If you work in Florida, unless your employer falls into one of a very small number of exceptions, your employer is required to carry workers’ compensation insurance. This insurance is designed to give compensation to employees who sustain injuries on the job, without regard to fault. Under these policies, employees receive monetary compensation for medical bills, disability, death (paid to the deceased employee’s family or estate), or vocational rehabilitation.
The maximum dollar amount of the benefits employees are entitled to is set by law and changes annually. For 2019, the weekly maximum is $939 per week. In 2020, that amount is set to rise to $970 per week. There is also a statutory minimum of $20 per week. Read on for more advice about workers compensation and Florida law. To discuss your claim with a workers compensation attorney consider scheduling a free appointment with Sibley Dolman Gipe Accident Injury Lawyers, PA. Dolman Law has had years of experienced in workers compensation cases and has multiple office location throughout the state of Florida.
Filing Your Claim
To receive compensation for your on-the-job injuries, you must file a claim. This is done by reporting your injuries to your employer. Florida law mandates that workers’ compensation claims be filed within 30 days of the incident that lead to the injury. In certain circumstances, injuries may not be immediately apparent but instead develop over time. In that case, an employee must file a claim within 30 days of discovering it and must show that it was related to the employee’s job duties. If you do not file your claim within the deadlines set, your claim may be reduced or denied in its entirety, leaving you without the needed compensation you would otherwise have received.
Your Employer’s Responsibilities
Once you have filed your claim with your employer, it has an obligation to report your claim to its insurance company within 7 days. Sometimes, employers miss this deadline—either inadvertently or maliciously. In either case, if your employer does not take steps to report your claim, you are permitted to reach out to the insurance company yourself.
Once you’ve reported your injury to your employer, your employer will send you to a doctor. Florida law allows your employer to select the doctor except in cases in which emergency medical treatment is necessary.
7 Common Mistakes in Filing a Workers’ Compensation Claim
Like most things related to insurance, workers’ compensation can be a tricky area to navigate. That’s why it’s always to your benefit to retain an experienced Florida workers’ compensation attorney to help you through the process. Common mistakes people make when filing and pursuing their claims can lead to the denial of workers’ benefits. Don’t fall into that trap.
1. Not Filing a Claim Within 30 Days
Failing to file your claim can cause it to be dismissed out of hand. That time period is set by law and you must comply with it. Don’t make the mistake of notifying your employer orally either. Always put your notice to your employer in writing with as much specificity as you can concerning the details of the incident and the symptoms you are suffering.
2. Going to the Wrong Doctor
Your employer will select the doctor you see for your work-related injury. Understandably, if you already have an established relationship with a primary care physician or other type of doctor, you may want to see that person for treatment of your on-the-job injury. But you must see the doctor your employer sends you to. Most employers have a list of approved facilities and providers where their employees received sponsored treatment.
The doctor who treats you will prepare a report and present it to your employer. If this report does not come from an approved doctor, your entire claim can be nullified. It is also extremely important that you follow the orders the approved doctor gives you for treating your injury.
3. Missing Medical Appointments
The basis of a workers’ compensation claim is that your injury somehow affected your ability to do your job. This might be a complete inability to do the work or a requirement that you receive some type of accommodation because you can do the work but need a bit of help to do it. Failing to follow through with appropriate medical care can undermine your claim that you’ve been injured and damage the chances of your claim being approved.
4. Failing to Give Your Doctor Complete Information
It is critically important that you are completely forthright with your doctor and that the information you provide is complete and accurate. This includes sharing any and all symptoms you are experiencing. Minor symptoms may seem like no big deal to you, but seemingly unimportant symptoms can turn into larger problems down the road if you do not treat them.
You should also provide detailed information about how your injury occurred so that the doctor knows what types of injuries he or she is looking for and what symptoms to inquire about. Providing accurate and complete information will ensure that you receive the care you need and that the entirety of your claim is properly documented in your medical records.
5. Talking About Your Claim on Social Media
While you may be tempted to vent about your injury or speak your frustrations about your care or the process of getting your claim paid into cyberspace, it’s a bad idea to do so. In looking for reasons to deny your claim, your employer and its insurance company can access any public information to try to poke holes in your story. Similarly, avoid talking to too many people in person who could later be called to testify if you end up having to take your employer to court.
6. Not Properly Documenting Your Claim
It is the unfortunate truth that many workers’ compensation claims are challenged by both employers and their insurance companies. While of course neither is inherently bad, an employer’s insurance rates increase if it has numerous claims against it and insurers have a vested financial interest in paying out the least possible amount of money for claims.
That makes documenting your claim important. Immediately after your injury and in the months following as your claim progresses, be sure to document—and err on the side of having too much information rather than not enough.
- Photographs: If there is an accident scene, take pictures if you can. Photograph your injuries. As time goes on, continue to take pictures of your injuries to show how your healing is progressing and how much care you may still require.
- Witnesses: If there were witnesses to the incident, make sure you have a way to contact them. They may be called in proceedings to settle your claim and you need to be able to get in touch if it becomes helpful to your case. These cases can take a substantial amount of time to resolve as people change employers and move. Email addresses and phone numbers are most helpful as a means of reaching out to people who can potentially help your claim.
- Writing: Document in writing your own experience as soon as possible after the incident while the details are fresh in your mind and be sure to keep it in a safe place. If you later remember additional facts, add them to your writing.
- Medical records: Ask for and keep in a safe place all records from your medical care providers. You are entitled to these by law and you should ask for them. Strong medical records can help establish the causal relationship between your injuries and the work incident, your final prognosis, treatment progression, and the extent of your injuries.
- Medical costs: Keep everything. Every bill you receive. Every receipt for prescriptions or medical devices. These are the only way to show how much your injury has cost you. Tossing receipts or throwing bills away unopened because you don’t want to see the number can cause you to lose out on compensation to which you are otherwise entitled.
It’s not a bad idea to keep a pain journal or some other type of log of your symptoms and your reactions to them. You should also keep track of the dates and times of your appointments and the name of the provider you see, along with the results of the appointment and what was discussed during it.
7. Not Filing a Claim Because You Did Not Miss Work
Not all work-related injuries require hospitalization or missing days of work. Failing to file a claim because you didn’t miss work to deal with your injury will cause you to miss out on potential benefits to cover things like medical services or prescription drugs.
How an Experienced Florida Workers’ Compensation Attorney Can Help You
You don’t have to get very far into the workers’ compensation claim process to see how complicated it is and how many moving parts and different people get involved. A workers’ compensation attorney can help you every step of the way—from helping you determine which kind of documentation you need, to giving you advice about how to proceed with doctors, to completing and filing forms. Reach out to one right away so that you don’t miss out on the 30-day filing window.
Appealing a Denial
Working through the process to even get a decision about your claim is difficult and confusing enough, but if you get to the end of it all and the insurance company denies your claim, what’s next? An attorney can help you by appealing your denial. The Florida Division of Workers Compensation (DWC) is the agency set up to oversee all of the state’s workers’ compensation claims.
If an insurance company has denied your claim, the law allows you to appeal the denial to the DWC, but it must be done within either two years of the injury or last wage loss or medical payment, whichever is later. An attorney can walk you through that process and help you prepare your appeal paperwork. Don’t take that on without help – trust someone who has handled these cases before and knows how to deal with the DWC.
Filing a Lawsuit
In some cases, an employee’s injuries are serious enough that the compensation they receive from workers’ compensation doesn’t cover the costs of diagnosis, treatment, and recovery. And workers’ compensation itself doesn’t fully replace the wages an employee is losing from missing work because it is limited by statute.
In these situations, you may need to explore whether the workers’ comp insurance is underpaying you in an act of bad faith, something an experienced workers’ compensation lawyer can help you rectify. Your attorney can also determine whether a negligent third party may have contributed to your accident, because holding those third parties accountable could increase the compensation you might recover.
Here’s another place your documentation will come in handy—proving damages in a lawsuit requires much of the same information as proving your workers’ compensation claim, so those medical bills and records, photos, and that journal will give you a leg up in preparing your suit.
Most personal injury suits settle out of court and never make it to a jury trial. That’s why you must choose a proven negotiator for your lawyer. Negotiations can take place from the day your suit is filed up until the jury gets the case for deliberation, and keeping the door open to ongoing negotiation is always a smart move.
If you don’t receive a settlement offer you are willing to accept, your case may resolve at trial. Upon hearing all of the evidence in your case, the court will determine whether your workers’ comp engaged in bad faith denials or reductions of benefits, or if third party negligence contributed to your injuries—and if so, the amount of monetary damages you will receive as a result.
Consider an Experienced Florida Workers’ Compensation Attorney
It can be difficult to know what to do next after being injured at work. Speaking with an attorney you trust can ensure you move forward with the best plan possible.
Sibley Dolman Gipe Accident Injury Lawyers, PA
800 North Belcher Road
Clearwater, FL 33765