How Does Workers’ Compensation Work in Florida?

In a nutshell, workers’ compensation in Florida provides benefits to employees who suffer work-related injuries or illnesses. These no-fault insurance benefits help cover medical expenses, lost wages, and other expenses related to an employee’s injury or illness that occurred while on the job.

Legally, “no fault” means the same benefits are available even if a victim was mostly or entirely responsible for a work-related injury or illness. Full benefits are also available if a non-work or pre-existing condition to the risk and/or severity of injury.

No-fault is not to be confused with not contested. Insurance company lawyers have only one job, which is to reduce the amount of benefits these victims receive. In contrast, a Tampa workers’ compensation lawyer has a much different job, which is to obtain the best possible result under the circumstances.

Eligibility

Most employees in Florida are covered by workers’ compensation, including full-time, part-time, and seasonal workers. Primary exceptions include certain types of workers such as independent contractors, domestic workers, or certain agricultural workers. Significantly, a victim could be an independent contractor for financial or other purposes and be an employee for workers’ compensation purposes.

Employer’s Responsibility

Employers with four or more employees in most industries are required to have workers’ compensation insurance. For construction companies, the threshold is just one employee.

Employers must report workplace injuries to their insurance carrier and maintain the necessary coverage. If an employer drops the ball in either area, a Tampa workers’ compensation lawyer can obtain additional compensation in civil court.

Report the Injury

Employees must report any work-related injury or illness to their employer immediately (or within 30 days). Failure to do so may result in loss of benefits. After the injury is reported, the employer must notify their insurance carrier and file the appropriate forms.

Medical Treatment

Employees are entitled to receive medical treatment for their injury or illness from a doctor approved by the workers’ compensation insurance provider. Emergency treatment can be sought initially, but after that, the employee must usually continue care with an authorized provider.

Benefits Provided

Once again, regardless of fault or responsibility, workers’ compensation benefits in Florida generally include:

• Medical Benefits: Coverage for doctor visits, hospital stays, surgeries, prescriptions, rehabilitation, and any necessary treatment related to the injury.
• Temporary Total Disability (TTD): If an employee cannot work for a period of time due to their injury, they may receive temporary benefits to replace lost wages. These benefits are typically two-thirds of the average weekly wage (subject to maximum limits).
• Temporary Partial Disability (TPD): If the employee can return to work part-time or in a different role but is earning less, they may receive compensation for the wage difference.
• Permanent Partial Disability (PPD): If the injury leads to permanent impairment, the employee may receive compensation for a permanent disability.
• Permanent Total Disability (PTD): If the injury prevents the employee from ever working again, they may receive benefits for the rest of their life.

Death benefits are also available to survivors. If a worker dies from a work-related injury or illness, their dependents may receive death benefits.

Filing a Claim

If there’s a dispute over benefits or eligibility, employees can file a petition with the Florida Division of Administrative Hearings for a formal hearing. Workers who disagree with the insurer’s decision or compensation can appeal the decision to the Florida Workers’ Compensation Division.

Time Limits

Employees usually have two years to file a workers’ compensation claim from the date of the injury or from the date they knew or should have known that the injury was related to their work.

For occupational diseases, there’s a two-year limit from when the employee becomes aware of the condition and its work-relatedness.

Insurance Fraud

Both employers and employees are required to be truthful in the workers’ compensation process. Fraudulent claims or the intentional misrepresentation of information can result in penalties, including fines or criminal charges.

 Connect With a Hard-Working Hillsborough County Lawyer 

Injury victims are entitled to important financial benefits. For a confidential consultation with an experienced workers’ compensation lawyer in Tampa, contact Kobal Law. Virtual, home, and hospital visits are available.

Source:

myfloridacfo.com/division/risk/workers-compensation