Workers’ Compensation is a system designed to provide medical and disability benefits to employees injured on the job without the necessity of litigation. Prior to the creation of the Workers’ Comp system in the United States in the early 20th century, workers injured on the job had to resort to the courts to attempt to recover financially for their injuries. Unfortunately, they would usually lose the lawsuits based on one or more of three legal doctrines:

• Contributory negligence – the employer wasn’t liable if the worker was in any way at fault in the injury
• “Fellow Servant” doctrine – the employer wasn’t liable if another employee was in any way at fault in the injury
• Assumption of risk – the employer wasn’t liable because the employee knew and accepted the risks of the job when they took it

As a result, it was very difficult for injured workers to recover compensation.

What Is the Legal Underpinning of Workers Comp?

In 1908, President Theodore Roosevelt signed the first federal workers’ compensation law, which covered certain federal employees in unusually hazardous jobs. That same year, Congress passed the Federal Employers’ Liability Act, which lets injured railroad workers sue their employers but requires proof that the railroad’s negligence caused the injury. In 1911, Wisconsin passed the nation’s first state workers’ compensation law to be upheld as constitutional, and by 1948, when Mississippi passed its law, every state then in the Union had a workers’ compensation program.

What Does the Workers’ Comp Program Do?

In Florida, most private employers with four or more employees, and construction employers with one or more employees, must carry workers’ compensation coverage. Rules differ in other states. This insurance provides medical and disability benefits for employees injured or made ill on the job. Both employers and employees are expected to perform certain tasks under the system.

Worker Obligations

When injured on the job in Florida, an employee must:

• Report the injury to your employer as soon as possible. Florida law requires you to report a workplace injury to your employer within 30 days after the injury happens or first appears. If the cause couldn’t be identified without a medical opinion, you must report it within 30 days after a doctor tells you the injury is work-related.
• Ask your employer which doctor you can see. You must use a doctor authorized by your employer or by the Workers’ Comp insurance provider.
• If your employer instructs you to do so, contact the Workers’ Compensation insurance company handling the claim. The name and address should be on the required workers’ comp poster in your workplace.
• If it is an emergency situation and no one from the employer can tell you where to go, go to the nearest emergency room and inform your employer as soon as possible about what has happened.
• Speak with the Workers’ Comp claims adjusters when they call you about the case. Florida law requires the insurer to send you an informational brochure within 3 business days after it learns of your injury.
• Review the Workers’ Compensation brochure and notification letter when you receive them. They may be accompanied by a copy of your accident report, which you should review for accuracy, a fraud statement for you to review and sign, a release of medical records for you to sign, and medical mileage reimbursement forms.

Employer Obligations

Your employer must cover some portion of your lost wages and provide your medical treatments. Make sure not to go to your personal physician. You must go to a doctor authorized by the Workers’ Comp insurance company.

What Benefits You May Receive

There are several different types of benefits that you may receive under Workers’ Compensation in Florida. An experienced Workers’ Comp attorney can assist you with your claim if you are having difficulty working the system. Some of the benefits include:

• Indemnity Benefit – Once you have missed seven days of work, you should begin receiving payments to replace a portion of the wages you could not earn after your accident. You cannot receive more than the state-specified maximum benefit under this program.
• Temporary Total Disability – If your doctor prohibits your working at all, you will receive payments of about two-thirds of your regular paycheck at the time of your injury. These payments begin on the eighth day of lost time from work. If you lose more than 21 days of work, you will be compensated for the first seven days. Workers with certain catastrophic injuries, such as loss of an arm or leg, paralysis, or blindness, receive 80% of their wages for up to 6 months after the accident. The statute limits temporary total disability benefits to 104 weeks, but the Florida Supreme Court held in Westphal v. City of St. Petersburg (2016) that a worker who is still totally disabled and has not reached maximum medical improvement may receive them for up to 260 weeks.
• Temporary Partial Disability – If you can work but not earn your usual wages, you may receive partial disability payments. You will receive 80% of the difference between 80% of your wages before the accident and what you can earn after it.
• Impairment Benefits – Once your doctor finds you have reached maximum medical improvement, you may receive impairment income benefits for a set number of weeks based on your permanent impairment rating, paid at 75% of your temporary total disability rate.

You should also receive medical treatment provided by the employer’s workers’ comp insurance company and may also receive assistance returning to the workforce.

What If I Disagree with the Insurance Company?

If you are experiencing difficulties with the Workers’ Compensation insurance company, first try to resolve the problem with your adjuster or adjuster management. If you continue to have problems, the Employee Assistance and Ombudsman Office of the Florida Division of Workers’ Compensation may provide some assistance. If the dispute is ongoing or if you are not receiving benefits as you should, you should contact a Workers’ Comp attorney to assist you in dealing with the insurance company.

Be Careful Out There!

It’s important to remember that trying to game the Workers’ Comp system can land you in very deep water indeed. Knowingly making a false, fraudulent, or misleading statement to obtain workers’ compensation benefits is a felony in Florida, including:

• Filing a false claim
• Attesting to false information on the application forms

Also, if you refuse to sign the required acknowledgment of Florida’s workers’ compensation fraud statement, your benefits are suspended until you sign it.

Florida Workers’ Compensation Attorney

As you see, what is intended to be a simple and useful program to avoid litigation is really rather complicated. Employers are not always eager to help with your claims, largely because claims will increase their insurance premiums, and you may need to retain counsel to get what you need from your employer. You may also want to seek an attorney if there are potential third-party defendants in your case, like, for example, the manufacturer of the equipment which injured you. Gary T. Iscoe is an experienced Florida workers’ compensation lawyer who is committed to helping workers obtain the full value of their claims. Your future matters, so please do not hesitate to reach out for more information about how we can help you by contacting us online or calling us at 800-800-6500 today.