Structure of A Workers’ Compensation Claim

When a worker is injured on the job, he or she is usually entitled to workers compensation benefits to compensate for medical expenses, rehabilitation and lost wages resulting from the accident. The requirements and terms of an injured worker’s right to receive workers’ compensation benefits in Florida is set out by statute, commonly known as the Florida Workers’ Compensation Law.

What is the Florida Workers’ Compensation Law?

Chapter 440 of the Florida Statutes contains the Florida Workers’ Compensation Law and sets out the requirements for receiving benefits. The general requirements are:

Your Employee Must Not Be Exempt: Under the law, some employers are exempt from providing workers’ compensation benefits to employees. The most common example is a non-construction industry employer with fewer than four employees. If your employer elects not to provide workers’ compensation coverage, it must give you clear notice that you are not entitled to coverage.

Your Accident Must Be Covered: Typically, to be entitled to coverage, your injury or accident must have happened “in the course of your employment” or, in other words, while you were performing your job duties. This does not mean that you must have been physically present at your place of work. As long as you were injured while carrying out the requirements of your job (making a delivery for example) your injury should be covered by Florida’s Workers’ Compensation Law.

There Must Not Be An Exception: Even if your employer qualifies and your injury happened at work, you may not be entitled to workers’ compensation benefits if your situation falls into an exception under the Florida Workers’ Compensation Law. For example, your claim for benefits may be denied if your injury was the result of your own intoxication or if it occurred because of horseplay or from a fight.

If your workers’ compensation claim was denied for any reason, contact a Clearwater workers’ compensation attorney immediately. A skilled workers’ compensation attorney can review your case and ensure you receive the coverage you are entitled to.

What Happens When I File A Claim?

In order to qualify for benefits, there are several steps you must follow after a workplace injury:

Report: If you are injured at work, you must inform your employer as soon as possible. Florida law requires that you report any job-related injury within 30 days of the date you become aware of it.

Claim: After your employer has been notified, your employer is required to report your injury to its workers’ compensation carrier within 7 days of your notice. You should receive a copy of the report your employer sends to the carrier.

Review: After receiving your application for benefits from your employer, the carrier will review it and make a determination of coverage. If your claim is denied, contact an attorney immediately for assistance.

Treat: You must visit a doctor authorized by your employer to treat your injury. Your employer and insurance company will have a list of authorized physicians for you to choose from. If your injury is an emergency and you cannot contact your employer before treating, go to the nearest emergency room and inform your employer as soon as possible.

I Have Begun Treatment, Now What?

Your treatment and temporary benefits as determined by your employer’s workers’ compensation carrier will continue until you reach Maximum Medical Improvement or MMI. MMI is the point at which your treating doctor has determined that further recovery or improvement is no longer reasonably expected.

After you have hit MMI, your doctor will then assign you a number, referred to as a Permanent Impairment Rating, or PIR. PIRs range from 0% to 100% and are you doctor’s estimate of the permanent damage done by your workplace injury. A 0% PIR would mean your doctor thinks you have made a full recovery and suffer no long term effects from your injury.

The PIR you are assigned as a direct effect on the amount and kind of permanent benefits you may be entitled to, including if you are entitled to permanent benefits at all. If you disagree with your PIR or think continuing treatment would help you to improve, call a New Port Richey workers’ compensation attorney right away.

Contact a New Port Richey Workers’ Compensation Lawyer Today for a Free Consultation!

If you are injured at work and feel you are not receiving all of the benefits to which you are entitled, contact a skilled New Port Richey workers’ compensation lawyer immediately. An experienced attorney can help evaluate your unique situation and be your best advocate in confronting your employer’s workers’ compensation carrier.

To schedule a free consultation with the Dolman Law Group, call our office today at 727-853-6275 or send us an email through our online contact form.

Dolman Law Group
5435 Main Street
New Port Richey, FL 34652
(727) 853-6275