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Reality vs. Intent: Florida’s Work Comp System

Clearwater Florida Workers Compensation Attorneys - Dolman Law Group

The Florida legislature enacted Florida Statute Chapter 440 [1] with the specific intent noted in §440.015 [2]. “It is the intent of the Legislature that the Workers’ Compensation Law be interpreted so as to assure the quick and efficient delivery of disability and medical benefits to an injured worker and to facilitate the worker’s return to gainful reemployment – .” See Fla. Stat. 440.015.  Without doubt Florida’s legislative intent appears favorable.  Unfortunately, the stated intent falls way short of the reality that is Florida’s Worker’s Compensation system.   Additional language contained within §440.015 states in relevant part, “Therefore, an efficient and self-executing system must be created which is not an economic or administrative burden.”

A logical interpretation of the legislative intent would result in a belief that every time suffers from a work related accident or condition, they receive any and all workers compensation they’re entitled to in a timely manner.  Though logical, such an interpretation is entirely flawed.  If Florida’s Legislative intent in creating worker’s compensation laws was actually followed by insurance companies providing worker’s compensation coverage, governmental entities like Florida’s Division of Worker’s Compensation [3], and Florida’s Office of the Judges of Compensation Claims [4] would not exist.  The reality is that insurance companies providing worker’s compensation coverage frequently delay or deny the payment of lost wages, and delay and deny authorization of medical care.  We represent people injured on the job because of these disputes, delays, and denials.  Consultations with our office are free.

When a worker’s compensation insurance company is aware that you’re represented by an attorney, the manner in which your claim is handled changes. The words, “your claim,” refer to lost wages and medical care you’re entitled to receive at the expense of the work comp insurance company.  If lost wages or medical care are denied, delayed, or otherwise not paid appropriately, we file a pleading referred to as a Petition for Benefits [5]. Once a Petition for Benefits is filed, the clock is ticking limiting the time for a work comp carrier to act without having to pay additional expenses.  If the work comp insurance company does not provide the benefits requested within 30 days of our filing a Petition for Benefits, they can incur the expense of attorney fees, costs, and have to pay you a penalty and interest on monetary amounts you’re owed.   If you have questions about whether you’re receiving the full amount of benefits you’re entitled to, we encourage you to contact us for free and find out.

We represent people on both ends of the spectrum in terms of the level of difficulty they’re experiencing regarding receiving work comp benefits.  We represent those whose claim has been denied entirely and those with no benefits being denied.  In the first instance, the need to file a Petition for Benefits is obvious.  Without lost wages being paid of medical care authorized, someone suffering from work related injuries is without the potential remedies available through Florida’s worker’s compensation dispute resolution process. In the second instance involving an injured employee receiving what they’re entitled to from a work comp carrier, attorney representation provides the opportunity to ask any question concerning benefits, medical care, what to expect in the future, and receive an informed response specific to their case.  In the event that any benefits they’re entitled to become denied or delayed, the fact we’ve already undertaken representation allows us to quickly respond by filing a Petition for Benefits.  Attorney representation also allows us to help you navigate the complexities of the work comp system.  We work to help ensure you do not make any statements or engage in any activity that would be detrimental to your claim.

These delays and denials occur as a result of the insurance company’s financial interest.  Paying the correct amount of lost wage benefits and authorizing medical care are expenses that directly reduce an insurance company’s profits.  What is beneficial to someone suffering from a work related injury or condition is not at all similar to what is beneficial to an insurance company.  It is important to remember that regardless of Florida’s Legislative intent, an insurance company providing worker’s compensation coverage to an employer is a business. The primary purpose for starting a business is usually financial [6]. Financial incentives are known to cause unethical behavior and other unintended negative consequences [7]. We’re not suggesting that financial incentives always result in unethical behavior.  Studies exist in support of the conclusion that financial incentives increase productivity [8]. Several psychological theories support the premise that linking rewards to performance can stimulate performance improvement by increasing employee motivation [9]. However, a worker’s compensation insurance company’s financial incentives are driven by decreasing the amount spent in connection with someone’s work related accident.   One of the most predominant methods for decreasing the amount of costs in a claim is for a work comp adjuster to deny benefits.  Insurance companies providing work comp coverage play the odds in order to decrease odds.  Meaning, workers compensation insurance companies are betting that not everyone will be sufficiently informed and otherwise motivated to retain an attorney.  Work comp insurance adjusters know that if they provide false information to someone injured on the job by telling them they are not entitled to a certain benefit, or that a doctor changed his/her mind against providing a certain surgery/treatment, that some people will believe them.  The result of believing such false information is that the person doesn’t speak to a worker’s compensation attorney and discover what they are truly entitled to.   If you, a friend, or family member, have been injured on the job, or suffer from a work related condition, contact our office at 727-451-6900 for a free consultation.

Dolman Law Group
800 North Belcher Road
Clearwater, FL 33765
727-451-6900

Visit the Dolman Law Group’s Workers’ Compensation Page for More Information. 

References:

[1] http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0440/0440.html
[2] http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0440/Sections/0440.015.html
[3] http://www.myfloridacfo.com/division/wc/
[4] https://www.jcc.state.fl.us/jcc/
[5] http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0440/Sections/0440.192.html
[6] http://www.ehow.com/info_7805152_purpose-starting-business.html
[7] http://knowledge.wharton.upenn.edu/article/the-problem-with-financial-incentives-and-what-to-do-about-it/
[8] https://scholar.google.com/scholar?q=studies+in+support+of+financial+incentives&hl=en&as_sdt=0&as_vis=1&oi=scholart&sa=X&ved=0ahUKEwit-6aPuZnOAhVGJiYKHZVoC2sQgQMIGjAA
[9] http://scholarworks.gsu.edu/cgi/viewcontent.cgi?article=1032&context=pmap_diss