At Kogan & DiSalvo, we understand the long-ranging consequences of a serious work injury. Our Delray Beach workers’ compensation lawyers have the specialized experience to secure the benefits to which you are entitled.
If you need trusted legal guidance about the best steps moving forward, we invite you to reach out for a confidential case review. We have handled many cases in which employers or insurance companies denied employees their workers’ compensation benefits. We offer a free consultation so that you can find out if your case is valid, and there are no upfront fees to worry about.
What is Workers’ Compensation in Florida?
Florida laws on workers’ compensation are outlined in Sections 440.01–440.60. These statutes are in place to ensure that employees who are injured or develop an illness on the job have access to medical and wage replacement benefits.
If your employer has 4 or more part or full-time employees, then they are required to carry workers’ compensation coverage. If your employer is in the construction industry, this workers’ comp coverage is mandatory regardless of hired employees. Agricultural employers with 6+ full-time employees or 12+ seasonal employees who work more than 30 days must also carry workers’ compensation coverage.
Unlike a personal injury lawsuit that hinges on proving negligence, workers’ compensation insurance in Florida is a no-fault system. If you are hurt or develop a disease within the scope of your employment, you can file a workers’ compensation claim to cover medical bills and lost income stemming from your injury.
Workers’ Compensation Restrictions
In order to qualify for workers’ comp benefits, the injury must occur in the scope and course of employment. You may be barred from filing a claim under the following situations:
- The workplace injury was self-inflicted
- You were intoxicated or taking drugs
- You ignored safety rules and protocols
What Should I Do After a Work Injury in Delray Beach?
If you have an accident or are hurt on the job, take the following steps. A failure to do so may negatively affect your worker’s compensation claim:
- Tell Your Employer – Report your work injury as soon as possible. Any job-related injury must be reported within 30 days of the accident, or within 30 days of a medical professional determining you sustained a job-related injury or illness.
- Complete a Report of Injury or Illness – that is provided by your employer.
- Seek Medical Attention – if your injuries are serious and your employer is not available to suggest a medical provider for urgent treatment, go to your nearest ER and inform your employer about what happened as soon as possible.
- Follow Medical Treatment Plans – Attend all doctor appointments and follow their medical treatment plan without fail. This is important for establishing any future settlement for your workplace injury.
- Don’t Offer Official Statements – without consulting with a Delray Beach work injury lawyer first. Your attorney can help you avoid common pitfalls and handle necessary communications with insurance companies.
- Understand Your Basic Rights – Many workers fear retaliation from their employer after reporting an accident. The law is on your side and forbids employers from threatening, intimidating, or firing employees based on a worker’s compensation claim.
Florida Workers’ Compensation Benefits
The following benefits are available through the Florida workers’ compensation system. You should receive your first payment within 21 days of reporting your workplace accident, and the benefits are not subject to state or federal taxes.
- Medical Benefits: Worker’s comp pays for all medically necessary care to treat your workplace injuries. This includes doctor’s appointments, diagnostic tests, prescription medications, hospitalization, prostheses, and attendant care, as well as mileage reimbursement for transportation to and from your medical appointments.
- Wage Loss Benefits: If you are unable to work for more than 7 days, you will receive weekly benefits to replace a portion of your lost wages.
- Temporary Partial Disability: If you are unable to earn the same income you did at the time you were injured you may qualify for partial disability benefits.
- Temporary Total Disability: If you are unable to work in any capacity, benefits of 66 – 80 % of your regular wages are paid, but subject to a maximum reimbursement.
- Impairment Benefits: Once your doctor confirms you have reached Maximum Medical Improvement (MMI), you will be evaluated for a permanent impairment rating.
What Are Some Common Reasons for Benefit Denials?
Did your employer deny you workers’ compensation benefits? If you were hurt on the job or became sick, speak to a work injury attorney in Delray Beach about your rights.
Generally, benefits can be denied for one of several reasons. The company’s chosen workers’ compensation physician may report that the injury could not have happened at work, the injury is not as severe as the employee believes, the injury was preexisting, or the employee did not see a doctor promptly. A physician’s negative opinion can lead to denied benefits.
Indeed, Florida’s workers’ compensation law requires that the injury occurs in the course of employment, whether at the employer’s building or in transit to and from work away from the employer’s premises. A worker who is in a traffic collision during a lunch break would not qualify.
Employees hurt while engaging in horseplay on the job can also be denied for misbehaving if the activity had nothing to do with their jobs. Employees who are injured while under the influence of alcohol or drugs while at work are not covered either.
Moreover, violating the procedure for claiming benefits could result in forfeiting benefits. For example, an employee who did not report their injury to the company or a supervisor—or when indications of illness first began within a specified amount of time—can be denied compensation. In Delray Beach, this period is 30 days. A person should contact Delray Beach workers’ compensation lawyer to gain a better perspective on the common reasons for benefit denials. Such information could be potentially used to build a strong civil case.
How Do I Appeal a Denied Workers’ Compensation Claim?
Employees can take legal action to attempt to reinstate their benefits, and may even attempt to handle it themselves without the benefit of legal counsel. However, this can place them at a disadvantage unless they have a thorough knowledge of the entire legal process involved.
To begin, an employee must file a worker’s compensation claim with the Florida Division of Workers’ Compensation within 30 days of the relevant incident in accordance with the law. If the claim is denied, the employee may enter mediation with the Florida Division of Workers’ Compensation in an attempt to resolve the issue. If mediation is not successful, the employee may file a Petition for Benefits that formally requests benefits be paid.
Next, a judge in the Office of the Judges of Compensation Claims will review the petition and decide whether or not to allow benefits or to dismiss the petition or any part of it. An employee’s last resort is to appeal to the First District Court of Appeals in Florida.
Speak with Delray Beach workers’ compensation lawyers to learn more about reinstating benefits.
Contact Kogan & DiSalvo’s Workers’ Comp Attorneys Today
When you are represented by a Delray Beach personal injury lawyer who is well-versed in Florida’s workers’ compensation law, you stand a better chance at winning the compensation you deserve.
The dedicated attorneys at Kogan & DiSalvo know the system well and handle all aspects of worker’s compensation claims and denials. Our legal team also represents injured workers throughout the petition process if necessary. Do not hesitate to call today and get started on your case.