What To Expect From The Florida Workers’ Compensation System

workers compThe Florida Workers’ Compensation Law (Chapter 440) was initially created to provide certain monetary and medical benefits to injured workers efficiently, and without delay. However,  the workers’ compensation system as it presently exists is extremely complicated. Sweeping legislative changes made over the past twenty-five years  have greatly limited benefits available to injured workers, made it more difficult to prove claims, and given employers and insurance companies tremendous  control over medical treatment available to victims of on the job accidents.   Any objective analysis of the law leads to the inescapable conclusion that despite its stated goals, the law currently seeks to advance the interests of industry to the detriment of those most responsible for its success : Florida’s work force. As a result, without legal representation, injured employees may not receive the benefits they need.

 

 

What to Do If You Are Injured On The Job

Phone-CallsIf you believe you have been injured while working in any way, you should immediately report your accident to your employer personally and request medical care. You should complete a “Notice of Injury” report and obtain a copy of it.  You should  report your accident to your employer’s workers’ compensation carrier directly, as well. Remember that you only have 30 days from the date of your accident, to report it to your employer. If your employer delays or resists  your attempts to secure medical care you should contact Leo, right away.

 

Injured workers often hesitate to report their accidents for fear of retaliation from their employers. This is understandable. While the law specifically forbids the firing of an injured employee because he or she has filed a workers’ compensation claim, Florida is an “employment at will” state. All too frequently, employers begin attempts to discharge employees for alleged (and often contrived) job performance based issues, once they are injured. Please remember that even if you are fired from your job, you still have the right to compensation and medical care for your on the job injuries. If you believe you have been fired from your job because of filing a workers’ compensation claim, you should contact Leo for guidance.

 

Work related accidents can take many forms. While the most common involve falls, injuries sustained while attempting to lift or  move objects, etc., other work related injuries are more difficult to identify and can occur gradually, over time. Occupational illnesses and repetitive motion injuries secondary to repeated trauma such as repetitive clerical  or data entry duties, repeated lifting, twisting, bending, stooping, squatting, etc., can also be covered by the Florida Workers’ Compensation Law. Injured workers who develop mental ailments due to chronic pain caused by job related job physical injuries are eligible for treatment in the form of psychotherapy, counseling, testing, psychotropic medications, and the like.

 

Please bear in mind that the workers’ compensation statute was designed to  be essentially a “no fault” law. Absent extraordinary circumstances, injured workers cannot recover damages for negligence, pain, suffering, loss of enjoyment of life, etc., from their employers; they are limited to receiving benefits available under the Florida Workers’ Compensation Law. However, if your accident was caused by a third party (as a result of a work related vehicular accident, for example), you should immediately contact Leo, as you may be able to pursue a civil action for monetary damages against the third party.

 

 Leo handles cases involving work related injuries, such as :

work injury Back injuries, Brain injuries,

  Broken bones, Burns, Carpal tunnel,

 Cartilage injuries, Chronic pain syndrome,

  Eye injuries, Heavy lifting injuries, 

 Ligament injuries, Mental or psychological injuries,

  Neck injuries,  Occupational diseases or exposure injuries,

 Post surgical complications or residuals,

  Repetitive stress or trauma injuries, etc.

 

 

 

 

Your Rights

Medical Care

workers' comp tampaYou are entitled to medically reasonable and necessary treatment which is causally related to the injuries suffered in your accident. This means the workers’ compensation insurance company or carrier must cover all medical care you need as a result of your accident, whether it be in the form of office visits, diagnostic studies, physical therapy, surgery, etc.

 

Typically, your employer has the right to choose your initial medical provider. Should you become dissatified with your initial doctor, you do have the right to request a change of treating physician. However, you should be very careful about when to exercise this right, as you can only request a change in doctor once during the pendency of your claim. Moreover, as your employer and its workers’ compensation carrier also have the right to choose your “new” treating doctor, you should consult with Leo before taking this important step.

 

You also have the right to an independent medical examination (IME) by a physician of your choice. Again, you should consult wth Leo regarding not only when to  request an IME, but what type of specialist to consider for purposes of an IME, as well.

 

One issue injured workers frequently have to contend with involve “pre-existing conditions”. As the law indicates that medical evidence must show the industrial accident is “the major contributing cause” of the work related injury, insurance companies often seek to deny claims if the injured worker has suffered accidents, injuries, or illnesses, in the past. For that reason it is vitally important you disclose any and all past health issues completely no matter how minor you may believe them to be, when seeing a workers’ compensation  doctor for treatment of your on the job injuries. If you fail to provide an accurate medical history, the insurance company will almost certainly deny your right to medical care  on the grounds you have “misrepresented” your past medical history in an an effort to fradulently secure workers’ compensation benefits. If your right to medical care is denied by the insurance company, you should immediately contact Leo for assistance.

 

Compensation

 

workers-compensation-coverageCompensation is not allowed for the first 7 days of disability caused by an on the job injury. However, if the injury results in disability of more than 21 days, compensation is  paid at the rate of 66.7  percent of your pre-injury average weekly wage. Once you reach “maximum medical improvement” or “M.M.I.”, your eligibility for temporary benefits ends, and your eligibility for permanent benefits, begins.

 

 

 

 

 

There are different classifications of compensation benefits available to injured workers :

 

          TEMPORARY TOTAL DISABILITY BENEFITS

 

These are benefits which are payable while you’re on “no work” or “T.T.D.” status, at the rate mentioned above. There must be objective medical evidence to document your disability. Therefore, it is very important that you keep all your doctors’ appointments; failure to complete prescribed treatment can prolong your disability and result in termination of your compensation benefits.

 

          TEMPORARY PARTIAL DISABILITY BENEFITS

 

These are benefits which may be payable when you have been released to work with limitations or restrictions, but have yet to reach a point of “maximum medical improvement (M.M.I.)”.  Temporary partial disability benefits or “T.P.D.” is payable at a rate equal to 80 percent of the difference between 80 percent of your average weekly wage and the salary you’re able to earn, post injury. However, weekly T.P.D. benefits may not exceed an amount equal to 66 and 2/3 or 66.7 per cent of your average weekly wage, at the time of your accident.

 

Injured workers are eligible for a maximum of 260 weeks  of temporary benefits.

 

          IMPAIRMENT BENEFITS

 

Impairment benefits ( “I.B.’s”) are payable once your authorized doctor(s) state you have reached a point of maximum medical improvement, and assign you a permanent impairment rating (P.I.R.)  to the body as a whole. M.M.I. does not mean that you are “cured”, or have recovered from your work related injuries, 100 percent. Rather, M.M.I. signifies the point after which your authorized treating doctor(s) don’t believe your condition can be expected to improve.

 

Injured employees are often released from care once they attain M.M.I. However, your right to authorized medical treatment for your work related injuries continues, even after being placed at maximum medical improvement. To keep your right to medical care for your work related injuries alive, you must be treated by a doctor authorized by your insurance company within one (1) year from the date you were last seen by an authorized doctor. If you fail to do so, your right to further medical care at the expense of your insurance company will forever  terminate by legal operation of the statute of limitations. For that reason you should insist on receiving medical treatment for your work related injuries, at least every six (6) months. If you call your insurance adjuster for permission to see your authorized doctor(s) and do not receive prompt attention, call Leo for immediate assistance. Unfortunately, some insurance adjusters will intentionally ignore or  delay your request, in the hopes that the statute of limitations will run against your case.

 

Impairment benefits are paid bi-weekly at the rate of 75 percent of your average weekly temporary total disability benefit rate; however IB’s shall be reduced by 50 percent for each week in which you earn income equal to or in excess of, your pre-injury average weekly wage.

 

You are entitled to impairment befits for the following time periods :

 

1.Two (2) weeks for each percentage point of impairment from 1 percent up to and including 10 percent.

 

  1. Three (3) weeks for  each percentage point of impairment from 11 percent up to and including 15 percent.

 

  1. Four  (4) weeks for each percentage point from 16 per cent up to and including 20 percent.

 

  1. Six (6) weeks  for each percentage point of impairment from 21 percent and higher.

 

          PERMANENT TOTAL DISABILITY BENEFITS

 

If you suffer catastrophic work related injuries or can prove you are physically incapable of engaging in at least sedentary employment within a 50 mile radius of your residence, you are eligible for Permanent Total Disability (P.T.D.) benefits. Permanent Total Disability benefits are paid at the rate of 66.7 percent of your average weekly wage. Your eligibility for P.T.D. ends when you reach the age of 75.

 

The Statue  Of Limitations

 

Like many aspects of the Florida Workers’ Compensation Law, application of the statute of limitations can be confusing.

 

Injured workers have two (2) years from the date of accident to file a workers’ compensation lawsuit, or “petition for benefits”, against their employer and workers’ compensation carrier. Once more than two years from the date of accident has elapsed, injured workers must file a petition for benefits within one (1) year from the date they last received monetary benefits from the carrier, or within one (1) year from the date they were last furnished medical treatment authorized by the carrier. Failure to adhere to these time constraints will result in your right to monetary or medical benefits for your on the job injuries being FOREVER BARRED by legal operation of the statute of limitations.

 

It is YOUR responsibility to seek authorized medical care or file a petition for benefits, on a timely basis. Your  insurance adjuster will certainly not assist you by reminding you to do so, as it is in the workers’ compensation carrier’s best interests for you to allow the statute of limitations to run against your case.

 

Protect your rights! If you have any questions or concerns about a potential workers’ compensation claim, contact Leo IMMEDIATELY at 1 (855) LDGOMEZ  for a free consultation, which can take place at his office, your home, or any other location which is convenient for you. Leo is always ready to provide you with prompt answers to your questions, aggressive representation, and will personally handle your case to its conclusion. And remember : workers’ compensation cases are handled on a contingency basis. You pay no fees or costs unless Leo successfully obtains  benefits  on your behalf.

 

 

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EMAIL : info@leodgomezlaw.com