Workers' Compensation Overview

In the workers' compensation process, there are some details that must be included. The location and description of the at-work accident or injury are necessary to proving that an employee is covered under Florida's workers' compensation laws. Additionally, the employee's personal background may be required to prove that benefits are necessary and deserved. If your employer is hesitant to proceed with filing a workers' compensation claim, you need to know your options before it's too late. The Coye Law Firm's experienced and thorough workers' compensation lawyers can help you in any process of the claim. Call us before it is too late to pursue the benefits you're entitled to under the law.

Useful links about Workers Compensation 
 

Jurisdiction

The Florida work comp laws apply to injuries in two cases. If the primary location for employment is in Florida or if the contract for employment was entered into in Florida, then the injured worker has protection under the law. Many other criteria determine if a case is valid, but if an injury occurs in these two situations, then it is in a covered jurisdiction. For example, if you are driving to another state from Florida for a conference on company time and get injured in a car accident, you may have a workers' compensation claim even if the accident happened outside of the state. Additionally, your employer does not need to be located in Florida in order to be covered under the Florida workers' compensation law. If you work for a company that is located in a different state but live in Florida, you may also be covered. 
 

Report & Description of the Accident

A vital part of the workers' compensation claim process is reporting the injury correctly. If injured at work, the employee must report the injury to a supervisor by either giving written or verbal notice within 30 days. If this deadline is missed, the employee's case may be denied. Injuries that occur as the result of misbehavior or extreme deviation from normal duties are generally not covered by workers' compensation. 

The employer is responsible for filling out the First Report of Injury or Illness form with the employee, filing it with the Florida Division of Financial Services, and giving a copy to the employee. The Wage Statement formshould be filed at the same time or as soon as possible. If an employer doesn't file this paperwork, it can result in interest, fees, and penalties. Even if the injury is thought to be caused by something other than work, the employer needs to complete the forms. 

The description of the accident includes:
  • where it occurred
  • the employer or company's name
  • the date of the accident
  • injuries sustained
This can include injuries resulting from repeated trauma. For example, a truck loader may be able to claim workers' compensation benefits if years of heavy lifting creates a spinal injury. In any case, causation needs to be shown for an injury.
 

Employee Profile

Typically, the settlement of a workers' compensation claim has details on the employee's age, educational background, and work history. Date of birth and a brief description of their skills as it relates to their job are included. These details help to bolster the employee's case by proving they are competent at their jobs. Additionally, it provides a statement about their position at the time of the injury. This information appears at the beginning of the settlement to help prove that the employee is entitled to benefits.
 

Determining the Average Weekly Wage Rate

In order to determine the amount of compensation an employee is owed as a result of being injured and out of work, the average weekly wage rate must be calculated. The Florida Workers' Compensation Act contains a formula for determining this. If the employee worked substantially (75% or more of their normal hours) during the 13 weeks prior the incident, then their average weekly wage is found by adding up the wages of the 91 days immediately preceding the event (excluding the day of the injury) and dividing it by 13. The formula is essentially:

Previous 13 weeks earnings / 13 = average weekly wage

The wage used to find this average is the employee's gross earnings, which means that deductions don't affect the outcome. Raises received in the 13 week period may be applied, but only if they predate the injury. Seasonal workers and workers who have two jobs present challenges to this formula, so referencing the state statute on the determination of pay is the best way to find your specific circumstance. 

Employees can receive between 66 2/3% and 80% of their lost wages in a workers' compensation claim. Some circumstances may change the average weekly wage
 

Medical Care

Injured workers are entitled to medical benefits in addition to financial benefits. Medical opinions need to be given by an authorized treating physician according to the law. In order for treatment to be covered, it needs to be medically necessary, a widely acceptable practice, based on scientific criteria, safe, and non-experimental. Prostheses are covered under the law, as well as up to 24 chiropractic visits within 12 weeks. Except for emergency care, all treatment needs to be authorized by the employer's insurance carrier. However, they have three days to respond when treatment is requested. Any and all communication or paperwork is vital to keep track of in the worker's compensation process to preserve your claim. 

Even if you are healthy enough to return back to work, the medical recovery process may not be over. Employers are often required to provide an injured employee with continuing medical treatment until they reach "maximum medical improvement." This is when no further recovery from an injury or disease is anticipated. If this date is reached and the employee is still suffering from the injury or disease, they may be entitled to a benefit settlement. 

Some employers insurance carriers may prefer to set up a managed care system to deal with injuries that take time to heal. This is basically a written agreement between the insurance company and health care provider to provide appropriate care. 
 

Attorneys Fees

In the course of your workers' compensation claim, attorneys fees are determined by many criteria. Attorneys fees may be paid by insurance companies, employers, and other agencies. The amount and sources of these wages are best computed by an experienced workers' compensation attorney and their staff. 
 

Use of Settlement & Waiver of Claims

When a workers' compensation claim is settled, there is an agreement between the parties involved that requires their approval and signatures. Within this document, there is a section used to describe the way the employee plans to use a lump-sum settlement, if the agreement requests one. A lump-sum payment can be requested if the employee wants to handle their own medical care and payment of attorneys fees. It is important to consult with an attorney before deciding on your own course of action in a workers compensation claim because your needs may be fulfilled in a specific type of arrangement. 

In the general release of a workers' compensation claim, it may be explicitly stated that by accepting and signing the document, the injured employee can not claim the employer has violated a number of laws relating to the injury. Additionally, there may be a statement saying the employee cannot sue based on these laws. The legal repercussions of a general release are complicated and stringent. These kinds of claims are discussed much more in depth here. It is important to know what benefits you will receive and what you are responsible for by settling your claim. Speak with the Coye Law Firm today to understand this document and how it can resolve your case. 

The entire process for a workers' compensation claim can seem overwhelming at first glance. With the help of an experienced workers' compensation attorney and department, you can claim the benefits needed to recuperate from an injury or illness suffered at work. Call the Coye Law Firm today.