FAQ about Workers Compensation
Getting injured on the job is a stressful experience. Besides a painful accident and a difficult recovery, you may have to worry about medical bills, lost wages, and other financial burdens. Workers compensation can help you get by financially while receiving the medical care you need, but navigating the complex rules and regulations can be daunting. Here’s a quick guide to some of the most frequently asked questions about workers’ compensation.
What is workers’ compensation?
Worker’s compensation is a no-fault insurance system designed to protect injured workers and their families.
Regardless of who caused the injury, employers are required to carry insurance that covers medical expenses, lost wages, and other benefits for work-related injuries and illnesses. This system ensures you receive the support you deserve without the need to sue your employer.
Eligibility and Coverage
Who is eligible for worker’s compensation?
Most employees in Florida are covered by worker’s compensation, regardless of their job title or salary. Exceptions may include independent contractors, certain public employees, and volunteers.
Independent contractors may be eligible for worker’s compensation under specific circumstances, such as performing work under the direct supervision and control of the employer. Certain public employees may have special coverage through a system like the State of Florida Division of Risk Management.
What types of injuries and illnesses are covered?
Any work-related injury–meaning any injury caused or contributed to by your work or working environment–is covered under workers’ compensation. This includes both accidental injury and occupational diseases like carpal tunnel.
Common injuries covered by worker’s compensation include:
- Slip and fall injuries
- Repetitive strain injuries
- Traumatic brain injuries
- Exposure to hazardous substances
- Electrocutions
- And more
Every case is different. You can confirm your injury is work-related and covered under workers’ compensation by consulting with a doctor or attorney.
Do I need to report my injury/illness?
In most states, including Florida, you have up to 30 days after your injury to report it to your employer or you may forfeit workers’ compensation coverage.
After you report your injury to your employer, they are required to report your injury to their workers’ compensation insurance carrier within a week. If they fail to do so, you can report it yourself, either through your employer’s insurance carrier or your state’s workers’ compensation officials.
What if I’m partially at fault for my injury?
Worker compensation is a no-fault insurance system. Even if you were partially to blame for your own injuries, you’re still eligible for workers’ compensation.
There are some exceptions, like if you injured yourself on purpose. Consult with a workers’ compensation attorney for an assessment of your eligibility.
Benefits and Compensation
What kind of medical benefits do I get?
All medical care required to treat your work-related injury is covered under workers’ compensation at zero cost to you. This includes:
- Doctor visits
- Hospitalization
- Surgery
- Medication
- Physical therapy
- Medical tests
- Prostheses
- Transportation costs
What are wage replacement benefits?
If your injuries impair your ability to work, either partially or completely, you’re entitled to wage replacement benefits. A series of ratings and formulas will determine the portion of your income that is covered.
- Temporary total disability: if you are completely unable to work for at least 7 days, you are eligible for 66% of your lost wages.
- Temporary partial disability: if your ability to earn your previous wages is temporarily affected, you may be eligible for benefits to make up the difference.
- Impairment income benefits: if you have reached maximum medical improvement and still cannot earn your previous wages, you may receive benefits based on your impairment rating, as evaluated by a doctor.
- Permanent total disability: if your injuries are so severe that you are permanently left unable to work, you may receive permanent total disability benefits.
Am I eligible for other benefits?
You may be eligible for other benefits as well. If you are unable to return to your previous work, you may receive vocational training and employment assistance. In the event of your death, your dependents may also be eligible for funeral costs and death benefits.
Work with a workers’ compensation attorney to learn more about what additional benefits you may be eligible to receive.
Claims Process and Procedures
How do I file a worker’s compensation claim?
After you’ve received a work-related injury, you should report your injury to your employer right away. Your employer is responsible for workers’ compensation insurance coverage, and they must file a claim with their insurance carrier within a week of you reporting your injury.
If you don’t hear from your employer’s workers’ compensation insurance carrier, and your employer isn’t cooperating with your attempts to resolve the issue, you should contact an attorney and file a petition with the appropriate state offices.
What happens after I file my claim?
After you report your injury, you should hear from your employer’s insurance carrier shortly. They’ll request whatever information they may need to investigate the claim, like medical records, witness statements, and other evidence.
What if my claim is denied?
If your workers’ compensation claim is denied by your employer or their insurance carrier, you have the right to file a petition with your appropriate state authorities, like Florida’s Employee Assistance and Ombudsmanf Office.
An experienced workers’ compensation attorney can help you navigate the appeals process and protect your rights to compensation.
Common Concerns and Issues
What if I need more time off work?
Under Florida law, you are required to make a good-faith effort to return to work once cleared by your doctor. Otherwise, you may be giving up some of your lost wage benefits.
If you believe your doctor has cleared you to return to work too early, you have some options, including a one-time change in the doctor handling your case.
Can I be fired for getting injured?
Florida law, like with many other states, prohibits employers from firing or otherwise retaliating against employees for filing a workers’ compensation claim. However, this only protects you from retaliation for filing a workers’ compensation claim–you may still be let go if you’re physically unable to perform your job duties.
If you believe you have been illegally discriminated against, you may have legal options to fight back. Working with a workers’ compensation lawyer can help you fully protect your rights.
Do I need a lawyer?
While you can technically file a worker’s compensation claim yourself, having an experienced workers’ compensation attorney on your side can significantly increase your chances of success. An attorney can:
- Help you navigate the complexities of the legal system
- Gather evidence to support your claim
- Negotiate with the insurance carrier for a fair settlement
- Represent you at hearings and appeals
- Ensure you receive all the benefits you deserve
Werner, Hoffman, Greig & Garcia Can Help
Navigating the complexities of the workers’ compensation process can be daunting. When you’re recovering from a life-altering injury, the last things you want to deal with are uncooperative insurance companies and government offices.
The experienced workers’ compensation attorneys at Werner, Hoffman, Greig & Garcia are here to help. We understand the intricacies of workers’ compensation law and we have a proven track record of securing compensation for our clients.
To learn more about how we can help or to schedule a free case evaluation, please contact us online or at (800) 320-HELP.
