Experiencing an injury at work in Florida can be a very stressful and challenging ordeal, as you navigate not just the physical pain but also the financial concerns and anxiety about what comes next. You are certainly not alone in this experience; in 2022, Florida sadly recorded 307 fatal work injuries, and in that same year, medical payments for workers' compensation claims totaled a significant $1,614,808,332, illustrating how vital this support system is. If you've been injured on the job, understanding how to file for workers' compensation in Florida is a critical first step toward protecting your rights and accessing essential benefits for your recovery. This article is designed to help you navigate the Florida workers' compensation claim process. It will guide you through each stage, from reporting your workplace injury to obtaining the compensation you rightfully deserve, allowing you to concentrate on your healing and recovery journey.

Understanding Your Rights and Initial Obligations When Filing for Workers’ Compensation in Florida

The Florida Workers' Compensation system is designed to provide medical care, wage replacement, and other benefits to employees who suffer injuries or illnesses arising out of and in the course of their employment. It is a no-fault system, meaning that, with limited exceptions, an injured worker is entitled to benefits regardless of who caused the job-related accident.

How Long Do I Have to Report My Work Injury in Florida?

Initiating a workers' compensation claim in Florida begins with an employee notifying their employer about a job-related injury or illness. You must report the incident as soon as possible.

• Reporting Deadline: For most injuries, Florida law mandates that employees report the incident to their employer (such as a supervisor, manager, or HR department) within 30 days of the injury occurring.
• Gradual Injuries/Illnesses: If a condition or illness develops over time due to work duties (e.g., repetitive stress injuries or occupational diseases), the 30-day reporting window begins from the date the employee becomes aware, or reasonably should have become aware, of the condition and its relationship to their employment.

Failure to adhere to these reporting deadlines can jeopardize an employee's eligibility for workers' compensation benefits. When reporting, it is advisable to provide a detailed account of the accident, the nature of the injury, and any symptoms experienced.

How Do I Get Medical Treatment for My Work Injury in Florida?

Once an injury is reported, the employer is obligated to take specific actions:

1. Medical Attention: The employer should direct the injured employee to an authorized medical provider for an evaluation. Except in emergency situations, the employer or their insurance carrier has the right to select the treating physician. It is vital to provide this doctor with a complete and accurate history of the injury and symptoms.
2. Reporting to the Insurer: The employer must report the injury to their workers' compensation insurance carrier within 7 days of their knowledge of the injury. If the employer fails to do so, the injured employee can contact the insurer directly or seek assistance from the Florida Division of Workers' Compensation.
3. Insurance Carrier Investigation: The insurance carrier will then conduct an investigation to determine the compensability of the claim. This may involve reviewing medical records, analyzing the employee's work history and wages, obtaining an independent medical examination (IME), and assessing the employee's ability to work. The insurer is required to either approve or deny the claim promptly.

What Injuries Are Covered by Workers' Compensation in Florida?

Florida's workers' compensation law generally covers any injury or illness that arises out of and in the course of employment. This is a broad definition, encompassing a wide range of workplace injuries and conditions.

Common Physical Injuries:

• Traumatic Injuries: These result from a specific event or accident, such as
  • Slips, trips, and falls leading to fractures, sprains, or head injuries.
  • Injuries from being struck by or caught in/between objects or equipment.
  • Lacerations, punctures, and crush injuries.
  • Burns from heat, chemicals, or electricity.
  • Vehicle accidents while performing job duties.
• Repetitive Stress/Motion Injuries: These develop over time due to repeated physical tasks, including
  • Carpal tunnel syndrome.
  • Tendonitis.
  • Back strains or sprains from repetitive lifting.
• Overexertion Injuries: Caused by excessive physical effort like lifting, pushing, pulling, or carrying heavy objects.
• Amputations.
• Hearing loss due to prolonged exposure to loud noise.

Occupational Illnesses:

Exposure to harmful substances or conditions in the workplace can lead to illnesses covered by workers' compensation, such as

• Respiratory conditions from inhaling dust, fumes, or chemicals (e.g., asbestosis, silicosis).
• Skin diseases from contact with irritants.
• Illnesses caused by exposure to infectious agents (e.g., in healthcare settings).
• Poisoning from toxic substances.

Aggravation of Pre-Existing Conditions:

If a work-related accident or exposure aggravates or accelerates a pre-existing medical condition, the worsened condition may be covered. For instance, if a pre-existing back problem is made significantly worse by a workplace fall, benefits may be available for the aggravation.

Psychological Injuries:

Mental or nervous injuries, such as post-traumatic stress disorder (PTSD), may be compensable under Florida law if they are a direct result of a physical workplace injury. For a purely mental injury (with no accompanying physical injury) to be covered, it generally must arise from something more than the usual stress or exigencies of employment and often requires a higher burden of proof.

Injuries Generally NOT Covered:

It is also important to note situations where injuries may not be covered:

• Injuries sustained while the employee was not on company time or engaged in work duties (with some exceptions for traveling employees).
• Injuries resulting from an employee's intoxication by alcohol or illegal drugs.
• Self-inflicted injuries or those caused when an employee was the aggressor in a fight.
• Injuries occurring while an employee was engaged in unlawful activities.

What Benefits Does Florida Workers’ Compensation Provide Besides Medical Care?

Eligible injured workers in Florida may receive several types of benefits. We categorize these into medical, indemnity (wage loss), and other essential support.

Medical Benefits

• Doctor's visits (including specialists when authorized).
• Hospitalization and surgical procedures.
• Prescription medications.
• Physical therapy and other rehabilitation services.
• Prosthetic devices.
• Medically necessary assistive devices (e.g., wheelchairs, crutches).
• Mileage reimbursement for travel to and from authorized medical appointments and pharmacies.

It is extremely important to receive treatment from physicians authorized by the workers' compensation insurance carrier, except in cases of emergency. Unauthorized medical care may not be covered.

Indemnity (Wage Loss) Benefits

These benefits are designed to replace a portion of the wages lost due to the inability to work or a reduced earning capacity because of the work injury.

1. Temporary Total Disability (TTD) Benefits:
   
   • Eligibility: Paid when an authorized physician states the employee is unable to perform any work due to the injury.
   • Amount: Generally, TTD benefits are two-thirds (66 2/3%) of the employee's average weekly wage (AWW) at the time of injury, subject to a statewide maximum weekly cap. For certain severe injuries, this can increase to 80% of AWW for up to six months.
   • Duration: Payable for a maximum of 104 weeks, or until the employee reaches Maximum Medical Improvement (MMI), whichever occurs first. MMI means the condition has stabilized, and further material recovery is not reasonably expected.
   • Waiting Period: There is a 7-day waiting period. Benefits are not paid for the first 7 days of disability unless the disability lasts for more than 21 days, in which case benefits for the initial 7 days are paid retroactively.
2. Temporary Partial Disability (TPD) Benefits:
   
   • Eligibility: Paid if the employee can return to work with restrictions (light duty) but earns less than 80% of their pre-injury AWW due to those restrictions.
   • Amount: Calculated as 80% of the difference between 80% of the employee's pre-injury AWW and the amount they are currently earning while on light duty.
   • Duration: Also subject to the 104-week cap (combined with any TTD benefits received) or until MMI.
3. Impairment Benefits (IB):
   
   • Eligibility: Once an employee reaches MMI, if the authorized physician determines they have a permanent impairment resulting from the work injury, they may be eligible for impairment benefits. The physician assigns a permanent impairment rating (PIR) as a percentage.
   • Amount & Duration: The amount and duration of these benefits are based on the PIR and the date of the accident, following a statutory formula.
4. Permanent Total Disability (PTD) Benefits:
   
   • Eligibility: Awarded if the work-related injury leaves the employee permanently unable to engage in any meaningful employment. Certain catastrophic injuries may result in a presumption of PTD.
   • Amount: Generally, these benefits are paid at the TTD rate (two-thirds of AWW) and can continue until age 75 or for life in certain circumstances.

Reemployment Services

If a work injury prevents an employee from returning to their previous job, they may be eligible for reemployment services through the Florida Division of Workers' Compensation. These services aim to help injured workers return to suitable gainful employment and can include

• Vocational counseling.
• Job-seeking skills training.
• Resume writing assistance.
• Job placement assistance.
• Transferable skills analysis.
• Vocational evaluations.
• Training and education for a new occupation.

To be eligible, an employee must generally have a compensable Florida workers' compensation injury, meet certain date-of-accident criteria (on or after October 1, 1989), be legally eligible to work in the U.S., and request screening within one year of the last receipt of indemnity benefits or medical treatment related to the injury.

Death Benefits

If a work-related injury or illness results in an employee's death, their surviving dependents (e.g., spouse, minor children) may be entitled to death benefits. These benefits include:

• Compensation payments to dependents, up to a maximum total of $150,000.
• Funeral expenses, up to $7,500.
• Educational benefits for the surviving spouse.

Workers' compensation generally protects employers from wrongful death lawsuits, even when negligence is involved. In specific situations, you may have the opportunity to file a claim for wrongful death. It is essential to consult with an experienced attorney who focuses on workers' compensation in Florida to carefully assess the specifics of your case.

What Should I Do If My Florida Workers’ Compensation Claim Is Denied?

If your workers' compensation claim is denied, don't assume that's the final word. You have the right to dispute the denial. The insurance company must provide you with a written explanation for the denial. Your first step is often to try and resolve the dispute with the insurance carrier directly or through the Employee Assistance Office (EAO) of the Florida Division of Workers' Compensation, which offers informal dispute resolution services. If this isn't successful, you can file a "Petition for Benefits" with the Office of Judges of Compensation Claims (OJCC) to have a judge review your case. There are deadlines for filing this petition, so it's important to act promptly. If your claim has been denied, it’s essential to seek the guidance of a workers’ compensation attorney in Florida without delay.

Do I Need a Lawyer to File for Workers’ Compensation in Florida?

You are not legally required to have a lawyer to file a workers' compensation claim in Florida. Many claims are straightforward and can be handled without legal representation, especially if the injury is minor and the employer and insurance carrier are cooperative. However, it can be highly beneficial to consult with an experienced workers' compensation attorney if problems with your claim arise.

Hurt at Work in Florida? Brandon J. Broderick Can Assist You in Filing for Workers' Compensation

Sustaining injuries in a workplace accident in Florida can completely upend your life, leaving you feeling vulnerable, anxious, and uncertain about your next steps. Please know that you don't have to navigate this challenging journey alone. At Brandon J. Broderick, Attorney at Law, we approach every client's situation with deep empathy and compassion, recognizing the physical, emotional, and financial toll such an event can take.

We are here to stand firmly by your side, offering unwavering support and experienced legal guidance to help you understand your rights and pursue the compensation you rightfully deserve, allowing you to focus on your healing and recovery. Contact us today for a free consultation.