IF YOU ARE INJURED AS A RESULT OF A WORK-RELATED ACCIDENT, YOUR EMPLOYER'S WORKERS'
COMPENSATION COVERAGE PROVIDES MEDICAL AND PARTIAL WAGE REPLACEMENT BENEFITS THAT
YOU MAY BE ENTITLED TO.
As soon as the insurance carrier for your employer knows about your work-related injury, the carrier is supposed to:
Determine the compensability of your injury.
Provide an authorized doctor.
Pay for all authorized medically necessary care and treatment related to your injury.
Authorized treatment and care may include:
Travel expenses to and from your authorized health care provider
Once you reach maximum medical improvement (MMI) which is the day that your health care providers have all stated that further improvement regarding your condition is unlikely, you are required to pay a $10.00 co-payment per visit for future medical attention.
WAGE REPLACEMENT BENEFITS
Your workers' compensation benefits for lost wages will start on the eighth day that you are unable to work. You will not receive wage replacement benefits for the first seven days of work missed, unless you are out of work for more than twenty-one days due to your work-related injury. In most case, the wage replacement benefits will equal two thirds of your pre-injury regular weekly wage, but the benefit will not be higher than Florida's Average Weekly Wage (AWW). If you qualify for wage replacement benefits, you can generally expect to receive your first check within twenty-one days after the carrier becomes aware of your injury, and bi-weekly thereafter. You will be eligible for different types of wage replacement benefits, depending on the progress of the claim and the severity of the injury.
TYPES OF WAGE BENEFITS
Temporary Total Disability: These benefits are provided as a result of an injury that temporarily precludes you from returning to work and you have not reached MMI.
Temporary Partial Disability: These benefits are provided when the doctor releases you to return to work and you have not reached MMI and earn less than 80% of the difference between your pre-injury wages and your post-injury wages.
The maximum amount of time you can receive any temporary disability benefits is 104 weeks or until the date of MMI is determined, whichever is earlier.
Permanent Impairment Benefits: These benefits are provided when the injury causes any physical, psychological or functional loss and the impairment exists after the date of MMI. A doctor will assign a permanent impairment rating, expressed as a percentage to the injury. If you return to work at or above your pre-injury wage, the permanent impairment benefits are reduced by 50%.
Permanent Total Disability: These benefits are provided when the injury causes you to be permanently and totally disabled according to the conditions stated in the law.
Death Benefits: The maximum benefit is $150,000 for any death resulting from a work place accident.
STATUTE OF LIMITATIONS
If you have been injured while in the course and scope of your employment, you must immediately report the injury to your employer. Additionally, you must request medical attention if necessary. Failure to do so within 30 days of the incident, will subject you to waiving your right to your Workers' Compensation benefits due to your failure to timely report the accident and the injuries you sustained. You have two years from the date of your injury to file a claim. Your eligibility for benefits may be eliminated one year from the date you last received a wage replacement check, or one year from the date you last received authorized medical care and treatment.
PETITION FOR BENEFITS
To begin the judicial procedure for obtaining benefits that are due and owing under the law and have not been provided by the employer or insurance carrier, a Petition for Benefits must be filed with the Offices of the Judge of Compensation Claims.
INJURED WORKER RESPONSIBILITIES
(DO NOT LET YOUR EMPLOYER SCARE YOU FROM OBTAINING THE BENEFITS YOU ARE ENTITLED TO!)
Contact your supervisor/employer immediately to notify them of the on the job injury.
Tell your employer you want medical attention if you believe your injury necessitates it.
Provide the insurance carrier with your personal signature verifying that you have reviewed and understand the mandatory Fraud Statement.
Report any wages (from all employment) to the insurance carrier when requested.
Keep your appointments with your authorized health care providers.
Follow your doctor's treatment plan and comply with any restrictions.
WORKERS' COMPENSATION INSURER RESPONSIBILITIES
Timely provision of medical care
Timely provision of wage replacement benefits
Timely payment of medical bills
Timely reporting your claim to the Division of Workers' Compensation
EMPLOYEE ASSISTANCE OFFICE
The Division of Workers' Compensation Employee Assistance Office (EAO) helps prevent and resolve disputes between injured workers and the employer/carriers. If the insurance carrier does not provide the benefits to which you believe you are entitled, you can call the EAO at 800-342-1741. EAO specialists will address your complaints and conduct an investigation, if necessary, to determine why it is you are not receiving your benefits.
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