Few things in life are more difficult than when a serious injury or illness prevents you from doing your job. It's even more stressful when your disability is work-related, and you must navigate the complex workers' compensation system to make ends meet.
Here's what you need to know about qualifying for workers' comp in Florida, and how much you might receive in benefits.
The purpose of workers' compensation is to provide financial support to employees who incur medical expenses, rehabilitation expenses, and wage loss due to a work-related accident or illness. In general, to recover benefits you must prove you were injured in the course and scope of employment, but you don't need to prove your employer was at fault.
In Florida, all employers in the construction business and those with four or more employees must carry workers' comp coverage. This means that workers employed by these businesses can recover mostly tax-free benefits for work-related accidents and occupational illnesses without having to prove fault. The tradeoff is that you generally cannot sue your employer in court, and therefore can't receive compensation for pain and suffering.
In Florida you have 30 days from the date of the accident to report a workplace injury to your employer. If the injury or illness is not readily apparent, you have 30 days from the date you learn of your disability from a doctor. The statute of limitations for filing a claim is two years; however, don't hesitate to report your accident because if you miss the 30-day deadline your claim could be denied.
Florida law recognizes some exceptions to the 30-day time limit. These exceptions come into play when your employer:
The "actual knowledge" exception is satisfied when an agent of your employer knows of your workplace injury. This would occur, for example, if a co-worker witnessed you injure your back falling off a ladder while stocking shelves.
Florida also recognizes "exceptional circumstances" for missing the deadline, but this is a fact-specific analysis that is decided on a case-by-case basis. The takeaway here is that you should comply with the 30-day time limit whenever possible rather than risk relying on an exception. The quicker you get the ball rolling, the faster you obtain benefits and restore some normalcy to your life.
In Florida, medical treatment that is authorized by your employer or your employer's insurer will be covered. This means that in most cases you can submit bills for such things as doctor's visits, diagnostic tests, physical therapy, and prescription medication.
You will be eligible for different types of benefits depending on how long you cannot work.
Temporary total disability benefits cover two-thirds of your average weekly wage up to a limit that's adjusted every year. In 2021, the maximum is $1,011 per week. In general, the maximum amount of time a worker can receive these benefits is two years. They can be cut off sooner if your doctor decides you are ready to return to work or concludes that you have reached maximum medical improvement, meaning you will not improve with more treatment.
Recoverable when your doctor clears you for work, but you are only able to earn 80% of your pre-accident wages.
Florida law provides recourse when you can work but lost some degree of bodily function as a result of your accident. In this situation, your disability will be quantified as a percentage known as an "impairment rating" and plugged into a specific formula to determine how long your benefits will last. You can figure out the amount of your benefits through Florida's impairment benefits calculator once you know your impairment rating.
These benefits are paid at the same rate as temporary total disability benefits to those who cannot perform any work. Injuries that fall into this category can include such things as amputation, severe spinal injury, brain damage, and blindness. Permanent total disability benefits last until the disabled worker reaches the age of 75 unless the worker does not qualify for social security in which case the benefits continue for life.
In general, you are not paid for the first seven days of your disability unless you are out of work over 21 days.
Florida law provides vocational services to help you find a new job if your disability prevents you from returning to your regular job. These services include continuing education, on-the-job training, vocational counseling, and job placement assistance.
Family members and dependents of an employee who died due to a work-related accident or occupational disease are entitled to benefits up to a maximum of $150,000. There's also coverage for funeral and burial expenses up to $7,500.
Unless your work-related injury is relatively minor you should consider hiring an experienced workers' compensation lawyer to help you navigate the system. Like any other type of legal claim, there are nuances, deadlines, and court rules that must be followed. And, depending on the situation, the workers' compensation insurer may be reluctant to pay. You will only get one chance to litigate your claim so regardless of whether your disability is temporary or permanent, it's often a good idea to seek the advice of a lawyer.