How Does Florida's Workers' Compensation System Work?

Florida's worker's compensation system aims to safeguard workers who experience job-related injuries or illnesses by offering them benefits. Both employers and employees must grasp the workings of this system to adhere to state regulations and guarantee that injured workers are properly cared for.

This article will explore elements of Florida's workers' compensation system, such as the eligibility criteria, the various benefits offered, and the process for filing claims.

What Is Workers' Compensation?

In Florida, employers must have workers' compensation insurance, which protects employees who get hurt or fall ill while on the job. The system operates on a no-fault basis, so workers don't have to show that their employer caused their injury or illness to receive benefits.

Who Is Eligible for Workers' Compensation in Florida?

In Florida, most employees are covered by workers' compensation, but some exceptions exist. Here's a general overview of eligibility:

• Employers with Four or More Employees: Florida law requires businesses with four or more employees, whether full-time or part-time, to carry workers' compensation insurance.

• Construction Industry: Businesses in the construction industry must carry workers' compensation if they have one or more employees.

• Agricultural Industry: Agricultural employers with six or more regular employees or 12 or more seasonal employees (who work more than 30 days) must also provide workers' compensation coverage.

Workers' compensation may not cover certain employees, such as independent contractors. Verifying your status with your employer is essential to determine if you're eligible for these benefits.

Types of Benefits Provided Under Florida's Workers' Compensation System

Florida's workers' compensation system offers several types of benefits to injured workers, depending on the severity of the injury and its impact on the employee's ability to work:

1.Medical Benefits: Workers' compensation covers all necessary medical treatment for the injury or illness. This includes doctor visits, hospital stays, surgeries, medications, physical therapy, and other medically necessary treatments. The employer or insurance carrier typically selects the authorized treating physician.

2. Temporary Total Disability (TTD) Benefits: Employees who cannot work due to an injury may be eligible for Temporary Total Disability benefits. These benefits typically amount to two-thirds of the employee's average weekly wage, subject to the state's maximum benefit limit. TTD benefits continue until the employee can return to work or reach maximum medical improvement (MMI).

3. Temporary Partial Disability (TPD) Benefits: Suppose an employee can return to work in a limited capacity (e.g., fewer hours or light-duty work). In that case, they may receive Temporary Partial Disability benefits. These benefits compensate for the difference between the employee's pre-injury wages and post-injury earning capacity.

4. Permanent Total Disability (PTD) Benefits: If an injury results in a permanent disability that prevents the employee from returning to work, they may be eligible for Permanent Total Disability benefits. These benefits are paid at the same rate as TTD and continue for life.

5. Permanent Impairment Benefits: Suppose an employee reaches maximum medical improvement but is permanently impaired. In that case, they may be eligible for Permanent Impairment benefits. The amount and duration of these benefits depend on the severity of the impairment. They are determined using the Florida Impairment Rating Schedule.

6. Death Benefits: In the unfortunate event that a work-related injury or illness results in the employee's death, their dependents may be eligible for death benefits. These benefits can cover funeral expenses and provide financial support to the dependents.

The Workers' Compensation Claims Process in Florida

Filing a workers' compensation claim in Florida involves several key steps:

1.Report the Injury: Employees must report their injury or illness to their employer as soon as possible but by 30 days after the incident or the discovery of the illness. Report within this timeframe to avoid a denial of benefits.

2. Seek Medical Treatment: After reporting the injury, the employer will provide the employee with a list of authorized medical providers. The employee must seek treatment from one of these providers for the workers' compensation claim to be valid.

3. File a Claim: The employer is responsible for reporting the injury to their workers' compensation insurance carrier, who will then file a claim with the Florida Division of Workers' Compensation. The insurance carrier will investigate the claim and determine whether to approve or deny benefits.

5. Claim Approval or Denial: The employee will begin receiving benefits if the claim is approved. If the claim is denied, the employee will receive a Notice of Denial explaining the reasons for the denial. Employees can appeal the decision if they believe the denial is unjust.

6. Dispute Resolution: Suppose a dispute arises over the denial of benefits or the benefits awarded. In that case, the employee can request mediation or a hearing before a Judge of Compensation Claims. It is advisable to seek legal representation during this process to protect the employee's rights.

Conclusion

Florida's worker's compensation program aims to assist workers who experience job-related injuries or illnesses. Understanding how the system functions, such as the qualifications for eligibility, the various benefits offered, and the procedure for filing claims, is crucial. This knowledge can ensure injured employees receive the support they are entitled to.

If you or someone close to you has suffered an injury and requires guidance in navigating the Florida worker's compensation system, our skilled Jacksonville lawyers at Rite Law are available to assist. Contact us today for a consultation. Allow us to advocate on your behalf.