Suffering an injury on the job can leave you unable to work. In Florida, your employer has a legal obligation to provide Workers’ Compensation insurance to protect you in the event you do get hurt. But what if the insurance company tries to find reasons not to pay your claim?
If you find yourself unable to pay your bills or get the treatment you need to get better, a Workers’ Compensation lawyer in West Palm Beach can help you.Your lawyer will ensure the protection of your legal rights and fight on your behalf for the financial compensation you are due.
Is My Employer Obligated to Provide Workers’ Compensation Insurance?
Chapter 440 of the Florida Statutes indicates that every company must provide Workers’ Compensation (WC) coverage, as long as they meet one of the following criteria:
- Non-construction industry: employs four or more workers, part- or full-time
- Construction industry: employs one or more workers, part- or full-time
- Farm/agriculture industry: employs five or more workers, employs 12 or more seasonal workers for 30 days or longer
The law applies to both private and public companies; government offices and agencies; and employment agencies.
However, just because an employer has a legal obligation to provide WC coverage does not mean it does.
You can check to see if your employer has to provide coverage — and verify that coverage is in force — on the proof of coverage search page of the Florida Employee Assistance Office (EAO), sponsored by the state Division of Workers’ Compensation.
If you already sustained a serious injury on the job and you discover your employer does not have valid WC coverage, contact a Workers’ Compensation lawyer in Palm Beach as soon as possible. A lawyer can explain your legal rights and help you determine what to do next.
Do I Qualify for Workers’ Compensation Benefits?
Some workers who do not legally qualify for WC benefits in Florida include:
- Seasonal agricultural laborers (who work less than 30 days)
- Small farm laborers
- Professional athletes
- Domestic workers (home-based)
- Incarcerated persons
- Persons performing community service
- Independent contractors
The Florida legal standard for independent contractor status requires meeting certain criteria, which may include the following:
- Receives compensation per project
- Maintains his own business location
- Provides the tools and materials necessary to complete his work
- Holds professional licensure
- Bills for services
- Has a bank account for the business
- Has a federal or state tax ID number for the business
- Works without direct oversight
- Sets his own hours
- Does not take direction or supervision
Sometimes, however, employers wrongfully classify employees as independent contractors to avoid paying taxes, benefits, and worker’s comp.
If your employer currently classifies you as an independent contractor, you do not have WC coverage.
If you do not believe your work arrangement falls under the independent contractor classification, consider contacting a worker’s comp lawyer in West Palm Beach. The team at the Law Firm of Anidjar & Levine can help you determine whether you have a legal entitlement to WC coverage with your current employer.
Will Workers’ Compensation Cover Your Injury?
The Florida statutes obligate employers to provide insurance that covers work-related illness, accidental injury, disability, and death for employees.
Certain factors may disallow your claim, however.
Some circumstances under which the insurance company may deny your claim include preexisting conditions and injuries sustained while you were:
- Violating the law
- Intoxicated on drugs or alcohol
- Violating safety regulations
- Violating company policies or procedures
- Engaged in unsafe behavior (i.e., horseplay)
If your company requires that you wear a hardhat and steel-toe boots on the job for safety, WC insurance may deny your claim if you sustained a head or foot injury while not wearing the required gear.
As long as you were in compliance with the law, safety rules, and company policies when you sustained your work-related injury, however, your employer’s WC insurance should cover you.
If your employer or the insurance company tells you otherwise, contact a Workers’ Compensation lawyer in West Palm Beach to help you pursue your claim.
What Benefits Does Workers’ Compensation Provide?
This means that WC insurance covers any emergency care, doctor’s appointments, therapy, medication, testing, or medical procedures, as long as you go to an authorized medical provider or facility.
“Workers’ Compensation coverage will compensate you for your time off work, at a rate of two-thirds of your standard weekly salary or hourly wage”
If you cannot return to work for more than seven days, Workers’ Compensation coverage will compensate you for your time off work, at a rate of two-thirds of your standard weekly salary or hourly wage up to the statutory maximum (Florida’s average weekly wage).
You can collect partial disability if your doctor only allows you to return to work with restrictions. If you cannot return to work at all, Workers’ Compensation will pay you long-term disability benefits. Death benefits are also available to family members, in the event of a fatal injury.
If the insurance company refuses to pay for your medical care or disability benefits, call Anidjar & Levine for help pursuing your claim.
What Is the Process for Filing Florida Workers’ Compensation Claim?
“Florida law gives you a maximum of 30 days to report the incident.”
The first step in filing a claim is reporting your accident and injury to your employer and seeking medical attention. Florida law gives you a maximum of 30 days to report the incident. You or your employer must then file an accident report with the insurance. This must occur within seven days.
Take extra care when preparing the report because the insurance company may use it to try to find some way to minimize its payout.
The insurance company will likely refer you for an independent medical evaluation (IME) with a doctor of its choosing. Based on the results of the IME, the insurance company will decide what benefits it will provide.
Unfortunately, the IME doctor may attempt to minimize the seriousness of your injury, allowing the insurance company to pay out a smaller amount of money.
Before you submit your accident report, consult with a Workers’ Compensation lawyer.
A lawyer from the Law Firm of Anidjar & Levine can help ensure that your report does not compromise your legal rights. We can also refer you to another doctor for a second medical evaluation. This will be especially important if the insurance company attempts to deny your claim.
Talking to a Worker’s Comp Lawyer Can Help Protect Your Rights
If your employer or WC insurance company has denied your injury or disability claim, you need a worker’s comp lawyer to help you pursue the compensation you deserve.
- Protecting your legal rights
- Preparing and submitting important claim documents
- Helping you obtain a second opinion
- Building a strong case for your claim
- Negotiating with the insurance company
- Providing counsel and support
- Fighting for the compensation you deserve
If the insurance company will not negotiate in good faith, your lawyer can file legal action and take your case to court.
If you would like to meet with a Workers’ Compensation lawyer in West Palm Beach at no cost to you, contact the Law Firm of Anidjar & Levine today at 800-747-3733.