When you’ve been injured on the job, you may wonder when, or even if, you should seek legal help with a workers’ compensation claim. The short answer is that a Sarasota workers’ compensation lawyer can be a huge help in every stage of the claim process, and might be indispensable if your claim is denied.
Workplace Injuries By the Numbers
According to an infographic from the National Safety Council, a worker in the United States is injured on the job every seven seconds. This equals 510 workplace injuries an hour, and 4,500,000 per year. In 2016 alone, 104,000,000 production days were lost due to workplace injuries. The most common types of workplace injuries resulting in lost workdays included those due to overexertion or repetitive motion, contact with objects or equipment, or slips, trips, or falls. The occupations associated with the most workplace injuries included the service industry; transportation or shipping; manufacturing or production; installation, maintenance, or repair; and construction.
About Florida’s Workers’ Compensation Law
As explained by Florida’s Office of Insurance Regulation, workers’ compensation is insurance purchased by an employer or business in order to provide benefits for job-related injuries. With a few exceptions, all employers are required by state law to purchase workers’ compensation coverage. Employees are compensated through this coverage regardless of fault. The stated legislative intent of Florida’s workers’ compensation law is to assure quick and efficient delivery of disability and medical benefits to an injured worker and to facilitate the worker’s return to gainful employment at a reasonable cost to the employer.
The Division of Workers’ Compensation’s 2017 report states that workers with compensable injuries are entitled to receive medically necessary treatment. If the worker’s injury results in a disability that last for more than 7 days, the worker is entitled to receive a portion of his or her lost wages. Additional benefits are available for employees whose injuries are permanent. A workplace accident that results in the death of an employee, survivor benefits and the cost of funeral services may be available.
The most common type of workplace injury to require a workers compensation claim and payments for lost time at work is a sprain or strain. The upper extremities are the most commonly injured part of the body in workplace incidents, followed by the lower extremities and the back. Fall or slip injuries are one of the more common ways that employees become injured on the job.
Frequently Asked Questions About Workers’ Compensation in Florida
Q: How long do I have to report an injury to my employer?
A: You should report your injury to your employer within thirty days or risk having your claim denied.
Q: How long does my employer have to report my injury to their insurance company?
A: Your injury must be reported to your employer’s insurance company within 7 days after you make them aware of it.
Q: Can I go see my own medical provider?
A: Not necessarily. The medical provider you see for your work-related injury must be authorized by your employer or your employer’s insurance company.
Q: If I file a workers’ compensation claim and it is approved, do I have to pay any medical bills associated with my work-related injury?
A: No, the bills will be submitted by the medical provider to your employer’s insurance company for payment.
Q: How much will I be paid for lost time from work?
A: You will not receive lost time benefits for your first seven missed days of work, unless you lose more than 21 days due to your disability. In that case, the insurance company may opt to pay for those first seven days. In most cases, after the first seven missed days, your benefit check will be 66 2/3 percent of your average weekly wage. The average weekly wage is calculated using the 91 days immediately preceding your injury.
Q: Can my employer fire me if I am disabled due to a work-related injury and I have filed a claim for workers’ compensation benefits?
A: No, it is against the law for your employer to fire you due to you filing or attempting to file a workers’ compensation claim. However, your employer is not legally required to hold a job open for you until your doctor releases you to work.
Q: What is the statute of limitations on a workers’ compensation claim in Florida?
A: A claim can be filed within two years after the injury occurs. After a year following your last medical treatment or payment of compensation, your workers’ compensation claim is considered closed. Additionally, if you settle your claim for medical benefits with the insurance company, any future medical treatments required after the settlement is reached are your responsibility to pay.
Changes to Florida’s Workers’ Compensation Law
According to a report from the local ABC affiliate, WWSB7, starting October 1, first responders suffering from work-related PTSD are now eligible to file workers compensation claims. The new law covers firefighters, police officers, paramedics, and EMTs, and only covers those who have witnessed the death of a minor or a death involving serious bodily harm. Eligible first responders can seek to recover lost wages due to work missed because of post traumatic stress after these events.
An additional report from Action News Jax states that first responders have up to a year after the traumatic event to file their PTSD claim. In addition to making workers’ compensation available for those suffering from PTSD, the new law also requires employers of first responders to provide training about mental health awareness, prevention, and treatment, the report noted.
WUSF News noted that prior to the passage of the new law, which is Senate Bill 376, PTSD was only covered by workers’ compensation if the mental injury was accompanied by a qualifying physical injury. The National Council on Compensation Insurance reported that the fiscal impact of the new law is estimated to be about $7 million.
When You Should Talk to an Attorney About Your Workers’ Compensation Claim
Here are just a few of the many situations in which a lawyer can help you with your workers’ compensation claim:
- Your claim is denied: It isn’t uncommon and, in fact, it is often considered routine, for employers and workers’ comp insurers to reject unquestionably legitimate claims. The reasoning behind this is quite simple: employers and workers’ compensation insurance companies literally bank on the idea that many workers will fail to appeal a claim denial. Often, they are correct. Having the expertise of an attorney familiar with this ugly practice means you’ll have the best chance to get a fair and faster settlement for your injuries.
- Benefits don’t pay promptly: If you have been hurt and are trying to recover, deal with the financial stress of lost work and all the other mounting costs, delayed payments can become a serious issue. The cause for these delays can be countless, from administrative to clerical or insurance coding errors. Attorneys who understand the nuances of the system and know how to get results will expedite your payments and minimize errors that cause those costly delays.
- Lost wages and medical bills exceed your settlement offer: Workers’ compensation carriers may offer to settle a disputed claim for far less than the worker is entitled to receive. But, without quality legal advice, the worker may not know this and accept the offer, thinking it’s the best she can do. Having a lawyer on your side to negotiate and advise on a settlement will help ensure that you don’t take too little or become convinced that you’re entitled to less than you actually are.
- You are unable to return to work: In the case of permanent or permanent partial disability, legal guidance becomes even more important. Workers’ compensation benefits for permanent or career-ending disabilities may involve substantial lump sums or ongoing payments. They can be complicated, and because of their potentially large cost to insurance companies, insurers may fight these claims more aggressively.
Knowledgeable and savvy workers’ compensation attorneys can help cut through the insurance companies’ tactics and get you the settlement you deserve for your illness or injury.
During the process of preparing, filing, and fighting a workers’ compensation claim, other complicated legal issues can arise. Having an experienced Sarasota personal injury attorney by your side to confront these challenges is important. For instance:
- Employer retaliation: Workers sometimes fear that filing a workers’ compensation claim will prompt their employer to retaliate, either by demoting them, firing them, reducing their hours, or taking other adverse work action. Employers ought to know that this constitutes illegal conduct, but retaliation still happens, and when it does, a lawyer who knows how to protect and enforce your rights is important.
- Third party involvement in your injury: Many industries involve collaboration among different companies, including employees of different employers working on the same site, sharing common workspaces. When a party other than your employer contributes to your injury, an experienced legal team can help sort out the legal responsibilities of anyone outside the realm of workers’ compensation, in addition to helping you pursue your claim.
- Serious employer misconduct or negligence: We never want to think of our employers as people who cut corners in ways that make us unsafe. When we do encounter such unsavory behavior from those who sign our checks, however, that may warrant more aggressive legal action. While the workers’ compensation system is designed to dissuade and prevent lawsuits against employers, suits outside of and in conjunction with workers’ compensation may be called for. An experienced lawyer who aggressively fights for your rights will help you hold all responsible parties accountable and get the justice you deserve.
What Will Your Attorney Do for You?
Dealing with the workers’ compensation system and understanding how the claim process works can be an intimidating and confusing task. It often isn’t realistic for someone suffering the effects of an on-the-job injury to have the time, capacity, or ability to handle such a burden. Here are some of the ways an attorney can help you throughout the workers’ compensation claim process:
- Answering your questions. If you have been injured in a work-related accident or fallen ill as a result of your job responsibilities, then you probably have more than a few questions about what to do next. You might want to understand the workers’ compensation process better. You might be wondering how to find a doctor. You might be worried about how you are going to afford your legal bills. We believe your lawyer’s first job is to listen to your questions and try to answer them in clear, simple terms, so that you can feel confident that you understand what’s happening as you go through the process of seeking compensation for your injuries.
- Investigating and filing the claim. If we’re involved in your case early enough, our team can help you prepare and file a workers compensation claim. This is important because filing a claim on time, in the proper format, and with the correct information, can mean the difference between a claim being approved in full and being denied. We have experience helping injured workers collect the information they need for a successful claim, and selecting the appropriate healthcare providers for follow-up treatment. Following up with insurance adjusters. Our experienced attorney can help you by staying on top of the claims determination process. We know how to speak with insurance adjusters, and how to respond to their questions, in order to get results for our client.
- Contesting a denied claim. If an insurance company denies your workers’ compensation claim, we can help you fight back. We can guide you through the process of appealing a claim decision, negotiating a settlement, and litigating a claim hearing. We can also advise you about whether you have rights outside of the appeal process, such as in the case of your claim having been denied for a wrongful reason such as retaliation.
- Enforcing your legal rights in court. If your on-the-job injury affects your legal rights beyond the workers’ compensation process, we can help you enforce those rights in and out of court. For instance, if your injury resulted from a third-party’s negligence, we can prepare and pursue a claim against the responsible party in court or arbitration.
Dolman Law Group Accident Injury Lawyers, PA – Sarasota Office