Benefits Available in Workers’ Compensation Claims

Since 2016, the average benefit payments in a workers’ compensation claim have declined by almost 20 percent. Almost every year, lawmakers lower workers’ compensation insurance premiums, in the name of attracting more businesses to the state. Lower premiums mean less money in the system, which means less money for injured victims and their families.

A Tampa workers’ compensation lawyer works hard to ensure that these victims get a fair-sized piece of a shrinking financial pie. The effort pays off. Injured workers cannot possibly go toe-to-toe against insurance company lawyers, so these lawyers never make victim-friendly offers in these situations. So, attorney-driven workers’ compensation settlements are about three times as large, on average, than do-it-yourself settlements.

Lost Wage Replacement

This benefit hinges on the victim’s Average Weekly Wage. The name is deceptively simple. A high school “average” is based on prior grades, and prior grades alone. The AWW is mostly based on prior cash income. But additional considerations apply.

The AWW looks forward as well as backward. If Tony cannot work the hours necessary to obtain a bonus or he misses overtime opportunities because of his injury, his AWW must reflect those losses. Furthermore, the AWW also includes non-cash compensation, like housing allowance and free commissary meals.

Depending on the nature of the injury, the insurance company pays lost wage replacement benefits in one of three ways:

• Temporary Total Disability: Generally, victims cannot work until they fully recover from their injuries. In these cases, the victim is entitled to two-thirds of his/her AWW for the duration of that temporary disability. The law recently changed on this point. These benefits now last up to five years.
• Temporary Partial Disability: The same principle applies, but TPD replacement is more controversial. If a victim must work part-time or can only handle a light duty assignment, workers’ compensation pays two-thirds of the difference between the new and old incomes. Light-duty assignments often include parking lot attendant and other menial jobs that recovering victims resent, but they must work in order to obtain benefits.
• Total Disability Benefits: A “disability” is only partially a medical condition. A disability is also an educational and vocational condition. Partial hearing loss might disable a radio DJ, but it might not disable another worker. Furthermore, “disabled” means “unable to work.” It doesn’t mean bedridden.

In Florida, a 21-day waiting period applies before the lost wage benefit kicks in. Some victims are entitled to retroactive lost wages in some cases.

Medical Bill Payment

Florida law requires workers’ compensation insurance companies to pay reasonably necessary medical expenses. Disputes often arise in this area, which is why an advocate like a Tampa workers’ compensation lawyer is so important.

Transportation expenses are a good example. Insurance adjusters almost always balk at paying helicopter medevac costs. They usually are reluctant to pay for an ambulance as well, if they believe an Uber ride may have done the job.

Transportation costs are just the beginning of the medical bills in a job injury case. Hospitalization averages $3,000 a day. Ancillary costs, especially physical therapy costs, may be almost as high.

High medical bills have an emotional effect on victims. The stress hampers physical recovery. A stress-free environment helps victims return to work faster, which is what everyone wants in the end.

Work With a Compassionate Hillsborough County Attorney

Injury victims are entitled to important financial benefits. For a free consultation with an experienced workers’ compensation lawyer in Tampa, contact Kobal Law. We do not charge upfront legal fees in these matters.

Source:

nasi.org/research/workers-compensation/workers-compensation-benefits-costs-and-coverage/#:~:text=Cash%20benefits%20were%20stable%2C%20while,3%20between%202016%20and%202020