Ocala Workers’ Compensation Lawyer
If you get injured on the job, your medical expenses will be paid by your employer’s insurance, along with a major portion of your wages while you are out of work and recovering from your injury. At least, that’s how it’s supposed to work. Practically all employers in the state of Florida are required to purchase workers’ compensation insurance to cover their employees when they are injured on the job. Not only is workers’ compensation insurance required, but it’s also often the only recourse you have when you are injured on the job. In most cases, you aren’t allowed to sue your employer or a co-worker for negligence; your only option is to file a claim for workers’ compensation benefits. Contact our experienced Ocala workers’ compensation lawyers for more information or assistance.
Florida Workers’ Compensation Claim Process
It should be a simple matter to claim workers’ compensation benefits when you’ve been injured on the job, but it isn’t. Florida’s workers’ compensation system favors the employer, and it can be an uphill battle for the injured worker to get needed medical care and wage loss benefits while they are out of work. At the Musleh Law Firm, our family has been representing injured people in Ocala since 1949. We are there for you when a workplace accident or illness knocks you off your feet. Our job is to make sure you get the benefits you are entitled to under the law in a complete and timely fashion. Learn more below about the Florida workers’ compensation claim process, and contact the Musleh Law Firm for professional legal advice and assistance at any step along the way.
Report your injury promptly
Florida workers’ compensation laws can be found in Chapter 440 of the Florida statutes. Section 440.185 requires you to report an accident as soon as possible, but not more than 30 days from the date of the initial manifestation of the injury. If you don’t notify your employer within this 30-day period, you can be kept from filing a claim for benefits, so this notice requirement is not to be taken lightly.
Once you’ve reported the injury to your employer, they have seven days to notify their insurance carrier. The insurance company then has three days to send you a brochure informing you of your rights and responsibilities under the law. If you think your employer hasn’t timely notified the insurance company, you can report your injury directly to the insurance company yourself. The carrier’s name and phone number should be on the “broken arm” poster that is required to be posted at your workplace. If you can’t find this poster, call our office for help.
Petition for Benefits
Once you have properly reported your injury, your employer or the insurance company should authorize you to seek medical care and initiate the payment of benefits. Workers’ comp pays the doctors directly, so you should never be billed for authorized medical care. Wage replacement benefits begin after you have been out of work for seven days.
If your claim is denied or unreasonably delayed, the next step is to file a Petition for Benefits. This petition is a formal request that beings the judicial procedure for obtaining benefits. Depending on the issue in dispute, you have up to two years to file this petition.
A Petition for Benefits is filed with the Office of the Judges of Compensations Claims. This office will review the petition and dismiss it if it is incomplete, further delaying or damaging your ability to get benefits. The petition should include detailed descriptions, dates and other information, and it should be supported with documentation from your doctors or other relevant sources. Our Ocala workers’ compensation lawyers can help make sure your petition is strong and complete, so make sure and contact us before trying to file a petition on your own.
You should only file a Petition for Benefits after a good faith attempt to resolve the dispute with the carrier. We are happy to work with you at this stage, as well, and try to get you your benefits sooner rather than later. Once the Petition has been filed and served on the insurance company, it has 14 days to either pay the requested benefits or file a response justifying its refusal. The matter will then be referred to a formal hearing before a judge, which will involve the presentation of evidence, testimony and legal arguments. You will want to be represented at this hearing by an attorney experienced in litigating Florida workers’ compensation cases.
If the judge’s decision isn’t favorable, your attorney can discuss the next steps for you, which may include appeal to the district court.
How much does workers’ compensation pay in medical benefits?
Workers’ compensation is supposed to pay for all of your medical treatment, so long as it is authorized, medically necessary care. This includes doctor visits, hospital stays, physical therapy, tests, prescriptions, prostheses, attendant care and more. You can receive care from your authorized primary doctor as well as specialists when medically necessary. Workers’ comp also pays for mileage to and from the doctor and the pharmacy.
Who decides what care is authorized and what treatment is medically necessary? You don’t get to see your regular physician after a workplace accident or choose the doctor who will treat you. Instead, your employer or the insurance company authorizes a doctor initially, and the insurance carrier authorizes any follow-up treatment after your initial visit. If you are having trouble getting the care you need because of insurance company denials or delays, we can help.
What kinds of wage replacement benefits are available?
Florida workers’ compensation provides different types of benefits depending on the nature and extent of the injury. Generally speaking, your wage replacement benefits may be classified as Temporary Total Disability, Temporary Partial Disability, Impairment Income Benefits, or Permanent Total Disability. In addition to these categories of income replacement, you may also be eligible for reemployment benefits such as retraining or vocational counseling.
Temporary Total Disability – Your employer pays TTD benefits when you cannot work because of the injury. The amount of TTD is two-thirds of your average weekly wage, up to the state maximum, which was $939 in 2019. For certain severe injuries, you can receive 80% of your regular wages for up to six months after the accident. In any case, TTD benefits may be paid for up to a total of 104 weeks. Benefits don’t kick in until you have been out of work for eight days, but if you wind up off the job for 21 days, then you can go back and collect benefits for those first seven days.
Temporary Partial Disability – TPD benefits are available when your doctor authorizes you to return to work on restricted duty. If you earn less than 80% of your regular wages on your restricted assignment, you can collect TPD benefits for up to 104 weeks.
Impairment Income Benefits – Once you’ve achieved maximum medical improvement for your condition, you’ll be assigned a rating for any lingering disability. The insurance company uses a statutory formula to calculate your weekly IIB benefit and the number of weeks you can receive IIB, based on your wage and percentage of impairment.
Permanent Total Disability – If you can never work again because of an occupational illness or on-the-job injury, you can receive PTD wage replacement benefits for the rest of your life, assuming your condition never improves.
Florida Workers’ Compensation FAQs
If you’ve never had to file a workers’ compensation claim before, you probably have a lot of questions. What is the process for filing a workers’ compensation claim? Is my injury covered by workers’ comp? Why did the insurance company deny my claim? Below we answer some basic questions that most often come our way as we help injured workers in Ocala pursue a claim for Florida workers’ compensation benefits. If you have other questions or need help with a claim or denial, call the Musleh Law Firm at 352-732-0600 for a free, initial consultation with a skilled and dedicated Ocala workers’ compensation lawyer.
Q. How do I know if my employer carries workers’ compensation insurance?
A. Just about every employer in the state of Florida is required by law to have workers’ compensation coverage for their employees. Non-construction employers with four or more full-time employees must have workers’ comp insurance. Construction employers with just one full-time or part-time employee are also covered. Farmers with six or more regular workers or 12 or more seasonal employees who work more than 30 days must also cover their employees for on-the-job injuries.
Your employer should have a poster in the workplace (the “broken arm” poster) that says who their carrier is. If you can’t find out from your employer if they have workers’ comp coverage, call the Florida Division of Workers’ Compensation, or call our office.
Q. Can I see my regular doctor for an injury on the job? Do I get to choose which doctor I see?
A. Unfortunately, Florida law says it’s your employer or their insurance company that chooses a doctor for you. If you don’t like the doctor they authorized, you can request a one-time change to a different authorized physician, and the insurer has five days to comply with your request. You do have the right to select your pharmacy and pharmacist, but not all pharmacies participate in the Florida workers’ compensation system. When using a participating pharmacy, the pharmacy bills the insurer directly instead of you, so you don’t have to pay anything out of pocket. That’s how it works when you see an authorized physician, as well.
Q. What is an IME? Do I have to attend?
A. IME stands for Independent Medical Examiner or Independent Medical Examination. If you or the insurance company disagree with the doctor’s diagnosis or recommended treatment, you can request an IME by a different doctor. If the insurer orders an IME, you do have to go, even though this exam is not done to provide treatment but merely to give the insurer leverage to deny or limit your claim or terminate your benefits. We can help you prepare for your IME by explaining in more detail the purpose of the exam and what you can expect at the IME.
Q. Does Florida workers’ compensation cover a fatal accident on the job?
A. Workers’ compensation does provide benefits for a fatal accident, including a death that occurs within one year of the accident or after five years of continuous disability. Benefits include up to $7,500 in funeral expenses, educational benefits to a surviving spouse, and other compensation to dependents, as defined by law, up to a maximum of $150,000.
Q. Does workers’ compensation cover illnesses or diseases?
A. Yes. Florida workers’ compensation does cover occupational disease from toxic exposure or other job-related causes as one of the many types of covered injuries. You’ll need to prove sufficient exposure and causation by clear and convincing evidence, which is a tough legal standard compared to how other types of injuries are proven. Our Ocala workers’ compensation attorneys can help you prepare your claim for an occupational illness or disease or fight a denial of your claim.
Q. Are my benefits taxable?
A. Florida workers’ compensation benefits are not considered taxable income. If you are working and receiving temporary partial disability (TPD), you’ll pay taxes on your earned wages but not on your TPD benefits.
Q. Can I receive Workers’ Compensation and Social Security Disability (SSD) at the same time?
A. You can get SSD and worker’s comp at the same time, but your worker’s compensation benefits will be offset or reduced if the two benefits combined exceed 80% of your average weekly wage. SSD is much harder to get than workers’ compensation, as the Social Security Administration uses a very strict definition of disability and only provides SSD to people who are permanently and totally disabled.
Q. Can I settle my workers’ compensation claim for a one-time payment? Should I?
A. You can settle your claim for a lump sum, but if your medical condition worsens and your costs exceed your expectations, you won’t be able to go back and seek any more help from the insurance company. Talk to your attorney about whether a settlement is in your best interests, and let your attorney negotiate the settlement on your behalf to get the best result.
Q. So, what happens when you file a claim after an on-the-job injury, and your employer denies the claim?
A. The personal injury attorneys at the Musleh Law firm fight every day on behalf of people injured in a motor vehicle accident or on the job. We’ve taken on the biggest insurance companies and achieved results. See below for some general information on Florida workers’ compensation and how our lawyers can help.
If you’ve been hurt on the job and need help collecting workers’ compensation benefits, call the Musleh Law Firm at 352-732-0600 for a free consultation on your claim.
Get the Workers’ Compensation Benefits You are Entitled to After an Injury on the Job
Your employer and their insurance carrier come up with many reasons to deny benefits or terminate them early. You need an attorney on your side looking out for you who can make sure you are treated fairly and receive the benefits you need and deserve. This is precisely what we do at the Musleh Law Firm. If you were hurt on the job in an Ocala workplace accident or incurred an occupational illness or disease, call the Musleh Law Firm at 352-732-0600. We offer a complimentary consultation to learn about your case and advise you on your options, and we only charge a fee after we have been successful recovering benefits for you.