Workers’ compensation covers almost all injuries that happen while you are at work. Florida law requires almost all employers to carry workers’ comp insurance.
An employer must carry workers’ compensation insurance if they have:
- More than one employee in the construction industry
- more than four employees in a non-construction industry
- Or more than six regular or 12 part-time or seasonal workers in the agriculture industry
Workers’ compensation insurance pays medical expenses and partial income if an employee suffers injuries.
Who Workers’ Compensation Covers
All construction businesses, regardless of size, must carry workers’ compensation.
Some businesses do not have to carry workers’ compensation, including:
- Businesses that hire only independent contractors
- Homeowners who hire domestic servants
- Volunteers at charities
- Entertainment venues for independent performers
- Professional sports teams for athletes
- Sponsors of amateur athletic events for referees and umpires
- Taxi companies and car services for independent drivers
Almost all other employers must carry workers’ compensation.
Workers’ compensation allows an employee to file a claim against the insurance instead of filing a lawsuit. This channel for compensation allegedly reduces the amount of money an employee puts out while recovering compensation for work injuries.
However, workers’ compensation doesn’t always cover all employee expenses. Workers’ compensation insurance also benefits the employer because workers’ compensation renders the employer immune from workplace injury lawsuits.
What Workers’ Compensation Covers for Clearwater Workers
To claim workers’ compensation, you must have suffered your injury or illness during the course and scope of your employment. You do not necessarily have to be on company property. For example, some drivers could claim workers’ compensation for injury during a vehicle accident off company property.
If the workers’ compensation insurance company believes the injury happened outside your work hours or is unrelated to your employment, it will deny your claim. For example, if you had a back injury prior to your employment and cannot lift, workers’ comp will most likely deny your claim.
However, if your work caused a pre-existing condition to flare up, you could claim workers’ compensation. For example, if you were able to walk without pain, but your work required you to carry and lift boxes, and these activities are a major contributing cause of your back getting worse, you could likely claim workers’ compensation because your job aggravated the pre-existing condition.
Other conditions workers’ compensation covers include:
- Repetitive stress injuries. If repetitive motions cause stress fractures, inflammation, and nerve damage by wearing down cartilage, you could have a workers’ compensation claim. You must show that your work significantly contributes to the injury.
- Toxic exposure. If your job exposes you to dangerous particulates and chemicals that are a significant factor in your developing illness, you could claim workers’ compensation benefits. However, you must prove a connection between exposure to these particulates and chemicals and your illness.
Workers’ compensation generally covers all medical expenses related to your injury or illness as long as an approved medical provider treats you. Workers’ compensation also pays 66 2/3 of your average bi-weekly earnings. Typically, the insurance calculates your average weekly wage by averaging your pay for the 13 weeks before your injury. This average serves as the basis for computing your compensation.
Reporting Your Injury
After suffering a workplace injury, you have 30 days to report your injury to your employer. If you do not report within this timeframe, you cannot claim workers’ compensation benefits.
However, this bar does not apply under certain circumstances, including:
- The employer had actual knowledge of your injury
- You did not know the cause of the injury until you received a medical opinion. You have 30 days to notify your employer once you receive the medical opinion.
- Your employer did not post a notice regarding reporting injuries under Florida Statutes §440.055
- Certain exceptional circumstances
The same rules apply if you lose a loved one in a workplace accident, except the employee’s estate or agent notifies the employer. The agent or estate must make formal notice. Documents prepared by an attorney in connection with litigation, including but not limited to notices of appearance, petitions, motions, or complaints, shall not constitute notice.
Once you notify your employer of your injury, your employer must report your injury or the death of a loved one to its carrier within seven days. Your employer must also provide you with a copy of the report.
Types of Workplace Accidents
The accidents you could have at work depend on your job and workplace setting.
Some common workplace accidents include:
- Trips, slips, and falls. You could trip or slip and fall in any industry, including working in an office or on a construction site. In an office, you could trip over a cord someone left in a hallway or on a slippery floor where someone tracked in the rain or spilled something. Certain worksites, such as construction worksites, have work areas conducive to falling, such as bridges or the second story or roof of a new building.
- Soft tissue injuries. These are mostly pulled, torn, or strained muscles, common in workplaces requiring lifting. You could easily hurt yourself if an employer does not provide proper lifting training.
- Falling objects. Injuries from this accident are usually found on construction sites or jobs where people work above others, like in warehouses. Even light objects that fall can cause severe or catastrophic injuries or death. This type of accident is often devastating when the employee doesn’t notice or suspect a falling object, such as something falling off a warehouse shelf.
- Repetitive strain injuries. These injuries are common with workers who make repetitive movements with their joints, including typing. Using ergonomic equipment and taking breaks can lessen the chance of suffering from RSI.
- Motor vehicle accidents. Not only could car crashes happen while driving a work vehicle, but they could also happen on a worksite and involve cars, trucks, forklifts, and heavy equipment.
- Cuts, scratches, punctures, and scrapes. These injuries can happen in any industry, even in an office. Anything from office implements to power saws could cause cuts. Your employer can reduce the risk of these injuries by providing safety equipment and training.
- Toxic fumes. If you work around toxic fumes and your employer doesn’t provide the proper personal protective equipment, you could sustain lung damage, eye and skin reactions, and other injuries.
- Loud noises. Industrial deafness is common because workplaces expose workers to loud noises. An employer that provides and requires ear protection can prevent these injuries.
- Fights at work. If someone picks a fight with another employee, one or both of them could suffer severe injuries or even die. Employers should have procedures to deal with employee grievances to prevent fighting injuries.
When an Employee Can Sue an Employer for Workplace Injuries
An employee can sue an employer for workplace injuries in two circumstances:
When the Employer Does Not Carry Workers’ Compensation
If Florida law requires an employer to carry workers’ compensation insurance and the employer refuses, that employer is vulnerable to a lawsuit if someone suffers injuries or dies while at work.
For a hypothetical example, Widget Factory employs 100 people full-time, year-round. Employee Bob Smith suffers a crushed hand because the press he was working on had a missing safety feature and slammed down on his hand. Widget Factory let its workers’ compensation lapse. Bob has no other recourse other than to sue Widget Factory for his injuries.
When an Employer’s Actions or Inactions are Purposeful
Florida law provides for recourse for employees when an employer purposefully injures them. If an employer purposefully injures an employee, the employee can file a lawsuit against the employer.
The injuries you could sustain at work depend on the circumstances. Someone who falls because a rusty ladder broke will sustain different injuries than someone who works with presses with malfunctioning safety features.
Potential injuries include:
- Bumps, bruises, scrapes, cuts, scratches, and punctures
- Strains and sprains
- Pulled and torn muscles and other soft tissue injuries
- Face and eye injuries
- Ear injuries, including deafness, in the case of explosions or flash fires
- Lung injuries from breathing smoke or chemicals
- Internal injuries
- Head, neck, and shoulder injuries
- Crushed bones and crush injuries
- Traumatic brain injuries
- Back and spinal cord injuries
- Amputation of a digit or limb
- Road rash in the case of company drivers involved in an accident
Any open wound could become infected, whether from a workplace injury or surgery to repair a workplace injury. Workers’ compensation insurance also covers infections and other secondary injuries.
Finally, workers’ compensation is responsible for the additional injuries if a workplace injury or your work exacerbates pre-existing injuries or illnesses.
Recovering Damages After a Workplace Injury
If you recover damages from workers’ compensation, you can only recover medical expenses and a portion of your income. However, if you sue an employer for damages, you could recover additional compensatory damages in the form of economic and non-economic damages.
Sometimes referred to as special damages, economic damages have a monetary value.
Most people who can sue instead of or in addition to filing a claim against workers’ compensation insurance recover some economic damages, including:
- Medical expenses for doctors’ appointments, surgeries, follow-up appointments, prescriptions, over-the-counter medicines and equipment, ambulatory aids, and prescription equipment (such as oxygen).
- Home health care
- Nursing home and rehabilitative home care
- Accessibility aids for your vehicle, such as wheelchair ramps and lifts and hand controls
- Accessibility aids for your home, including wheelchair ramps, handrails, grab bars, and widened doorways
- Loss of earning capacity, future and current. If your accident injuries cause long-term or permanent disabilities that force you to work part-time or full-time but at a rate lower than your previous occupation, you could recover compensation for partial loss of earning capacity.
- Death-related expenses, including funeral expenses, burial expenses, cremation expenses, certain probate costs, and probate attorney’s fees and costs
Sometimes referred to as general damages, non-economic damages do not have a monetary value.
Generally, only those who suffer long-term or permanent disabilities caused by accident injuries or those who lost a loved one can recover non-economic damages, including:
- Pain and suffering, including emotional distress
- Loss of quality of life if you have to make life-long changes such as taking prescriptions or using ambulatory aids
- Loss of companionship if you can no longer enjoy time with your family or attend family activities and events
- Loss of consortium if you can no longer enjoy a physical relationship with your spouse
- Loss of use of a bodily function, such as your hearing, eyesight, or bladder control
- Loss of use of a body part, such as an arm or a foot
- Inconvenience if you have to hire someone to do the chores you usually do, including but not limited to house cleaning, grocery shopping, lawn maintenance, and home repair and maintenance
- Excessive scarring and disfigurement
- Amputation of a digit or limb
Should I Retain an Attorney for a Workers’ Compensation Claim?
Yes, especially if you applied for workers’ compensation and the board denied your claim. For initial claims, a lawyer can help you complete the paperwork. For appeals, a lawyer can help you through the appeal process.
If you don’t know if you have a valid claim, a Clearwater workers’ compensation lawyer can determine whether you should file a claim or file a lawsuit against someone else to recover the compensation you deserve. For example, if you were running an errand for your employer and someone crashed into you, you might not be able to file a workers’ compensation claim, depending on the circumstances.
Workers’ compensation and car accident attorneys will help you determine against whom you can file your claim.
If you suffered injuries or lost a loved one in a workplace accident, contact a Clearwater workers’ compensation attorney as soon as possible for a free, no-obligation case evaluation.