What Should I Do When My Employer Refuses to Pay Injury Benefits?
Employers or their insurance carriers may resist covering an employee's on-the-job injury. If they refuse or are slow to pay benefits for a qualified injury, then the employee or their attorney must file paperwork to formally request the funds. This paperwork is called a Petition for Benefits or a PFB. The petition can request many things, including:
- Medical care
- Lost wages
- Reimbursement of travel costs for medical care
- Recognition that the employee should be covered by workers' compensation insurance
Basic Information To Include On a Petition for Benefits formThe PFB is an official document and relates directly to a workers' compensation case, therefore it must include some basic information regarding the on the job accident. The name, address, and phone number of the employee, employer, and insurance company are listed at the top of the form. The date and location of the accident are also listed prominently.
Below this basic information is a spot for the attorney(s) to list their contact information and Bar numbers. These details help to ensure that the attorneys are qualified to represent an injured employee or their employer.
Accident details are listed in the center of the page. Required fields include:
- Job description
- Description of accident
- Parts of body injured
- Description of work during accident
- Treating doctor
- Medical improvement status
Legal Aspects of a Petition for BenefitsAfter basic information, the next two pages of the PFB have a lot of legal details, such as impairment ratings and compensation rates. These details are determined by medical and legal professionals and governed by state statutes. Additionally, the injured employee must sign a statement saying that their claim is not fraudulent. Filing a false insurance claim is a third-degree felony.
Filing a Petition for Benefits in Florida
PFBs are filed with the Office of the Judges of Compensation Claims at the Department of Administrative Hearings. The main office is in Tallahassee, but the Orlando district has its own judges and office.
The Florida workers' compensation system requires both parties to attempt a compromise prior to going to court: either through mediation or standard negotiations. Mediation gives the employer, their insurance carrier, and the injured employee the opportunity to meet and resolve the disputed aspects of a case before going to trial. If the dispute is settled prior to mediation, then the meeting can be canceled. Because of the unfortunately high number of workers' compensation claims in Florida, the courts want those involved to work towards a resolution before going to court.