Workers’ Compensation Laws
The Law Offices Of Adam Baron Advocates for Injured Employees in Florida
Encountering an accident or illness at work is a devastating and difficult situation to overcome. Without our jobs, we cannot pay our bills or support our families. Fortunately, the workers’ compensation system provides recourse to employees who are hurt on the job in the form of workers' compensation benefits payments. Navigating this process can be especially difficult due to its complex rules and the insurance companies that are in charge of determining the amount of benefits to which you are entitled. Experienced workers’ compensation attorney Adam Baron has assisted Coral Springs residents and other individuals in pursuing a settlement after suffering a debilitating job-related injury.
Workers Compensation Benefits
Workers’ compensation benefits can be awarded for medical coverage, temporary disability, i.e. lost wages, and permanent partial or total disability.
- Medical Coverage: Employers are legally responsible for the medical treatment of an employee who is injured on the job or who suffers from occupational disease. Medical expenses that must be paid by the employer include doctor / hospital visits, diagnostic tests, prescription medication, and / or physical therapy. In some cases, employers will also be responsible for reimbursing the cost of mileage for an employee who must travel to medical appointments.
- Temporary Disability Benefits: Temporary disability benefits may be awarded to persons whose injuries no longer allow them to work the same number of hours per week. How much an employee will receive in benefits will depend on the capacity he or she is able to work post-injury. For example, an employee who cannot work at all for a designated period of time will receive temporary total disability, whereas someone who can work to some degree will receive temporary partial disability benefits.
- Permanent Disability Benefits: An employee whose injury or illness is so severe that it prevents him / her from ever returning to work will be eligible to receive permanent total disability benefits. An employee whose injury or illness is severe enough to forever limit the amount that he or she is able to work will be eligible for permanent partial disability benefits.
Workers’ Compensation Settlements
According to federal and Florida laws, injured workers are eligible to receive benefits after suffering an accident or illness at work. The workers’ compensation system was established many years ago as an agreement between labor unions and employers. The agreement provides workers with a system for obtaining benefits. In exchange, they are barred from pursuing a legal action against their employers for their injuries, with a few limited exceptions.
Unfortunately, many employers and insurance adjustors abuse this privilege and deny claims simply as a way to avoid paying out on the benefits owed to workers who are injured or made ill while on the job. For help with a claim denial, contact a Coral Springs workers’ compensation denial attorney at the Law Offices of Adam Baron, P.A. We will meet with you free of charge to discuss the options available to you at this time.
The first step in recovering benefits is to report your injury to your employer so that it can open a claim with its workers’ compensation insurer. It is important that you report your injuries immediately and see a doctor as soon as possible to begin documenting the nature and scope of your harm. The insurer will likely ask you to see a preapproved physician, who will then determine whether your injuries are temporary or permanent, and whether they are partial or total. These two classifications will guide the insurer in determining the amount of benefits that you should be awarded.
Workers Compensation Appeal Process
In the state of Florida, you have exactly 30 days from the date of your injury or illness to file a workers’ compensation claim for benefits. Claims filed after the 30-day limit will be denied. However, even claims filed within the 30-day time frame can be denied. Florida employers, and the insurance companies that represent them, can deny workers’ compensation claims if they believe them to be invalid.
If your attempts to resolve a claim denial with the insurance company are unsuccessful, you can formally appeal the decision with the help of a lawyer. Facts you’ll need to know before you start:
- A Petition for Benefits must be mailed to the Clerk of the Office of the Judges of Compensation (OJCC).
- You must file your petition within 2 years of the date of your injury or illness.
- You must file your petition within 1 year of the date of your injury or illness if you are petitioning a specific benefit, i.e. medical treatment, etc.
- The Insurance company has 14 days from the date of receiving your petition (provided by the OJCC) to respond.
The first formal step in the appeals process is the mediation hearing, which will be scheduled within 130 days of filing your petition. This is an informal conference, during which time a third party mediator will attempt to help you and the insurance company resolve the disputed claim.
If the mediation is unsuccessful, a workers’ compensation judge will be assigned to your case and a pretrial hearing will be scheduled. At the hearing, disputed issues will be identified and both you and the insurance company will have an opportunity to exchange evidence. At this stage of the process, it’s crucial to have a workers’ compensation attorney representing your case, as the insurance company will most definitely have legal representation acting on its behalf.
The final hearing will take place no later than 90 days after the pretrial hearing. At this time, attorneys for both parties will present evidence, testimonies, and witnesses to the judge. The judge will review this evidence and then issue a decision, which will be mailed to both parties within 30 days of the hearing.
Workers Compensation Denial
In some instances, an insurer may deny a workers’ claim for benefits or may award something less than what the worker believes he or she should receive under the law. Many insurance companies are open to settling a workers’ compensation claim because it limits their future financial exposure to providing continued benefits payments to the injured worker. In a settlement, the insurance company and the employee reach an agreement that the insurer will pay the employee a lump sum payment in exchange for the injured worker’s agreement to close his or her claim and to not seek any additional compensation or treatment through the workers’ compensation system related to the claimed injury.
Although the amount of the settlement can vary depending on the facts of the case, the insurance company will usually base the settlement on the amount of benefits that it would be required to pay the employee over his or her lifetime, or over the duration that the injury persists. An insurance company’s exposure to payouts tends to be higher if the employee has been deemed at Maximum Medical Improvement (MMI) status but requires additional medical treatment, is physically unable to go back to his or her job, or must undergo re-training before working again.
Explore Your Options with a Work Accident Attorney in Coral Springs
If you have suffered an accident or illness at a job in Coral Springs, Naples, and the surrounding area, work injury lawyer Adam Baron can help. I can guide you through each step of the claims process and be sure to inform you about your rights along the way. I offer a free consultation, so you have nothing to lose. Contact us online or call us at one of our regional office locations to set up an appointment. You can reach us in Broward County at (954) 716-8976, in Miami-Dade at (305) 770-2131, or in Naples/Fort Myers at (239) 352-5511. We also represent injured individuals in Miami, Coral Springs, North Miami Beach, Tamarac, and other cities.