When Should I Retain Counsel to Represent Me Regarding My Workers’ Compensation Claim?

If you have suffered what you believe to be a workers’ compensation injury, we advise you to hire an attorney right away, rather than file a claim on your own. Why? While many benefits are available to you under Florida Law the insurance company will not reveal or provide them to you unless your attorney makes a specific request. To ensure that you receive everything to which you are entitled, it is in your best interest to contact an attorney right away.

What Is The Definition of Workers’ Compensation Insurance in Florida?

Per the Florida Office of Insurance Regulation , “Workers' Compensation is insurance coverage purchased by the employer/business that provides benefits for job-related employee injuries. Florida law requires all employers to purchase workers' compensation coverage (with a few exceptions). Under a workers' compensation policy, employees are compensated for occupationally incurred injuries, regardless of fault. This coverage makes employers immune from some injury lawsuits by employees. In Florida, the Division of Workers' Compensation within the Department of Financial Services is the primary regulator for ensuring employees receive the proper benefits under this coverage, which includes benefits for medical expenses, disability, or death. The Office of Insurance Regulation primarily regulates the rates, forms, and solvency for this type of coverage. The amount of compensation is established by law.”

First Responders and Workers’ Comp Law

As we discussed in a previous post about the Heart and Lung Bill, in most cases, a first responder’s employer must cover cardiovascular disease, high blood pressure, or TB because of the presumption that these conditions were contracted as a direct result of their employment. With the passage of FL 112.1815, a law enforcement officer, firefighter, emergency medical technician, or paramedic can access indemnity and medical benefits for PTSD, whether it is accompanied by a physical injury or not. We’re proud of our involvement in securing this much-needed legislation.

In light of these recent protections for Florida first responders, you might be tempted to manage your workers’ comp claim on your own, regardless of the type of injury you have suffered on the job. But this could be a costly mistake.

Understanding the Florida Workers’ Compensation System

The Florida Division of Workers’ Compensation oversees all comp claims in the state. Florida, like every other state in the U.S., operates under a no-fault workers’ compensation system. This simply means that you are eligible for benefits as long as your injury occurred on the job or as a consequence of the work-related activity. In such a case, you may be eligible for a variety of benefits including, but not limited to:

Temporary Disability
Total Disability
Partial Disability
Remedial Care
Palliative Care

Reporting an Injury

Following an injury, the first thing you must do is notify your employer. For most injuries, Florida law requires that you do so within 30 days to ensure that you do not lose some or all of your workers’ comp benefits. Provide your employer with as much detail as you can in terms of when the accident took place, how you got hurt, and the type of symptoms you are dealing with.

After you have completed filing the report with your employer, they should send you to a doctor. Per Florida’s workers’ compensation system, your employer, through the workers’ compensation insurance company, mandates your treating physician, except in the case of emergency treatment. During your examination and consultation with the doctor, be honest and specific with them about the cause of your injuries and the severity of your symptoms.

Post-Injury Report: What Happens Next

Your employer has seven days to report your claim to the insurance company. If they refuse, you can then contact the workers’ comp insurance company directly. At that point, they will open an investigation to determine your eligibility for benefits. Be prepared for the insurance company to review your medical records; analyze your work experience and wages; order a medical examination to diagnose your condition; and require you to undergo a functional capacity evaluation to gauge your ability to perform your work duties.

Florida law requires that the workers’ compensation insurance company approve or deny your benefits as quickly as possible. If they approve your claim, you will begin to receive disability payments and other benefits. In the real world, however, insurance companies deny a multitude of workers’ compensation claims...which is why we began by urging you to seek legal representation.

Have you sustained an injury on the job?

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Disclaimer: The information in this blog post (“post”) is provided for general informational purposes only, and may not reflect the current law in your jurisdiction. No information contained in this post should be construed as legal advice from the individual author or the law firm, nor is it intended to be a substitute for legal counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate legal or other professional advice on the particular facts and circumstances at issue from a lawyer licensed in the recipient’s state, country or other appropriate licensing jurisdiction.