Receiving Compensation for Work-Related Injuries
If you were injured in an on-the-job accident or if you’re suffering from a repetitive stress injury, it is important to work with experienced Gainesville Attorneys. At the Goldberg Law Office, we have more than 25 years of experience representing individuals throughout north central Florida in personal injury and workers’ compensation cases.
What is Workers’ Compensation?
Most workers in Florida are covered by workers’ compensation. There are a few exceptions, but most Florida employers are mandated to provide workers’ compensation insurance when they have four or more employees. In the construction industry, employers with at least one employee must carry workers’ compensation. Workers’ compensation in Florida is a no-fault system. This means that workers are not required to prove fault for their injuries to recover workers’ compensation benefits.
Your Requirements Under The Workers’ Compensation Law
If you are injured on the job, you must report your injury to your employer, usually through your supervisor, within thirty days of the incident that you believe injured you. The overall statute of limitations for Florida Workers’ Compensation claims is two years. When reporting your injury, you should provide specific details about what happened, including the location, the time of day, and the nature of your injury.
Be sure to describe all areas where you are experiencing pain or discomfort. Oftentimes, a worker experiences a trauma which causes serious harm to one part of the body, but in fact also causes less major injuries to other parts of the body. If you do not claim all the areas in which you feel pain or discomfort, it is likely that the workers’ compensation insurance carrier will deny you coverage for your secondary injuries or problems.
It is also important that you seek an immediate medical evaluation to determine the extent of your injury. Unless it is an emergency situation that requires an immediate trip to the hospital, it is important that the employer provide an approved or “authorized” medical provider. Unfortunately, the employer (and subsequently their insurance carrier) get to choose your doctors or medical providers under the Florida Workers’ Compensation statute. Once you have been evaluated by a physician of the employer or their insurance carrier’s choosing, you may ask for a second opinion or a one-time change of physician. Even under these circumstances, the employer or their insurance carrier will get to determine which doctor you can see. If you choose to go to a physician on your own that was not approved, it is not likely it will be covered under the workers’ compensation system.
What Benefits Am I Entitled To?
The employer, usually through their insurance carrier, is required to pay for necessary medical treatments, testing, rehabilitation, and any medicines that are prescribed by an authorized physician for problems arising from the work injury. There are also potential benefits for missed time from work, permanent impairment, permanent disability and, of course, death. If you are taken out of work or restricted from the kind of work you are able to do and your employer does not provide you the prescribed work limitations, you may be entitled to temporary wage benefits which will pay two thirds (2/3) of your gross wages for the period of time the doctor keeps you out of work. An injured worker will generally receive their first check within 21 days of reporting the injury to the employer, and then will be paid bi-weekly or every two weeks for their period of disability.
Why Workers’ Comp Isn’t Fair to Florida Workers
We have found that in the thirty years of our injury practice, the many changes that have been made to the Florida Workers’ Compensation law have resulted in a law of very restricted benefits that is often unfair to injured workers. The current version of the law requires that you prove that your injury is the major contributing cause of your problems.
Here is a very typical fact pattern which will illustrate the difficulties with this aspect of the law: Let’s say you are over forty years of age and either by bending, lifting or in some other way you injure your back, and now have severe back pain which limits your ability to work or do your job. At some point, if your pain persists, the authorized physician will likely send you for an MRI. Many times the results of these tests will show that you have degenerative disk disease or some kind of preexisting arthritis condition, but no specific traumatic injury that can be identified on the scan. Even if you never had symptoms of back pain before, many doctors that employers use under the Workers’ Compensation statute will then say that the major contributing cause of your problem is not your injury, but the preexisting age-related condition of your back. This then allows the Workers’ Compensation carrier to deny further benefits. This kind of situation occurs all the time under the current Workers’ Compensation law.
The other significant change to the Workers’ Compensation law was to severely limit attorneys’ fees in workers’ compensation cases, which has had the result of severely limiting the kinds of situations which an inexperienced workers’ compensation lawyer can help an injured worker under the law.
In our firm, we often do not advise hiring a lawyer in a no-fault workers’ compensation claim that results in a relatively minor injury that allows you to return to your job, as long as the insurance carrier is paying you the proper benefits and your employer is allowing you to return to work at the appropriate time. On the other hand, if you have been denied benefits, or you have limitations and your employer will not let you return to work, or if your employer claims that the “position is filled” and no longer exists for you to return to, or fires you for some other reason, it is likely you can benefit from a workers’ compensation attorney. The other instance where we recommend representation in these cases is if you have suffered a serious injury that is going to keep you out of work for a long time (or prevent you from ever returning to work), or at least prevent you from returning to the job that you once had.
How Workers’ Compensation Settlements Are Handled
Settlement of workers’ compensation cases in Florida is voluntary. This means that an injured worker cannot pursue in court a recovery for a certain sum of money over and above the benefits you are entitled to under the law. Keep in mind that the Florida Workers’ Compensation law does not provide for “pain and suffering.” Pain and suffering is the kind of damages you are able to recover in a general personal injury case in Florida, and includes all the ways in which an injury has negatively impacted your life. Florida Workers’ Compensation statute only covers medical benefits and lost wage benefits. There is no recovery for pain and suffering, and the Workers’ Compensation law is an “exclusive remedy,” meaning that if your employer provides the legally required coverage, you cannot sue your employer, even if your employer or a fellow employee was at fault for your injury.
So, in the instances where you are not able to return to your job, do not want to return to your job, or your employer does not want you to return to your job, you may want to negotiate a resolution of any future entitlement to workers’ compensation benefits. This is best done with an attorney that understands the value of your case.
What is Maximum Medical Improvement?
Once you have received a certain amount of medical care, the doctors will likely conclude that you are “as good as you are going to get” and that you will not improve further as a result of further care. This threshold is called Maximum Medical Improvement. At that point, under the Florida Workers Compensation system, the doctor is required to assess your percentage of impairment and the insurance carrier is then required to provide you a certain number of weeks of “Impairment Benefits” based on that percentage of impairment. On the other hand, if you have suffered a very serious injury which would qualify as a “Permanent Total Disability,” then you could be entitled to benefits for the rest of your life.