Workers’ Compensation Lawyers in Fort Lauderdale, FL

 

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Workers Compensation refers to coverage that is purchased by an employer/business to provide benefits for any job-related employee injuries that a worker may incur at the workplace. Every employer in Florida is required to purchase workers compensation. This compensation applies to all workers who incur work-related injuries, regardless of whether they were at fault or not. The primary regulator for  compensation in Florida is the Division of Workers Compensation within the Department of Financial Services.

The Florida Workers Compensation Insurance protects all workers injured on the job. This would include coverage for any lost wages as well medical bills. All businesses in Florida with 4 or more employees are required to carry workers compensation. There are some businesses that are also required to carry this coverage even with less than four employees. Specifically, the Florida Workers Compensation is mandatory for:

• All construction industry employers with one or more full-time or part-time employee. In addition, subcontractors, not deemed as employees of the business, are also required to either have coverage or a valid exemption.
• Employers who are covered through an employee leasing company should ensure all employees are covered by Workers Compensation. In the event of any change in worker duties/tasks and any change in personnel, it is the employer’s responsibility to update this change if the duties and workers are not included in the leasing arrangement.
• All employers are required by law to inform the insurer of any change in the duties of the employees as well as any payroll increases.
• All non-construction industry employers with four or more full-time or part-time employees are also required to provide workers compensation coverage.
• All farmers with five or more regular employees and 12 or more seasonal employees who work for the employer for more than 30 days are required to provide workers compensation.

What Does the Florida Workers Compensation Policy Cover?

The Workers Compensation Insurance includes benefits for medical expenses, disability or death. Specifically, the coverage includes compensation for workers who incur physical injuries as a result of workplace accidents. This would include injuries that are a result of slipping or falling; injuries due to a disease contracted at work; an illness developed because of the work performed by the employee, and injuries/illness developed due to working conditions to which the employee is exposed. Coverage also includes compensation for dependents in case of death from an occupational injury or disease.

There are several types of benefits that workers get from the Workers Compensation Act. These include income benefits, medical treatment, mileage reimbursement and funeral and death benefits.  

Income Benefits include:

• Temporary Total Disability Benefits in case the worker is unable to perform all job functions because of an injury/illness sustained at the worksite. Workers can get up to 80% of their pre-injury wages for up to 6 months depending on the severity of their injury. If the injury is not very severe, they will receive 2/3 of their regular wages.
• Temporary Partial Disability Benefits for workers who cannot perform the same job duties as before but can still perform other tasks. If the new tasks result in lower pay for the worker and the worker does not make 80% of his wages prior to the injury, he can be compensated.
• Permanent Total Disability Benefits for workers who have been permanently affected by their workplace injury even after reaching maximum medical improvement. Their benefits are based on an impairment rating of greater than 0%, and this is determined by the Florida Department of Financial Services.

Medical Treatment – All workers who sustain a workplace injury or illness will be compensated for any medical treatment including prescriptions, medical bills, and bills for hospital visits and any other medical related cost.

Reimbursement for Mileage refers to any costs incurred by the worker to and from medical appointments as well as compensation for lost wages that may be incurred due to travel time and the time spent in medical treatment.

Funeral and Death Expenses for employees who die from injuries in the workplace. Relatives or other dependents of the worker are entitled to receive up to $150,000 in death benefits to compensate for the loss of the  earning capacity and up to $7500 for funeral costs.

Exemptions

The Workers Compensation Act in Florida does not cover:

• An injury sustained due to stress, fright, excitement or other mental-related issues.
• An injury or work-related condition that is incurred or causes a worker to dislike or fear another individual based on race, color, religion, sex, national origin, age or handicap.
• Pain or suffering since the employer is only required to compensate for medical.
• If the injury was sustained by the  willful intention to either injure or kill himself or another individual.
• If the injury is incurred while the employee is intoxicated or under the influence of drugs.

What to Do in Case of a Work Injury?

• If a worker is injured, they must tell their employer as soon as possible. Under the state law, employees are required to report the accident of a job-related injury within 30 days of the injury, the knowledge of the injury or within 30 days of a doctor determines that the employee has suffered a work-related injury.
• It is important to consult a doctor who is authorized by your employer or the insurance company.
• In the case of an emergency and the inability of your employer to tell you where to go for treatment, you can go to the nearest emergency room. However, you are still required to let your employer know about the accident/injury as soon as possible without any unnecessary delays.
• The employer, in turn, is required by law to report the injury to the insurance company within seven days of when the injury is reported to them. Employers are also expected to give the employee the name and number of the insurance company who will be handling the claim. In case the employer fails to report the incident or does not give the employee the contact information for the insurance company, the employee can call the  compensation hotline for assistance.
• In most cases, the injured worker will receive an informational brochure outlining their rights and obligations within 3-5 business days after the employer has reported the accident. They will also receive a notification letter which would explain the services provided by the Employee Assistance Office of the Division of Workers Compensation. Other possible documents that may be included may be a copy of the accident report, a fraud statement to be signed by the worker, a release of medical records to be signed by the employer and medical mileage reimbursement forms that the worker would fill out and send for reimbursement.

What to Do if Workers Comp Claim is Denied?

In Florida, you do not have to file any paperwork with the Florida Division of Workers Compensation unless your claim is denied. If that is the case, you can appeal the denied claim by filing a Petition for Benefits within two years of sustaining the injury or within one year of lost wages or medical payments, whichever is later. While the process may seem simple enough, it may be a good idea to hire a workers compensation lawyer to handle your claim. That is mainly because the insurance company that denied your claim will also have a lawyer and if you proceed without one, you may be at a disadvantage, and your claim may be denied again. When selecting a lawyer, do your research and choose one who has already had significant experience in this area. This will ensure your claim is handled by somebody who knows the system and will be able to proceed with your claim accordingly.

There are certain limitations that a workers compensation lawyer may be better able to deal with as compared to a regular worker. Ideally speaking, the goal of any successful economy is to enable businesses to grow. While there is no doubt that the Workers Compensation Act is designed to benefit employees in case of work-related injuries and accidents, there are certain elements that may sometimes favor the employers. This is especially true in cases of denied claims. Keep in mind that the insurance company is the one who picks the doctor treating you. The doctor’s diagnosis plays a critical role in determining the level of compensation for the worker. Many times, when a claim is denied, it is the diagnosis which is used to either deny or restrict the benefits. In addition, the employers want to see you back to work as soon as possible, and again, that is greatly dependent on your diagnosis and the doctor’s opinion with respect to your recovery time and medical condition. Sometimes, your actual medical state may be difficult to prove, and in such cases, there is a risk of the claim being denied. A workers compensation lawyer with experience in this area may be able to counteract these challenges and represent your interests in a much better way than you could on your own.