Work injuries can happen at any time and in any job. Construction workers and people who work around heavy machinery have the greatest risk of being injured on the job, but even an office worker who drives to an office supply store to buy paperclips can be injured in a work-related car accident.
In Florida, employees who are injured at work or while working are entitled to workers’ compensation. Most employees are protected by Florida’s workers’ compensation law. Harbor and longshore workers, as well as certain offshore workers, are protected by federal workers’ compensation laws. Workers have similar rights under either law.
The Right to Workers’ Compensation Coverage
Workers’ compensation protects employees, including part-time and seasonal employees. It does not protect independent contractors. A self-employed worker who provides services (such as cleaning or painting) to many different businesses is usually an independent contractor.
Some employers misclassify employees as independent contractors to avoid complying with employment laws, including paying for workers’ compensation coverage. An employee who works exclusively for one business should ask a workers’ compensation lawyer whether he or she might be covered by workers’ compensation laws even if the employer has paid the worker as an independent contractor.
After reporting a work injury to the employer or to the employer’s insurance company, employees have the right to receive information about workers’ compensation benefits. Employees must be given a brochure explaining workers’ compensation rights and benefits within three days of reporting an injury.
Workers’ compensation coverage is a right that can easily be lost. Employees should notify employers immediately when they are injured at work. Employees usually have 30 days to report the injury, but insurers are more likely to contest the claim for benefits if employees delay. Employees covered by Florida law usually lose the right to bring a workers’ compensation claim if they do not report the injury within 30 days.
Employees also need to attend every medical appointment. Employees usually lose their right to coverage if they stop treating, even for a single doctor visit. In addition, employees generally need to cooperate with the insurance company representative. Cooperation includes asking questions about how the work injury occurred. Employees who are uncomfortable with the insurance representative’s attitude may want to contact a workers’ compensation attorney for advice.
The Right to Medical Care
One of the fundamental rights of employees who suffer from work injuries is the right to medical care at the employer’s expense. Employees covered by Florida’s workers’ compensation law are treated by doctors chosen by the employer or its insurance company. Longshoremen and other workers covered by federal law have more flexibility to choose healthcare providers.
Except for life-threatening emergencies, medical care must be authorized by the employer or insurer before it is provided. However, the law requires authorization of medically necessary treatment, including office visits, examinations, tests, surgery, physical therapy, medications, protheses, and attendant care. Florida law also requires the employer to pay the employee’s travel expenses to obtain treatment.
Florida law places limits on certain kinds of health care benefits, including chiropractic treatment. While employers must usually authorize chiropractic treatment that is recommended by the treating physician, workers’ compensation will only pay for 12 weeks of treatment or 24 sessions, whichever comes first.
When care is pre-authorized, the employee should never receive a bill. Employees should contact the insurance company if they are billed for authorized medical services. If the insurer does not resolve the problem, or if the insurer refuses to authorize necessary care, the injured employee should contact a workers’ compensation lawyer for advice.
The Right to Wage Replacement
Employees who cannot return to work because of a work injury are entitled to temporary total disability (TTD) benefits. When employees are covered by state law in Florida, those benefits begin after the employee misses 7 days of work. If the employee misses more than 21 days of work, the employee is entitled to receive the benefit for the first 7 days that the employee missed.
A TTD benefit is usually two-thirds of the wage the employee was earning at the time of the injury. The benefit continues until the employee is able to return to work or the employee’s injuries are no longer healing, resulting in a permanent disability. However, TTD benefits must usually end after two years. Certain severe injuries may entitle the employee to 80% of earnings for a period of six months.
While the TTD benefit does not fully replace gross earnings, it is not treated as taxable income. The savings in payroll taxes offsets much of the difference between lost wages and the TTD benefit. However, the TTD benefit is subject to a maximum benefit, so higher income workers might not receive the full two-thirds of their wage.
Sometimes an injured employee will be medically cleared to return to work part-time or in a light-duty job. If the employee is paid at least 80% of former earnings, no further benefit is paid. If the employee cannot earn 80% of former earnings, the employee should receive temporary partial disability (TPD) benefits in addition to wages.
The Right to Permanent Disability Benefits
The treating physician will declare an employee to be permanently disabled when the work injury is no longer healing and has caused a lasting impairment. When employees will never be able to work in any job again, they are entitled to a permanent total disability benefit. Those benefits are relatively rare, but they are paid for catastrophic injuries like quadriplegia.
When an employee with a permanent impairment is capable of working, the employee is entitled to a permanent partial disability benefit, also known as an impairment benefit. The benefit calculation depends on an impairment rating that is assigned by a physician. The calculation also depends on the year in which the employee was injured, the amount of the employee’s average weekly wages at the time of the injury, and whether the employee can earn that average weekly wage despite the impairment.
Insurance companies often resist paying a fair impairment benefit. Injured employees who retain a workers’ compensation attorney can usually negotiate a better settlement than the insurer will offer to unrepresented employees