Lakeland Workers’ Compensation Attorney

When you’re injured on the job in Polk County, your employer-sponsored health insurance does not pay for your medical care or physical therapy. Instead, job-related injuries fall under the workers’ compensation program.

It’s important to note that before you seek treatment from a healthcare provider, you must see a doctor that is approved by your employer’s insurer. Your employer’s insurance company should pay for your medical treatment and provide you with temporary or permanent disability payments.

The workers’ comp program is designed to be a win-win for employers and injured workers. By providing these benefits, employers protect themselves from personal injury lawsuits filed by injured employees. Workers receive medical treatment for their injuries and wage compensation during their recuperation.

However, workers’ compensation does not always work well for injured parties. Often, a mistake on the paperwork and/or not submitting proper medical evidence will cause your claim to be denied.

A Lakeland workers’ compensation lawyer at Kogan & DiSalvo will help you file a workers’ compensation claim or appeal the denial of a claim.

The Role of a Lakeland Workers’ Compensation Lawyer

Workers’ compensation laws are complicated. If you suffer a minor injury in the workplace and your employer’s insurer accepts your claim, you are not likely to need legal representation. However, if you were denied benefits or have had other complications with your claim, you need a lawyer’s expertise. 

There are situations in which an employer may legitimately deny a workers’ compensation claim. For instance,

• if the employee was injured while under the influence of drugs or alcohol,
• if the injury occurred during a fight or was self-inflicted,
• or if the injury happened while you were on your way to or from work or during your lunch break

then you may be denied workers’ compensation. However, there are other situations in which employers, or their insurers, will attempt to deny a claim in which case, you may be able to fight back.

For example, they may allege your injury resulted from a pre-existing condition, which does not fall under workers’ comp coverage. If no one witnessed your accident and there is no surveillance video, the insurance company may claim you were making up the time and place of the injury.

Keep in mind that insurance companies will go to great lengths to avoid paying claims.

Understanding Workers’ Compensation in Florida

In Florida, most businesses with at least four employees must carry workers’ comp insurance. For construction companies, workers’ comp coverage is necessary for any business with at least one employee. Employers in the agricultural industry must obtain workers’ comp if they have six employees. If there are a minimum of 12 temporary workers during a season who work more than 30 days but less than 45 days in a calendar year.

When a worker is injured while on the job, they must notify their employer as soon as possible. If the employer does not receive notification within 30 days of the incident, the worker is at risk of losing the ability to recover compensation.

In an emergency, workers can go to the nearest hospital for care. If conscious, tell the hospital personnel you were injured while on the job. Otherwise, you must visit a doctor provided by the employer’s insurer. If you do not like that doctor, under workers’ comp regulations you are permitted one change of physician. 

Wage replacement benefits begin on the eighth day of your disability.

Common Injuries Sustained in the Workplace

Common workplace injuries include:

• Back or neck injuries
• Burns
• Broken bones
• Falls
• Head injury
• Lacerations
• Repetitive motion injuries
• Spinal cord injuries

Certain job-related illnesses may also qualify you for workers’ compensation benefits. These occupational diseases relate to the nature of employment. For instance, workers in certain jobs may develop lung conditions due to exposure to toxins or other harmful substances.

Benefits and Compensation

In Florida, the weekly compensation rate for injured workers is equal to 100% of the statewide average weekly wage. The Florida Department of Economic Opportunity determines the average weekly wage for the four calendar quarters ending each June 30. For instance, the maximum weekly compensation rate for work-related injuries and illnesses occurring on or after January 1, 2024, is $1,260.

Have questions about the benefits and compensation you can receive for your work injuries? Contact a Lakeland workers’ compensation lawyer at Kogan & DiSalvo and get all the information you need.

Temporary disability benefits

Temporary Total Disability (TTD) benefits should provide you with 66.66% of your wages as of the time of your injury, subject to the Florida maximum. TTD benefits are available for up to 104 weeks.

Temporary Partial Disability (TPD) benefits are paid when the doctor clears you to go back to work but on a restricted basis. If you cannot earn up to 80% of the wages you earned prior to your injury, you may prove eligible to receive TPD benefits. Again, these benefits are available for up to 104 weeks.

Permanent disability benefits

If your injuries are so serious that you can never work again, you may receive Permanent Total Disability (PTD) benefits. If you have reached Maximum Medical Improvement (MMI), your doctor has determined that your condition is not expected to improve. At that point, you are then evaluated for an impairment rating.

As long as your permanent impairment rating is above zero, you should prove eligible for PTD based on your rating.

Medical benefits

Workers’ comp medical benefits include:

• Emergency room visits
• Hospitalization
• Doctor’s appointments
• Physical therapy
• Prescription medications 
• Medical tests
• Medical equipment
• Mileage reimbursement for travel to and from the authorized doctor or pharmacy.

Much will depend on the individual employer’s plan and what it does and does not cover. Note that you must attend all scheduled appointments and follow the doctor’s treatment plan to the letter. Failure to do so will jeopardize your medical benefits.

Vocational rehabilitation

Workers’ comp insurance provides vocational rehabilitation benefits for those who can no longer perform the type of work they did prior to their injury. Many of these programs provide up to two years of training in new skills as well as certifications so that you can find new employment.

Death benefits

Workers’ comp death benefits are available to surviving family members if the death results from an accident within one year or follows continuous disability from an accident for up to five years. The benefits include:

• Funeral expenses up to $7,500.
• A surviving spouse without children: 50% of the average weekly wage.
• A surviving spouse with children: 50% of the average weekly wage for the spouse and 16.66% for the child or children.
• Surviving children but no spouse: 33.3% of the average weekly wage for each child. The eligibility of the child, unless physically or mentally incapacitated, ends once they reach the age of 18. For those enrolled in full-time school, eligibility ceases at age 22.

Total compensation cannot exceed $150,000. The surviving spouse may also receive education benefits.

What to Do If Your Workers Comp Claim is Denied

A denial of your workers’ comp claim must be sent within 120 days of the injury report date. If your workers’ comp claim is denied, you have the right to file an appeal. This is not something you should attempt to do on your own. It is wise to hire a Polk County workers compensation attorney. You must file the Petition for Benefits within two years of your injury.

• Your appeal is presented in front of an administrative judge. At this time, you can include additional relevant evidence. If the judge approves your appeal, you may receive benefits. Even if the appeal is denied, you have other avenues to explore.

• Within 130 days of filing the petition, you may have a mediation meeting with all parties. If no agreement results from mediation, the next step is a pre-trial hearing. This hearing defines the issues, and more evidence is exchanged between parties.

• The judge delivers their decision at a final hearing, held no later than 210 days after the filing of the petition. If your appeal is denied again, you can file a Notice of Appeal with the First District Court of Appeals within 30 days.  

How Kogan & DiSalvo Can Help You

If you or someone you know was injured while on the job and has a workers’ compensation claim, contact a Lakeland personal injury lawyer at Kogan & DiSalvo today and schedule a free, no-obligation consultation.

Florida law is strict regarding legal fees when it comes to workers’ compensation cases, so you will pay no fee unless you receive compensation.