Understanding Workers’ Comp Benefits in Florida: When Are You Eligible for Benefits?

Nov 13, 2022

Workers’ compensation laws vary widely by state. If you work in Florida, you should familiarize yourself with the rules so if you get hurt on the job; you know exactly what to expect and how to proceed.

What is Florida Workers’ Compensation?

Workers’ compensation is insurance that most companies in Florida are legally required to carry to cover employees injured on the job. Depending on the situation, the employee may be paid for their medical expenses and time off to recover. 

Generally, businesses with four or more employees must carry workers’ compensation insurance. A company officer or member of an LLC may apply to exclude themselves from workers’ compensation coverage. 

How Florida Worker’s Compensation Benefits Work

Getting injured at work can radically alter your lifestyle and cause permanent disfigurement, chronic pain, or ongoing difficulties. Workers’ compensation was designed to alleviate some of the financial burdens.  

Workers’ compensation rules follow a specific timeline. After you are injured, you must report it to your employer within 30 days. They, in turn, will contact the workers’ compensation company and file a first report of injury on your behalf. The employer has seven days to report the accident to the workers’ compensation company. 

The workers’ compensation company will evaluate the claim, and if they approve it, they will pay out benefits.

If the workers’ compensation company doubts your claim, they may open an investigation to ensure you are not lying about the severity of your injuries. You may also be required to visit specific WC-approved physicians for an independent medical exam and assessment. 

Types of WC Benefits

Florida has three types of workers’ compensation benefits: wage-loss benefits, medical benefits, and other benefits. 

Wage-Loss Benefits

You may receive wage-loss benefits if you cannot work after your injury. However, you will only be paid for the first seven days following your injury if your lost work time is more than 21 days. After that, depending on the severity of your injury, you may be paid total, partial, temporary, or permanent lost wages.

Temporary Total Disability (TTD)

The first type of wage-loss benefit is a temporary total disability. This is when you are injured to the point that you cannot work, but your doctor expects you to make a full recovery. Typically, this payout is 66 2/3% of your average weekly salary. However, if you are severely injured, you might receive up to 80% of your regular wage for six months following the accident. 

Your doctor will determine when you reach your maximum medical improvement (MMI), and these benefits will be terminated.

Permanent Total Disability (PTD)

If you are injured to the degree that you can no longer work again, you may receive permanent total disability compensation. These benefits start after you reach your MMI. They may continue until you reach the age of 75 or die, whichever is sooner. The workers’ compensation company will work with your doctors to determine the payout amount.

Medical Benefits

If you are injured on the job in Florida, workers’ compensation insurance will pay for all your medical bills, including emergency care, medical tests, doctor visits, hospital stays, and medications. In addition, if you must attend rehabilitation, those costs will also be covered. The one caveat is that you must see the doctors chosen by the workers’ compensation insurance company, or you will have to pay the bills yourself.

Other Benefits

Besides the standard benefits, workers’ compensation also pays death benefits if the employee dies due to an accident. The dependents of the employee will receive a one-time payment for funeral expenses.

If the injury has altered your ability to work, you may also receive vocational rehabilitation benefits, including vocational counseling, job training, skill building, and job placement. 

Which Situations Qualify for WC in Florida?

How much compensation you will receive will vary based on many factors. However, to qualify for workers’ compensation: 

  • You must have been injured on the job, meaning you must have been performing your job duties at the time of the accident. For example, if part of your job is getting lunch for everyone at the office and you are in a car accident on the way back, that may qualify as an on-the-job accident. 
  • The injury cannot be self-inflicted or happen while you are intoxicated by drugs or alcohol.
  • You must have been compliant with company safety policies. For example, your WC payments may be reduced if you fail to wear the required safety gear.
  • Full and part-time employees are eligible for workers’ compensation benefits.
  • Self-employed independent contractors do not qualify for WC benefits.

Help with Your WC Claim

Workers’ compensation situations are often tricky with extenuating circumstances or exceptions. They can also be challenging to win. After an injury, the last thing you need is to be fighting with your employer or insurance company for benefits.

If your employer or the workers’ compensation insurance company denied your claim, contact Adam Baron for help. We specialize in workers’ compensation injury cases and want to help you get the compensation you deserve.