What Does Florida Workers’ Compensation Insurance Cover?

July 30, 2022
What Does Florida Workers’ Compensation Insurance Cover?

Due to the rate at which injuries occur while on the job and the conflicts that come with employees having to sue employers for their injuries, Florida requires employers to purchase workers' compensation insurance, better known as workers' comp. Florida worker's compensation laws require employees to avail themselves of worker's comp if injured on the job.

This generally prevents employees from suing their employers. What does worker's compensation cover if you received an injury on the job? Is your employer ever liable for your injuries in a court of law outside of the worker's compensation requirements? This is what a worker's comp lawyer at Dolman Law Group can assist you with.

What is Worker's Compensation?

Worker's compensation is a process for which you can claim compensation for damages caused while on the job. It does not operate like a personal injury claim, where you must prove the at-fault party's negligence. There does not need to be an at-fault party at all; if you get injured or suffer an illness on the job, you can pursue payment for your economic damages through a worker's compensation claim. If your worker's compensation claim is accepted, your employer's insurance carrier can send you weekly cash benefits and pay for medical care needed to heal the workplace injury. Worker's compensation pays for economic damages, including medical bills, lost wages, and lost earning potential. They do not cover non-economic damages, such as pain and suffering, loss of consortium, or loss of enjoyment of life.

How Does Worker's Compensation Insurance Operate in Florida?

Most employers must purchase worker's compensation insurance to ensure their employees have protection from personal injuries sustained on the job. The following are the employers that must purchase Florida worker's comp insurance:
  • Employers with four or more employees
  • Construction employers with more than one employee
  • Agricultural employers with either six regular employees or twelve seasonal employees (must work more than 30 days but less than 45 days in a calendar year)
The cost of worker's compensation depends on the business's payroll, claims history, and what type of work the employees do.

How Does Worker's Comp Work In Florida?

The process of getting workers' compensation for your workplace injury or illness begins the minute the injury or illness happens. Florida worker's comp laws dictate that the victim has 30 days from the day of the workplace accident, to report their injury or illness. Not doing so will prevent the employee from getting much-needed workers' compensation to pay for damages. As a type of insurance, workers' compensation generally covers what you would expect your car insurance policy to cover if you were injured in an automobile accident. This includes, but may not be limited to:
  • Medical bills/medical care
  • Lost wages
  • Lost earning potential
  • Prescription medications
  • Medical equipment
  • Income replacement if unable to work
  • Disability benefits
  • Certain job replacement benefits
  • Travel expenses to and from an authorized treatment center or pharmacy

How Disability Affects Worker's Compensation Benefits

The nature and extent of your worker's compensation benefits depend on whether your injury created no disability, a partial disability, or a permanent disability on your compensation claim. For example, an accountant who slipped at work and broke an ankle may have medical bills but return to work the next day. In this case, workers' compensation may cover medical bills but not income replacement benefits. If you work construction and injure your ankle, you may now have a partial disability because you can't perform your normal job function for the next six weeks. In this case, workers' compensation would have to provide you with lost wage and income replacement benefits until you can resume your normal job activities. A workers' compensation attorney will focus on how your injury will impact your vocational skills going forward. If your disability permanently disqualifies you from your field, workers' compensation may have to pay to assist you in finding a different job or career. If you broke your neck at work and are now paralyzed, this is likely considered a total disability, and worker's compensation insurance may have to replace your income for the remainder of your life. A lawyer for worker's compensation will exhaustively review injury claims to determine whether the injury is permanent and how it impacts your vocational skills.

Does Workers' Compensation Insurance Cover slip and fall injuries?

Prohibitions on Receiving Workers' Compensation Benefits

To qualify for workers' compensation benefits, you must have sustained at least 50 percent of the injury on the job. For example, if you fell in your home and injured your arm and then you tripped at work and exacerbated the injury slightly, you are likely not eligible to receive workers' compensation benefits. You also may not receive workers' compensation benefits under the following circumstances:
  • The injury was intentionally self-inflicted
  • The injury resulted from you being on drugs or intoxication
  • You intentionally inflicted the injury to obtain workers' compensation benefits
  • The employee refused to observe safety rules or use readily available safety equipment
If you fall into these excluded categories, you can't successfully sue your employer for negligence. If the injury was purposefully self-inflicted or occurred because the employee was intoxicated, there is generally no case against another party because of the worker's own negligence. You probably could not successfully sue your employer if you refused to obey safety rules under the doctrine of assumption of risk.

What are the Penalties for Not Having Worker's Compensation in Florida?

It is not uncommon for business owners to be looking for ways to cut costs and improve the bottom line. One area where this is definitely not okay is with worker's compensation insurance. Cutting worker's comp insurance coverage is especially tempting if you think your employees' jobs are not dangerous or if you haven't had a serious work-related injury at your company in a while. However, business owners who don't have workers' comp insurance for their employees in Florida could face serious and costly consequences. The Florida Department of Financial Services is in charge of regulating and inspecting Florida businesses regarding many financial matters, including whether or not they have proper worker's compensation coverage. If a Florida employer operates without workers comp, they will first be issued a Stop-Work Order. This requires the business close down and stop all work until they comply with Florida law and pays any penalties. The penalty is usually equal to two times the amount that the business would have paid in worker's comp premiums during the two-year period before being caught.

Attempts by Florida Business To Avoid Paying Worker's Comp Benefits

On top of not having worker's compensation insurance, a business may operate illegally in regards to reporting injuries, denying worker's comp claims, and pressuring employees into not reporting injuries. Any threatening or illegal actions by an employer can result in a criminal charge. Additional civil actions or criminal charges could be filed if the business:
  • Operates without worker's compensation insurance (if their business type requires worker's comp)
  • Continues the insuring of a Stop-Work Order
  • Tries to conceal or forge worker comp violations
  • Fails to report an injury
  • Tries to ensure your claim is denied
  • Threatens to fire or intimidate to prevent an employee from filing a claim
  • Deducts the worker's comp cost from the injured employee's paycheck
  • Tries to pass an employee off as an independent contractor

Injured Florida Workers Could Sue if Their Employer Prevented Them from Getting Benefits

If your business or employer has attempted to impede your rights as an injured worker in Florida, you could have the right to sue and should contact an experienced worker's comp attorney. You could be entitled to recoup the cost of your medical expenses and lost wages, plus possible punitive damages if the situation was gross enough. It is a common worker's compensation myth to assume you do not have the right to sue for damages if your employer does not provide the medical benefits you need. Although it is rare, you could file a personal injury claim with your at-fault party's insurance company to pursue compensation for damages that occurred because of work. An experienced worker's compensation attorney can help you collect evidence, prove your employer prevented you from collecting worker's comp benefits, and negotiate a settlement with their insurance carrier.

Exceptions to Florida Worker's Compensation Laws

Workers' compensation insurance only covers injuries that occur during the scope of your employment. For example, if you and your boss take the same route to work and your boss rear-ends you, he can't defend your litigation against him by saying he is your employer. You can sue him for your personal injuries in Florida court because you didn't receive the injury during the scope of your employment. If you suffered an injury on the job, you may directly sue an employer who did not carry worker's compensation insurance. An employer may not use the worker's compensation law to defend against a suit for personal injuries or wrongful death if it does not carry the necessary coverage. This means that an employer would face direct liability if:
  • The negligence of another employee caused your injury
  • The employee assumed the risk of the injury
  • The injury was caused, in part, by the comparative negligence of another employee
An employer who did carry insurance but refused to process your claim promptly could face a lawsuit—for example, if your injury was serious and the employer was afraid that the insurance company would drop him or raise his rates. Sometimes this is also down to disorganization. Talk to a Florida worker's compensation lawyer about whether you qualify for an exception. Here is a breakdown of what fees to expect.

Pain and Suffering after a Work Injury

As we have discussed, Florida worker's compensation will cover medical bills and lost wages after you suffer an injury on the job, but what about pain and suffering? Florida worker's comp does not compensate an injured worker for pain and suffering, as you might expect with a personal injury that is not work-related. Despite this lack of coverage, this does not mean that it is impossible to receive compensation for pain and suffering after a Florida work injury. That's because your employer may not necessarily be the only person or party responsible for your injury. If you experienced pain and suffering after a work injury that you believe you deserve compensation for, you could pursue payment for said damages, just not through worker's compensation. You would have to file a personal injury claim with the at-fault third party's insurance company and have a personal injury lawyer make a case for you deserving pain and suffering compensation.

Pursuing Damages for a Third Party Involved in a Workplace Injury

Third parties might be responsible for your Florida work injury if you suffered an injury in certain circumstances. For example, a defective piece of equipment at work may have malfunctioned and caused a severe injury. The third party can be named in a separate lawsuit if this is the case. All kinds of parties can be liable other than your employer in a workers comp claim. The following are some of the parties that could share third-party liability for a workplace injury:
  • Maintenance company for negligence in equipment repair
  • Cleaners for leaving wet floors without warning signs
  • Manufacturers and sellers of defective products
  • Co-workers that behave negligently and cause an injury
The list goes on but the point of many parties possibly being negligent is the same. Dolman Law Group's team of investigators will be put into action if this is suspected, and we will find and pursue all parties responsible for your injury.

Contact Dolman Law Group for Hep With Your Worker's Compensation Claim Today

Worker's compensation insurance has both its benefits and shortcomings. It can help you pay medical bills and keep your family afloat with quick benefits if you received an injury on the job, but the benefits might not be sufficient if you suffered a severe or life-changing injury. The downfall to litigation, however, is it may take time to recover compensation for your injuries. Sometimes your worker's compensation carrier will deny or reduce your benefits, which you may need an attorney to fight. If you suffered a disabling injury while at work, whether temporary or permanent, contact the Dolman Law Group immediately so we can file a worker's compensation claim on your behalf. Dolman Law Group handles worker's compensation claims throughout the State of Florida regardless of which county you may reside in. We maintain offices on both coasts and have the resources to advocate on behalf of injured Florida workers. In fact, we have offices in Pinellas, Pasco, Hillsborough, Manatee, Broward, Dade, and Palm Beach Counties. While we started in Tampa Bay, we have grown to have a statewide presence. Our attorneys can analyze the facts of your case to determine whether you can litigate your claims or must avail yourself of worker's compensation insurance. Furthermore, they can work with your employer's insurance carrier to ensure you receive the full value of your claim. Call us today at (727) 451-6900 or contact them online for a free, no-risk consultation.

Matthew Dolman

Clearwater Personal Injury and Insurance Attorney

This article was written and reviewed by Matthew Dolman. Matt has been a practicing civil trial, personal injury, products liability, and mass tort lawyer since 2004. He has represented over 11,000 injury victims and has served as lead counsel in over 1000 lawsuits. Matt is a lifetime member of the Million Dollar Advocates Forum and Multi-Million Dollar Advocates Forum for resolving individual cases in excess or $1 million and $2 million, respectively. He has also been selected by his colleagues as a Florida Superlawyer and as a member of Florida’s Legal Elite on multiple occasions. Further, Matt has been quoted in the media numerous times and is a sought-after speaker on a variety of legal issues and topics.

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