Adult Floridians spend a large portion of their waking hours at work. It’s little wonder, then, that so many of our new clients at Sibley Dolman Accident Injury Lawyers come to us seeking legal services for work-related injuries. It’s our privilege to help them as best we can.
In many ways, suffering an injury at work is no different from getting injured anywhere else. Workplace injuries, like any other injury, cause pain and suffering. They require medical care. They keep you from working and from enjoying your favorite daily activities. They put you under enormous physical, emotional, and financial strain.
In other ways—primarily legal ones—work-related injuries are very different from an injury you might sustain in your off-hours. That’s because on-the-job injuries are primarily covered by Florida’s workers’ compensation system, which protects workers on one hand, but limits their rights on the other.
At Sibley Dolman Accident Injury Lawyers, our North Miami Beach Workers’ Compensation Attorneys represent Floridians who have suffered job-related injuries. We help them navigate the workers’ compensation insurance system and represent them in pursuing legal remedies outside of it. The legal services we provide help to ensure our clients receive the maximum compensation they deserve under workers’ comp, and if available, from other parties who have legal responsibility for our clients’ injuries.
To learn more about how the lawyers in our Aventura, Boca Raton, Doral, North Miami Beach, and Fort Lauderdale offices serve the interests of injured South Florida workers and their families, contact us today online or by phone at (305) 676-8154.
About Florida Workers’ Compensation
Workers’ compensation is a form of insurance. By law, Florida employers alone pay the premiums for this insurance. Workers’ comp provides benefits to employees who suffer work-related injuries. Most (but not all) employers in Florida have a legal obligation to provide workers’ compensation coverage for all of their employees unless they have been granted an exemption by the state.
How It Works
When a Florida worker sustains a job-related injury, workers’ comp covers the worker’s medical costs and may also provide temporary or permanent disability benefits, depending on the nature and severity of the injury. If a worker dies in a work-related incident, workers’ comp also provides the worker’s family or estate death benefits up to a maximum of $150,000. After getting injured on the job (either at a workplace, or in the course of performing a work-related activity), workers have 30 days to report the injury to their employer. The employer, in turn, has seven days to report the injury to its workers’ compensation insurance carrier.
Ordinarily, workers’ comp pays the worker’s medical bills directly, so long as the worker gets medical care from a doctor approved by the employer or its insurance carrier. If the injury temporarily or permanently prevents the employee from returning to work in the same capacity as before the injury for more than seven days, workers’ comp also pays the employee two-thirds of the wages the employee would have been able to earn if the injury hadn’t occurred.
Workers’ comp benefits come with a trade-off. In return for forcing virtually all employers to carry workers’ compensation insurance, Florida law says that employees can’t sue employers for their work-related injuries, except in some very limited circumstances. As a result, the amount of money an injured worker receives from workers’ comp can be lower than if the worker instead were able to take legal action against the employer for damages. This is what we mean by workers’ comp both providing workers important benefits, but also limiting their rights.
What Can Go Wrong
The process of seeking workers’ comp benefits as described above is the best-case scenario. Unfortunately, workers’ comp doesn’t always function as smoothly as Florida law requires. Here are some of the ways workers’ comp can go wrong for injured workers:
- Workers’ comp insurers sometimes deny benefits. For example, they might:
- claim the worker did not follow the rules for reporting a work-related injury;
- claim the worker did not get injured on the job;
- claim the worker does not need certain medical care; or
- claim the worker is not actually disabled.
- To cut corners and save money, some employers fail to carry workers’ comp insurance as required by the law. Others under-report the number of employees they have to cover, leaving employees with inadequate coverage.
- Because workers’ comp premiums are based on an employer’s history of having employees get injured, employers sometimes try to limit the number or size of workers’ comp claims their employees make by:
- Intimidating employees into not reporting work-related injuries.
- Retaliating against employees for reporting job-related injuries.
- Trying to undermine employees’ workers’ comp claims by giving false information to the workers’ comp insurance carrier.
When workers’ comp insurance denies benefits to a worker, the decision could be illegal depending on the facts and circumstances of the worker’s injury and its aftermath. When employers fail to carry workers’ comp insurance, intimidate or retaliate against employees for exercising workers’ comp rights, or lie to workers’ comp carriers, those actions are virtually always illegal.
Wrongful conduct by workers’ comp insurance companies and employers inflicts harm on employees at the worst possible time in the employees’ lives. The last thing workers need to deal with when they’re recovering from a job-related injury is resistance from the people and companies who are supposed to help them. When this happens, an experienced South Florida workers’ comp attorney can help injured employees protect their rights and receive the maximum compensation they deserve.
About Getting Help From an Experienced Workers’ Comp Attorney
In an ideal world, South Florida workers who have gotten injured on the job would not need the help of a workers’ comp attorney to recover every dollar of benefits they deserve for their injuries. Unfortunately, as described above, sometimes workers do not receive their rightful benefits because of misbehavior by workers’ comp insurance companies and employers.
An experienced Florida workers’ comp attorney helps workers obtain the maximum compensation they deserve for their work-related injuries. How do they do this? The answer varies from case-to-case, but some common tasks a workers’ comp attorney handles on behalf injured clients include the following.
Investigating Work-Related Injuries
Workers’ comp attorneys, their staff, and trusted experts they work with on a regular basis, spend lots of time investigating the facts and circumstances of workplace injuries. They typically have at least two goals in mind for these investigations: (1) to figure out how an injury happened and who is to blame, and (2) to figure out what compensation the injured worker needs to reach maximum physical, emotional, and financial recovery.
Many workers come to us at Sibley Dolman Accident Injury Lawyers with the misconception that it doesn’t matter who is to blame for a work-related injury. It’s true that workers’ comp insurance usually covers on-the-job injuries without regard to who caused them. But, sometimes injuries happen because of the actions of someone other than the employer or a co-worker (or because of intentionally harmful actions by either of them). In those cases, someone other than the workers’ comp carrier may also have legal liability to the injured worker, entitling the worker to damages beyond what workers’ comp pays. Experienced workers’ comp attorneys aim to leave no stone unturned in searching for these other, legally-liable parties.
Skilled workers’ comp attorneys also often put as much effort into evaluating their clients’ physical, emotional, and financial needs as they do into identifying how an injury happened and who is to blame. People often think of this as determining what a case is “worth.” At Sibley Dolman Accident Injury Lawyers, we treat it a little differently. We understand how dollars-and-cents are often poor replacements for the lives our clients led before their injury. We take the time to learn about our clients’ lives, loves, and dreams, to make sure our efforts truly encompass and communicate the damage a job-related injury has done to them and their families, and the assistance they deserve in order to return to a new “normal.”
Negotiating With Workers’ Comp Carriers and Others
Insurance companies, workers’ comp carriers included, stay in business by limiting the amount of money they pay-out to beneficiaries whenever possible. In Florida, the maximum workers’ comp benefits are fixed by law, which theoretically encourages workers’ comp carriers to offer competitive insurance rates and keeps costs down for employers. Even so, workers’ comp carriers will still try their hardest to minimize their own liability to injured workers. To push back against these efforts, injured workers often need someone on their side to negotiate directly with workers’ comp insurance carriers.
That is where a skilled workers’ comp attorney can help. From experience, attorneys know the methods workers’ compensation insurance companies use to avoid paying maximum compensation. They understand exactly what the law requires from workers’ comp carriers, and they hold those carriers to the letter of the law. They do this by handling all communications with the workers’ comp carrier on behalf of the injured worker, and by negotiating aggressively to achieve the maximum benefits available under Florida law.
When an attorney’s investigation discovers there are other parties who have legal liability to the injured worker, the attorney can also take steps to put those parties on notice of the worker’s potential legal claims for damages. This often leads to direct negotiations with those parties (or the parties’ attorneys) in hopes of reaching a fair and appropriate settlement of the workers’ potential legal claims. At Sibley Dolman Accident Injury Lawyers, we spend a large chunk of every day conducting these sorts of negotiations on behalf of our injured clients, often with great success.
Taking Legal Action
When negotiations do not achieve satisfactory results from a workers’ comp carrier or another party with legal liability to an injured worker, a skilled Florida workers’ comp attorney can also take the necessary steps to file and pursue legal action to protect the worker’s rights and to recover appropriate damages. Every case is different, but legal actions in workers’ compensation cases frequently consist of:
- Bringing suit against a workers’ comp carrier for wrongful denial or delayed payment of benefits;
- Bringing suit against an employer for taking illegal actions against the injured worker in connection with the worker’s exercise of rights under the workers’ comp laws; and
- Bringing suit against a third party with legal liability to the injured worker, seeking damages above-and-beyond what is provided under workers’ comp insurance.
Pursuing legal action is a big step that requires a commitment of time and effort by the injured worker, the worker’s family, and the attorney. It should never be taken lightly. It requires an attorney who is prepared to go to trial, and win, in order to achieve justice for an injured client. That is why workers injured on the job should seek out an attorney with deep experience in Florida workers’ comp and personal injury matters, and an established track record of success, like the team at Sibley Dolman Accident Injury Lawyers. The best chance an injured worker and the worker’s family can give themselves for recovering every dollar of compensation they deserve is to pick a skilled, aggressive, sophisticated attorney to handle their case.
North Miami Beach Workers’ Compensation Frequently Asked Questions FAQs
Most individuals expect to go to their job, accomplish their work, and then leave to enjoy time with friends and family. Unfortunately, things do not always go according to plan. You may show up at work one day and suffer from a sudden injury from a fall. Or, one day you might find yourself suffering from an injury that developed from consistent and repeated exposure to a hazard while on the job.
No matter the cause, if you have suffered an injury at work, you will need to understand federal and Florida-specific workers’ compensation systems to secure a recovery for your injuries. Read on for answers to commonly-asked workers’ compensation questions.
What is workers’ compensation?
Workers’ compensation is a system that allows individuals to seek recovery for injuries or illnesses caused by their job without filing a lawsuit. Rather than suing their employer, the injured individual files a workers’ compensation claim with the employer’s insurance company. The workers’ compensation system can be complicated, and it varies from state to state. In Florida, workers’ compensation requirements are managed by the Division of Workers’ Compensation.
One benefit of workers’ compensation is that it is a no-fault system, meaning there is no obligation for the employee to prove that the employer’s negligence caused the injury or illness. Workers’ compensation, however, can be a complicated system, and minor mistakes can result in unfair outcomes. Consider contacting an attorney if you are struggling to navigate the workers’ compensation system.
What are common North Miami Beach workplace injuries?
Any injury or illness received on the job will qualify as a workplace injury.
Common workplace injuries include:
- Repetitive motion injuries;
- Transportation accidents while on the job, especially for truck drivers, delivery drivers, and sales workers;
- Falls, slips, and trips;
- Impact injuries from objects or equipment;
- Machinery accidents;
- Exposure to harmful substances or environments;
- Fires and explosions; and
If you are unsure whether your injury would qualify as a workplace injury, contact an attorney to better understand your ability to pursue workers’ compensation benefits.
I was injured on the job—what should I do now?
Immediately report your injury to your employer. Any work-related injury or illness must be reported within 30 days of the accident.
Failure to report in this period of time is a bar to recovery, unless:
- The employer had actual knowledge of the injury regardless of the failure to report;
- A medical opinion was necessary to uncover the cause of the injury. In this case, the injury must be reported within 30-days of any medical opinion indicating the injury was work-related;
- The employer did not post notice of reporting requirements; or
- Exceptional circumstances justify the failure to report.
Once your claim has been reported and you are receiving medical treatment, be sure to communicate regularly with your employer. This includes providing them with any medical status or reporting forms received at medical appointments. You will also need to stay on top of any paperwork required by the insurance carrier, and provide regular updates on your medical status and any wages you have earned. If you are working with an attorney, the attorney could manage this communication on your behalf.
What are my North Miami Beach employer’s responsibilities?
The following employers are required to have workers’ compensation insurance coverage:
- Employers in any industry, other than construction, with more than four employees;
- Construction industry employers with one or more employees;
- State or local government employers; and
- Farmers with more than five regular employees and/or twelve seasonal agricultural labor workers, lasting thirty days or more
Federal government employers are also required to have workers’ compensation insurance. But, employees of these employers receive coverage under the Federal Workers’ Compensation program rather than the Florida program.
Your employer is required to report your injury to their insurance carrier within seven days of their knowledge of the injury. If your employer refuses to report the injury, you can self-report to the insurance company or seek assistance from the Employee Assistance Office. It’s best to ask us to help you file that report.
What are the insurance carrier’s responsibilities?
Once your employer reports your injury to its insurance carrier, they are responsible for ensuring the timely completion of the following:
- Appointing an approved medical provider;
- Paying wage replacement benefits;
- Paying medical bills;
- Reporting your claim to the Division of Workers’ Compensation; and
- Notification of any status changes for your claim.
What benefits could I receive through a North Miami Beach workers’ compensation claim?
Workers’ compensation compensates the injured employee for medical costs and lost wages.
Because of its no-fault nature, it does not include compensation for damages like pain and suffering, emotional distress, or loss of enjoyment.
Medical benefits: Medical treatment would be provided through the employer’s insurance carrier and includes treatment by an authorized primary care doctor and medically-necessary specialist. Do not contact or visit your own doctor; the insurance carrier must authorize the treating doctor.
Workers’ compensation will cover any medically necessary care or treatment for your work-related injury, including:
- Doctor’s visits;
- Medical tests;
- Physical therapy;
- Prescription drugs;
- Prostheses; and
- Attendant care.
- Mileage reimbursement for travel to and from doctor’s visits, including the pharmacy.
Lost wages: Lost wage benefits will not be paid for the first seven days of disability. If your disability lasts longer than 21 days, you may be paid for the first seven days. Your lost wage benefit is based on the extent of your disability as determined by an authorized doctor.
Disability will be classified in one of the following categories:
- Temporary total disability: If you cannot work for a period due to your injury, you will receive 66.67 percent of your regular wages for the period of temporary total disability, not to exceed 104 weeks.
- Temporary partial disability: If you can return to work with restrictions but can’t earn 80 percent of your prior wages, you may qualify for benefits for a period not to exceed 104 weeks.
- Impairment: If your condition has improved as much as possible but you still suffer from restrictions, your doctor will have you evaluated for an impairment rating. Your benefits will depend on your impairment rating.
- Permanent total disability: If your injuries leave you permanently unable to work, you are eligible for permanent total disability benefits.
Florida offers several benefit calculators to determine the potential scope of recovery for lost wages. Lost wage benefits are paid on a bi-weekly basis, and you should receive the first check no more than 21 days after the injury is reported.
When could I go back to work?
Your appointed doctor will determine when you are fit to return to work in full capacity, or on light duty, or with other restrictions. Your employer will determine if light duty or restricted duty is available to return to work. If your employer agrees to restrictions but does not adhere to them, you should not leave work. Instead, make the insurance carrier and doctor aware. If your employer sends you home, make sure they inform the insurance carrier that the employer cannot accommodate the restricted duty requirements. If you do not follow these steps, you may not receive your lost wage benefits.
If you disagree with your doctor’s decision about returning to work, you can request a second opinion. Your doctor can request the second opinion or you can submit a one-time change of doctor request. The insurance carrier would still be responsible for selecting your doctor. If a second opinion does not change the recommendation, you may pursue an independent medical evaluation, but you would be responsible for all costs associated with the evaluation.
Is my North Miami Beach employer required to hold my job for me?
Your employer is not required to hold your job for you, but they cannot fire you in retaliation for filing a workers’ compensation claim. If you are terminated and wish to contest the termination, you will need to demonstrate that the termination was due to retaliation and not for any valid reason. As an alternative to termination, your employer could reduce your work hours, re-assign job tasks, or reduce your hourly pay if you cannot perform the same job duties.
Proving retaliation is a complicated and fact-intensive analysis. A workers’ compensation attorney could help you understand the process and evaluate the strength of your retaliation claim.
What if the insurance company denied my North Miami Beach workers’ comp claim?
You must file a Petition for Benefits to contest a denied benefits claim. The time limit for filing a petition depends on the issue in dispute. While an attorney is not required for you to file a petition, a workers’ compensation attorney could help ensure that your petition is more comprehensive and filed in a timely fashion.
Can I still file a lawsuit against my employer?
Generally, that’s not necessary—should you need to sue, you would sue the workers’ comp insurance company. In Florida, workers’ compensation is the exclusive remedy for a North Miami Beach worker’ compensation injury incurred at the workplace, with few exceptions.
An injured employer may only pursue additional remedies in the following scenarios:
- Where the employer failed to secure payment of required workers’ compensation; or
- Where the employer either deliberately intended to injure the employee, or engaged in conduct that the employer knew was virtually certain to result in injury or death to the employee and said the danger was not apparent to the employee.
If you do not qualify for one of the above exceptions, you may also pursue a lawsuit if you are an independent contractor instead of an employee.
How do I establish that I am an independent contractor?
Workers’ compensation benefits and restrictions do not apply to independent contractors outside the construction industry.
Individuals are considered independent contractors under Florida’s workers’ compensation statute if they meet at least four of the following criteria:
- Maintain a separate business with his or her own work facility, transportation, equipment, materials, or similar accommodations;
- Hold or has applied for a federal employer identification number, unless they are a sole proprietor who is not required to obtain a federal employer identification number under state or federal regulations;
- Receive compensation for services or work that is paid to a business rather than to an individual;
- Hold one or more bank accounts in the name of a business entity for purposes of paying business expenses or other expenses related to services or work performed for compensation;
- Perform work or can perform work for any entity in addition to the employer at his or her own election without the necessity of completing an employment application or process; or
- Receive compensation for work or services rendered on a competitive-bid basis or completion of a task or set of tasks defined by a contractual agreement, unless such contractual agreement expressly states that an employment relationship exists.
Even if an individual does not meet four of the above criteria, the law may still consider them an independent contractor after evaluation of the following considerations:
- If the individual performs or agrees to perform specific services or work for a specific amount of money and controls the means of performing the services or work;
- If the individual incurs the principal expenses related to the service or work that he or she performs or agrees to perform;
- If the individual is responsible for the satisfactory completion of the work or services that he or she performs or agrees to perform;
- If the individual receives compensation for work or services performed for a commission or on a per-job basis, and not on any other basis;
- If the individual realizes or may realize a profit or suffer a loss in connection with performing work or services;
- If the individual has continuing or recurring business liabilities or obligations; and
- If the success or failure of the individual’s business depends on the relationship of business receipts to expenditures.
The burden is on the individual claiming independent contractor status to prove that they qualify as an independent contractor.
Pursuing workers’ compensation is a time-intensive and complicated process. Dealing with the administrative hoops and complications of securing workers’ compensation in addition to dealing with injuries can be overwhelming. Contact our North Miami Beach workers’ compensation attorneys for a free consultation today. We are experienced in assisting clients with workers’ compensation benefits.
Call Sibley Dolman Accident Injury Lawyers if You Need Help With Your Workers’ Comp Claim
With offices in five locations throughout South Florida, Sibley Dolman Accident Injury Lawyers is the law firm for Floridians injured in work-related accidents and incidents. Our team of legal professionals has years of experience recovering maximum compensation from workers’ comp insurance companies, employers, and third parties whose actions led to our clients’ suffering. We have particular experience helping families of workers who died from injuries at work, and helping workers who have sustained catastrophic injuries, such as brain trauma, spinal cord damage and paralysis, severe burns, and crushed or amputated limbs.
To learn more about the services we provide to injured Florida workers, contact us online, by phone at (305) 676-8154, or stop by one of our offices in Aventura, Boca Raton, Doral, North Miami Beach, and Fort Lauderdale. We offer free consultations and case evaluations for all potential clients. But, don’t wait. The clock is ticking on your ability to recover the maximum compensation you deserve on your workers’ comp and personal injury claims.
Sibley Dolman Gipe Accident Injury Lawyers, PA
1820 NE 163rd St #306,
North Miami Beach, FL 33162
What Our Clients Have to Say:
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