on the duration of the disability.
- Permanent Partial Disability Benefits – these are also paid at the percentage rate of 66 2/3. There is no weekly minimum in this case, and the maximum is $782. In the event of a non-scheduled injury, the maximum period is 364 weeks with a maximum amount of $284,648. The benefits for wage loss are not subject to a minimum amount in these cases but instead are based on actual wages lost.
- Disfigurement Benefits – the law in Florida covers any disfigurements that include any serious facial or head disfigurements. The benefit amounts are based on $250 for each percent of permanent impairment of the body between 1 and 10% and $500 for any permanent impairment over 10%.
What to Do If Injured on the Job in Boca Raton, FL?
The first thing to do if a worker sustains an injury in the workplace or in premises where the worker is doing something work-related is to report the accident/injury to the employer as soon as possible. In order to avail the benefits from Workers Compensation in Florida, the worker is required to report the incident no later than 30 days otherwise their claim will be denied.
The employer is also required to report the injury as soon as they become aware of it. If the company does not report the incident within seven days after having knowledge of the incident in question, the worker can report the injury to the insurance company. If there is still no response or action either on the part of the employer or the insurer, the worker can get further assistance by calling the Workers Compensation Hotline or the Employee Assistance Office at 1-800-342-1741 or by emailing them at firstname.lastname@example.org.
What Do Workers Comp Benefits Include?
In case of a work-related injury, all authorized medical bills will be paid by the insurance company. All medical bills should thus be submitted by the medical provider to the insurer. It is the employer’s responsibility to ensure that workers are adequately covered by the Workers Compensation Policy and that any injured worker receives the required medical care, treatment and prescriptions for any injuries sustained.
What If the Worker Can’t Work? Do They Still Get Boca Raton Workers Comp Benefits?
As per the law in Florida, workers will not be paid for the first seven days of disability. If this disability exceeds 21 days, then the insurance company may be required to pay for the first seven days. The benefits in such cases are generally 66 2/3 percent of the worker’s average weekly wages. This amount is paid bi-weekly. The worker is not required to pay income tax on this benefit amount. However, once they go back to work and begin to earn regular wages, they will be required to pay income tax on those wages.
Workers usually start to receive payments within 21 days of reporting their injury to the employer. In the case of any missed payments, the worker can call the insurance company, and if there is no support or response there, they can call the Employee Assistance Office.
Is it Necessary to Get a Workers Comp Lawyer to Claim Workers Comp Benefits in Boca Raton?
If a worker is injured and has reported the incident to the employer and the insurer, it is not mandatory to get a lawyer. However, there are certain advantages if the worker decides to retain legal representation. The Workers Compensation System in Florida is based on a no-fault approach. This means that a worker who sustains a work-related injury is not required by law to prove negligence on the part of their employer or any third party. The only thing that is relevant in such a scenario is whether the individual sustained those injuries while doing the work that was assigned to them. The legal term used for this is “within the course and scope of their employment.” This means that if the worker sustained the injuries within the scope of their employment, they would be entitled to these benefits.
It is important to keep in mind that while the worker is entitled to these benefits, the employer will report the incident to the insurance carrier who will then investigate the accident. This is usually done through an insurance adjuster who represents the insurance carrier. They are required by law to provide the benefits, but they are also required by the employer to limit the financial exposure for the business. That is why some claims may be denied. In such cases, it is in the worker’s interest to consult with a lawyer who has the skills and the expertise in this area and has previously worked on and settled cases related to workers comp. In the case of a disagreement between the worker and the insurance company, the lawyer can file a Request for Assistance with the Division of Workers Compensation, the employer, and the insurance company. The insurance company is required to respond within 30 days by either providing the benefits or denying the worker’s claim. If the claim is denied, the lawyer can then file a Petition for Benefits which would outline the problems the worker is facing due to the injury. If there is still no resolution, the worker can file a civil lawsuit.
Can a Worker Receive Workers Comp Benefits if They Can Still Work?
The Workers Compensation Policy in Florida is designed to benefit workers who are unable to work due to injuries sustained in the workplace. If the worker is able to work in some capacity, they are typically not entitled to these benefits. There are also other situations where the worker will not be entitled to any benefits. These include cases where the:
- Injury sustained was due to stress, excitement or other mental issues unique to the worker
- Injury sustained was due to the worker being under the Influence of alcohol or drugs
- Injury sustained was due to the intentional actions of the worker to kill or injure themselves or others