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What Is The Florida Workers’ Compensation Claims Process?

WorkComp

If it is your first time filing a workers’ compensation claim in Florida, you may wonder what to expect throughout the process. Today, we have prepared a guide to help you understand how the workers’ compensation claims process will unfold after a work-related injury.

If you have been injured at work or developed a work-related medical condition, it is advisable to seek the legal counsel of a Tampa workers’ compensation attorney to discuss your particular claim and help you navigate the process.

What Happens During the Workers’ Compensation Claims Process in Florida?

Here’s how the workers’ compensation claims process plays out when you report your injury or illness and file a claim to obtain the benefits:

  1. You report your injury to the employer. Under Florida law, you must notify your employer of your injury within 30 days of the workplace accident or the date you reasonably discovered that you have a work-related injury or illness.
  2. You seek medical attention. Typically, employers and their workers’ compensation insurance carriers authorize specific healthcare providers to diagnose and treat injured employees. However, if your employer does not have an authorized doctor or you need urgent medical attention, you can seek medical care at the nearest hospital.
  3. Your employer reports your injury to their workers’ comp carrier. Once your employer finds out about your injury, they have seven days to notify their workers’ compensation insurance provider.
  4. You receive the Information Packet. Once your employer’s workers’ compensation insurance company is notified about your injury, it will send you the Information Packet within three days after your employer reports your injury. The packet contains information about your rights and responsibilities as well as a copy of the employer’s accident report.
  5. Your workers’ compensation claim is accepted. Under Florida law, workers’ compensation carriers must issue the first check to injured employees within 21 days after the injury report. The amount of workers’ compensation depends on whether your injury is classified as critical and whether you are entitled to temporary partial or total disability benefits.

What if My Workers’ Compensation Claim is Denied?

Unfortunately, workers’ compensation providers do not always accept the injured employee’s claim. Here’s what happens if your claim is denied:

  1. The denial. Your employer’s insurance company must notify you of its decision to deny your claim within 120 days of the date your injury was reported.
  2. You make a good-faith effort to resolve the denial. You can speak with the insurance adjuster in an attempt to resolve the denial of your claim.
  3. You file a petition with the Office of the Judges of Compensation Claims (OJCC). If your good-faith efforts to resolve the denial are fruitless, you will file a petition for workers’ compensation benefits with the OJCC within two years of the date of the injury. The workers’ comp carrier has 14 days to respond to the petition.
  4. Your dispute proceeds to mediation. In most cases, the OJCC orders claimants and workers’ comp carriers to go to mediation. If this happens in your case, the first mediation session will be held within 130 days of the date you filed your petition.
  5. Your case proceeds to a pre-trial hearing. If you and the carrier cannot reach an agreement at mediation to settle your case, you will have to attend a pre-trial hearing before the Judges of Compensation Claims (JCC).
  6. The JCC issues a decision. After your final hearing, the JCC will have 30 days to issue a decision to either approve or deny your claim. If any of the parties disagree with the decision, that party can appeal the JCC’s decision within 30 days.

Contact a skilled attorney to help you navigate the workers’ compensation claims process in your particular case. Our knowledgeable workers’ comp attorney in Florida, Jason Kobal, can help. Call 813-873-2440 for a case review.

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