Important Facts About Workers' Compensation

If you have been injured on the job, you may be entitled to valuable medical and wage loss benefits. Exactly what benefits you are due varies greatly from state to state. The workers’ compensation “system” is a matter of state law, created by the state legislators. The rules of one state have absolutely no bearing on the rules of another. This article will help you determine which state rules apply and provide a brief overview of Florida’s benefits and requirements.

Which state rules apply?

The most common answer, and the simplest one, is to apply the law of the state where the accident occurred. If you were outside of Florida at the time of the injury, you may still be able to receive Florida benefits if the business operates in Florida and you were hired within the state. It is best to consult with an attorney to determine which state system will apply.

What are the Florida rules?

Florida’s workers’ compensation laws require that the employer authorize a physician to evaluate and treat an injured worker. The insurance carrier must then provide any medical benefits, including surgery, diagnostics, and specialist referrals, that the authorized workers’ compensation doctors say is medically necessary and at more than 51% related to the on-the-job injury.

Wage loss benefits essentially entitle an injured worker to 2/3 of his or her average weekly wage for the period of time in which the authorized physician has assigned work restrictions of “no work”, or light duty work restrictions which the employer cannot accommodate. There are also long-term permanent total disability benefits for workers who are unable to return to any work after recovering from their injury, as well as payments for any permanent impairment rating assigned by an authorized doctor.

Requirements to receive worker’s comp benefits

Florida’s workers’ compensation laws have several important requirements in order to receive benefits:

Be honest on employment applications– Many applications and post-hire medical questionnaires ask about prior injuries, current problems, and physical restrictions. While you may feel pressure to provide a “clean bill of health” in order to secure a job, failing to accurately disclose injuries and limitations relative to the job duties can be grounds for the complete denial of a claim in the event you are later injured. Disclose all conditions, injuries and limitations in writing in order to avoid this common technique used by insurance companies to deny your claim—don’t rely on the employer admitting that they were aware of your pre-existing condition.

Notify your employer – Florida law requires that you provide notice to a supervisor within 30 days of an accident, injury, or the manifestation of an injury. Notice does not have to be in writing or use “magic words,” but you must report the injury within 30 days or you may lose all access to benefits.

Inform your physicians of prior injuries or treatment– Whether you are sent to the emergency room, a walk-in clinic, or a specialist, notify all physicians of your medical history including prior injuries or treatment to the body parts hurt in the work accident. Pre-existing conditions are NOT grounds for automatically denying your workers’ compensation claim, but providing an inaccurate medical history CAN be grounds for a denial. List all prior treatment (even if it was a long time ago, or was very minor compared to your current injury) on the initial intake paperwork for each physician you see.

The Florida workers’ compensation system provides significant lifetime benefits, but there are also many common pitfalls. Do not let the workers’ compensation insurance adjuster have all the leverage in deciding your medical treatment and dictating your settlement offer. Contact our experienced workers’ compensation attorneys at Michles & Booth for a free consultation today.