Florida law requires employers to carry Workers’ Compensation insurance. This coverage pays for medical treatment if you get hurt on the job and replaces part of your lost wages if you cannot return to work. Unfortunately, some employees who sustain serious work-related injuries or illnesses must fight for the benefits they deserve.
If you are struggling with a Workers’ Compensation claim — and your unpaid bills have begun to pile up — seek help from a Workers’ Compensation lawyer in Miami.
What Benefits Will Workers’ Compensation Pay Me?
In Florida, Workers’ Compensation (WC) insurance pays for your medical treatment and care for injuries you sustain on the job. If the injury prevents you from returning to work, this insurance also pays a portion of your lost wages.
Although you must use authorized doctors and care providers, WC insurance should cover visits to your doctor, medications, tests, medical procedures and devices, and therapy or rehabilitation.
If you are out of work for seven days or more, WC will pay you two-thirds of your weekly wage, up to the state maximum (changes per year), for up to 104 weeks (two years).
If your injuries left you fully or partially disabled, or if the doctors determine you have improved as much as possible, the insurance company will calculate impairment benefits based on the degree of your disability.
Does My Employer Have to Provide Workers’ Compensation Coverage?
Any individual, entity, or organization that employs people has a statutorily mandated obligation to provide Workers’ Compensation coverage. This applies to private and public organizations, municipalities, government entities, employment agencies, and employee leasing companies.
A company is exempt from this requirement, however, if it employs fewer than four full- or part-time workers. If a company works in the construction industry and employs more than one worker, it must provide WC benefits.
Small farms are exempt also, if they employ fewer than five regular workers or fewer than 12 seasonal workers (for 30 days or less).
Note: A legal obligation to provide coverage does not mean your employer has a WC policy in place. You can verify your employer’s coverage by visiting the Florida Division of Workers’ Compensation’s Employee Assistance Office (EAO). This page allows you to search for your employer to verify the status of its WC policy.
If your employer does not have a valid policy in force, you can report it on the same EAO page.
Do I Qualify for Workers’ Compensation Benefits?
Some types of workers are exempt, however. These include domestic workers in a private residence, some types of agricultural laborers, and professional athletes. In addition, some small companies with a limited number of employees do not have to provide this benefit.
If you work as an independent contractor rather than a salaried or hourly employee, you do not qualify for WC benefits. Sometimes, employers mistakenly classify employees as independent contractors.
If you believe you qualify for benefits but your company says otherwise, consult with a Workers’ Compensation lawyer as soon as possible. A lawyer can help you determine if you do qualify for benefits and, if so, help you fight for the compensation you deserve for your injury.
What Types of Injuries Does Workers’ Compensation Cover?
“Workers’ Compensation insurers to cover most types of work-related injuries, illnesses, and accidental death.”
The Florida Workers’ Compensation statutes require workers’ Compensation insurers to cover most types of work-related injuries, illnesses, and accidental death.
The insurer will likely deny your claim if your injury occurred when you were:
- Engaging in horseplay
- Committing a crime
- Attempting to injure yourself or someone else
While denials for the reasons listed above are valid under the law, WC insurance companies also often deny valid claims. If this happens to you, contact a Workers’ Compensation lawyer in Miami for advice.
We can gather medical records and statements from doctors and other industry experts to support the validity of your injury or illness. Using this information, we can prove that your claim is indeed valid.
What Is the Process for Filing a Workers’ Compensation Claim?
However, we recommend reporting it immediately to protect your legal rights. You should also seek medical attention immediately. If you wait, the insurance company may assert that you were not seriously injured (or that your injury is not work related) if you did not see a doctor right away.
Once you report your injury, the employer has seven days to report your injury to the WC insurance company.
You or your employer must complete a detailed report of the accident that caused your injury and submit it to the insurance company to open your claim.
The WC insurer will use this report as it basis for approving or denying your claim. Consequently, you or your employer must complete it correctly. Make sure it accurately reflects how your injury affects your life.
The insurance company may require you to undergo an independent medical evaluation, or IME. A doctor chosen by the insurance company will examine you and report the results to the insurance company, with an opinion of how serious your injury is.
Because the insurance company chooses this doctor, he may be biased. Seeking a second opinion to bolster your claim may be a good idea.
How Would Having a Workers’ Compensation Lawyer Benefit Me?
- Protecting your legal rights throughout the WC claim process
- Collecting important evidence to support your claim
- Explain each aspect of the process and ensure you understand your options
- Assist with preparing and submitting important claim documents
- Speaking with the insurance company on your behalf
Whether you just sustained an injury, already opened your WC claim, or if the insurance company has denied your claim, a worker’s comp lawyer can help.
The Law Firm of Anidjar & Levine offers free consultations to answer any questions you may have and to explain all your options, so you can make an informed decision. To speak directly with a Workers’ Compensation lawyer in Miami, contact us today at 800-747-3733.