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Workers’ compensation is a form of insurance with many rules and formulas that can be daunting to anyone except those immersed in it. Oftentimes, those injured on the job face uncertain financial futures and significant medical costs.
If an issue arises in claiming workers’ compensation benefits, discuss it with our workers’ compensation lawyers at a free, no-obligation consultation. An adept and determined Boca Raton workers’ comp lawyer can assess the situation and explain the process and the rules involved. Attorney fees are not charged unless the lawyer wins the case.
Florida law requires all employers with four or more employees or at least 12 seasonal workers employed for 30 or more days to provide workers’ compensation coverage. Contract workers are not provided workers’ compensation coverage.
Benefits include payments for a percentage of lost earnings and medical care for the job-related injury. For example, strokes and heart attacks are covered if they were pre-existing conditions exacerbated by physical efforts from activity that was not usual to the employee’s type of work.
Employees do not need to prove that the employer was at fault in causing injury or illness, nor does it matter if the employee was at fault for getting hurt or sick.
Workers’ compensation is often referred to as “no-fault” insurance. As the name implies, it will pay regardless of who is at fault, including the injured party. For example, while an insurance company will want to investigate whether the injury was received while at work or performing work duties, it is inconsequential whether the injured party accidentally caused their injury.
Some of the most common causes of injuries in the workplace include:
Some of the most common workplace injuries include:
If an employee accepts a workers’ compensation settlement, they are not permitted to sue their employer for negligence it covers their liability. However, this does not exonerate third parties from liability if they contributed to the injury. Some common examples include:
At Kogan & DiSalvo, our Boca Raton personal injury lawyers can advise on any elements of third-party negligence that may be present in your workers’ compensation case and file a separate negligence claim.
In Florida, workers’ compensation disability benefits can meet several different needs–partial or total, temporary or permanent, and they include:
Temporary total disability benefits are paid at two-thirds of the average weekly wage of the temporarily disabled worker and are capped at a maximum established by year. For example, the maximum weekly payout is $1,099 for injuries in 2022, $1,011 for injuries in 2021, and $971 for injuries in 2020. However, serious injuries, such as paralysis or blindness, will receive a higher benefit rate of 80% of the injured workers’ average pre-injury wages with no cap.
Temporary total disability will continue until:
Temporary partial disability benefits can be received if an injured worker has not yet reached maximum medical improvement–but the doctor has indicated that the worker can return to work with some restrictions. If the worker earns less under these restrictions, they will receive 80% of the difference between the current and pre-injury earnings.
Although Florida law states that temporarily disabled workers can only receive benefits for up to two years, Florida’s state supreme court found that they can go for as long as 260 weeks if the injured worker has not met maximum medical improvement. Once temporary benefits are near their end, permanent impairment benefits or permanent total disability benefits will be determined.
A permanent impairment is when a worker will be able to work but has some level of disability that will not improve. To determine these benefits, the treating doctor will evaluate the worker to diagnose whether there are continuing medical conditions or impairments resulting from the injury. After assessing a worker’s impairment rating, it will be used to calculate the “scheduled loss of use” to determine how long permanent impairment benefits will last. This impairment income calculation can be done on the Impairment Income Benefit Calculator from Florida’s Division of Workers’ Compensation.
Employees must report the injury or illness to their supervisor or employer within 30 days from the time it happened, and the employer is allowed seven days to report the issue to the insurance carrier.
Missing the reporting deadline can make the employee ineligible to receive workers’ compensation benefits or delay the claim’s processing and the employee can be fined from $100 to $500. A Boca Raton Workers’ compensation lawyer can help individuals file their claim within the alotted period of time.
Employees must see a physician chosen by the employer as soon as possible. Mileage to the doctor’s office may be expensed. Under Florida law the employee can change doctors, but only once.
The employee is required to file a claim with the Florida Division of Workers’ Compensation at the earliest time possible. However, an employee has up to two years to do so under law. Failing to act in time risks losing benefits.
The claim requires when information pertaining to when and where the incident occurred, the names of any witnesses, and what caused the injury or illness. A Boca Raton Workers’ compensation lawyer can help the injured party fill in the necessary information.
The insurance carrier can deny a claim by alleging that the employee’s injury is from a pre-existing condition, the injury did not happen at work, or the employee is attempting fraud.
A worker is entitled to a hearing before a board of appeals if the claim is denied, benefits issues are unsatisfactory if the employee wants a second medical opinion because the insurance carrier’s doctors incorrectly released an employee to work, or even if an injury occurred.
The dispute may also be settled through mediation, which is a flexible and informal procedure presided over by a neutral mediator that is allowed more alternatives, such as modifying work assignments.
Employees are entitled to represent themselves without any legal representation. However, they are certain to be at a disadvantage because of unfamiliarity with the procedures and because the insurance carrier will have an experienced attorney representing the opposition.
Hire experienced Boca Raton workers’ compensation lawyers that can present evidence, challenge medical opinions, and use other strategies that could help you recover the benefits you deserve. If you have been injured while at work, consult a compassionate attorney that can advocate for you.
If you are injured and unable to come to us,
our attorney will come to you - there is no charge for us to do so.