Workers’ Compensation: what is it? How can it work for you? And, how can we help you?
A fry cook in a fast-food restaurant gets burned while operating the fry cooker; a construction worker falls off a scaffolding; the ceiling falling on a secretary at her desk; a clerk slipping and tripping in the mailroom – these are familiar everyday scenarios, aren’t they?
It’s not difficult to imagine any of these things happening at work, is it? Of course. You probably spend 8-12 working hours at your place of work. The longer time you spend at work, the higher the chance that you may get into an accident at work. Work-related accidents are the most commonly reported injuries in the US.
If you are a worker, and an accident like one of the above happens to you – what do you do?
The answer is, file a claim for workers’ compensation. The first and most important step to file a claim for workers’ compensation benefits is reporting your accident. This means telling your boss or supervisor that you had an accident on the job that caused an injury or physical problem. Filing a claim for workers’ compensation is a legal right under Chapter 440 Title XXI of the Florida Statutes, referred to as Workers’ Compensation law.
Unfamiliar with Workers’ Compensation? Read on, we promise – it will definitely be worth your time.
What is Workers’ Compensation?
First of all, Florida law requires businesses and employers to pay for and carry workers’ compensation insurance. This insurance then pays for medical evaluations and treatments required because of workplace accidents and in the case of deaths arising from work-related accidents. ONLY WORK-RELATED ACCIDENTS AND THE INJURES OR DISABILITIES SUSTAINED FROM THESE WORK-RELATED ACCIDENTS ARE PAID FOR BY THE WORKERS’ COMPENSATION SYTEM.
Second, workers’ compensation insurance pays money benefits based upon a formula in the law that considers the income that the injured worker earned before the accident. These benefits are paid out as percentage of what the injured worker earned before the accident. These benefits are paid to injured workers during their period of recovery when they are completely out of work or when their earning fall below a certain level. WORKERS’ COMPENSATION WILL NOT PAY FOR EMOTIONAL SUFFERING, ONLY FOR LOSS OF INCOME.
Third, let’s understand that an accident is an unexpected and unusual event that happens suddenly and leads to injury, physical problems, and possibly death. Think of a worker tripping and falling over an electrical power cord and breaking his leg. It’s unexpected and sudden. It is very important to note that even accidents that occur because of routine work such as lifting and carrying objects are usually covered by the law if the work being performed lead to the injury. Consider the case of a warehouse worker who lifts and moves heavy merchandise that leads to low back pain. Under such circumstances the injury will usually be covered by workers’ compensation insurance. ACCIDENTS ARISING OUT OF EMPLOYMENT ARE COVERED BY WORKERS’ COMPENSATION.
Fourth, exposure to a toxic substance may be covered by the workers’ compensation insurace. One historic example is Black Lung, a severe breathing problem that coal miners developed because of working in the mines – especially in those days when coal miners did not wear protective equipment. Disability resulting from Black Lung was compensable because there is clear and convincing evidence of exposure to coal while coal mining and the exposure to the toxic substance while at work was at a high level that caused the condition. OCCUPATIONAL DISEASES ARE COMPENSABLE UNDER WORKERS’ COMPENSATION.
GLOSSARY OF TERMS
Employee – any person who receives payment from an employer for the performance of work or service.
Employer – any person who hires and pays another to perform work or service. Homeowners are not employers of persons hired to carry out construction on the homeowner’s premises which is not leased, sold or resold.
Disability – any incapacity due to injury that stops an employee from earning the same wages he or she was receiving at the time of the injury.
Injury – personal injury or death by accident arising out of and in the course of employment.
Permanent impairment – bodily abnormality or abnormality of function of a part of the body or loss which exists after the date when maximum medical improvement can be achieved.
Wages – money rate at which service is rendered or paid under a contract of hiring in force at the time of the injury and includes only wages earned and reported to the IRS.
So, what does filing a Workers’ Compensation claim do for you?
Basically, filing a Workers’ Compensation claim makes it easy for you to claim benefits to pay for the lost income during the period of your recovery; or it makes it easy for you to get compensated for your disability or impairment.
Exactly how does it make it easy for you?
- Workers’ Compensation is a no-fault insurance scheme which the law imposes on all employers. This means that the law obligates an employer to set up a fund to pay for such work-related injuries and deaths. It will not be the employer himself who will pay for it but the insurance company of the employer.
- Workers’ Compensation claimants do not need to file a case in court. When you sustain an injury, you must report the injury to your employer. It will be your employer who will report it to his insurer and the insurer will ask their doctor to verify your injuries and if they are satisfied that this is work-related, then, you will be paid. You do not need to go to court to claim benefits. Only when the insurance company refuses to pay your claim do you need to file a case.
- Workers do not need to prove negligence on the part of the employer. Before the modern Workers’ Compensation system became the law, an injured worker had to prove that the employer was at fault in order to get paid. However, under the Florida Statute, such proof of negligence is not required. Only a showing that injuries occurred on the job is rquired.
- Workers cannot be fired from their job because they filed a claim for workers’ compensation. The Workers’ Compensation law expressly forbids an employer from firing a worker or even threatening to fire a worker simply because the employee filed a valid claim for compensation or attempted to file a valid claim for compensation.
What kinds of benefits can you get from Florida WORKERS’ COMPENSATION?
- If your disability lasts for 21 days or more, you will be paid at least 2/3 of your salary.
- Your valid medical expenses will be paid for. This will include doctors’ visits, hospitalization, medical tests, prescription drugs, prostheses and attendant care.
- If your disability lasts for more than 21 days, you can get disability benefit for at least 260 weeks.
In the case of the death of an injured worker:
- Funeral benefit of up to $7500.
- Compensation for the dependents of the employee of up to $150,000.00.
- Educational benefits for the surviving spouse of the employee.
What type of medical benefits can you get?
You are entitled to receive reasonable medical care that is required to treat the problems and conditions that came about because of your worker’s compensation accident. You will also be entitled to receive diagnostic testing and procedures that may be used to determine if the condition(s) or problem(s) are work related. This includes things like prescription medication, braces, crutches, surgical procedures, as well as physical and occupational therapy. Testing may include items such as X-rays, MRI, and CT scans.
But what if, your accident can be compensated under Workers’ Compensation – can’t you sue your employer if his negligence was the cause of the accident?
When can you sue your employer for injuries or impairments resulting from work-related accidents?
Generally the workers’ compensation system is the exclusive remedy or source of recovery for an injured worker. However, in limited circumstances, an employee can file suit against the employer in addition to his workers’ compensation claim. A claim for workers’ compensation will not stop you from filing a case against your employer if the employer engaged in conduct that was substantially certain to result in serious bodily injury or death.
What now? YOU ONLY HAVE 30 DAYS WITHIN WHICH TO FILE WORKERS’ COMPENSATION CLAIMS.
That’s right, you only have 30 days. You have 30 days from the date the accident occurred to report the accident to the employer. You haven’t got much time, have you?
And you probably wouldn’t be reading this page if you hadn’t gotten hurt at work or while working.
A friendly word of advice, and we wouldn’t say it if we didn’t think you’d benefit from this… you should probably call a Workers’ Compensation attorney. We have provided an overview of your rights, but there are many grey areas and unique cicumstances that need to be taken into consideration and analyzed by an attorney. For example, maybe it has been over 30 days since the accident? Maybe your personal doctor ran tests and gave an opinion that the disability you now live with is a result of the accident at work – but running all the tests took most of the 30 days and you’re running out of time. Can you still file a claim? Or perhaps you are suffering from a work-related occupational disease? Have you worked years and years, giving your strength and the best of yourself at your job and now, you’re sick and you have a nagging suspicion that, perhaps, your sickness came about because you were exposed to some toxic substance at work. Can you still file a workers’ compensation claim? Or maybe you have filed a claim and it has been denied? Or maybe you simply need to know how to file a claim for workers’ compensation?
Talk to someone who is familiar with Workers’ Compensation. Talk to someone who is knowledgeable and experienced in filing claims, filling out forms and someone who has helped others through this process of filing a claim. Why don’t you call us today?