No one clocks in expecting to leave work with an injury, but it happens, and thousands of employees file for workers’ compensation each year. This is a type of insurance designed to protect workers who suffer an injury on the job, and coverage can pay for medical bills or wages lost during recovery. In these cases, employees also generally give up the right to sue their employer for negligence, even if the accident could have been prevented. That trade-off means workers’ comp does not provide compensation for pain and suffering. In this post, we’ll go over what benefits are available through this system, how it works for workers in Florida, and some important rights and limitations injured employees should know.

 

1) How Long Do Employees Have to Report a Work Injury in Florida?

An employee in Florida only has 30 days from the date of the accident to report it. That could also be from the time that they realize the injury is work-related. Because some injuries may not appear right away or can get worse over time, it’s best to notify the employer of an incident as soon as it happens. Unfortunately, waiting any longer than 30 days could result in a denial of benefits.

2) Can an Employee File a Personal Injury Lawsuit for a Work Injury?

Usually, no. If an employee gets hurt at work, the claim will go through workers’ compensation. The employer must then cover all authorized, medically necessary care to treat the injury, including:

  • Doctor visits (primary and specialist)
  • Hospital stays, physical therapy, or needed testing
  • Prescription medications, prosthetics, and attendant care
  • Mileage reimbursement for travel to authorized providers

Most employers in Florida are required to carry workers’ comp. This is meant to cover damages for the injury without requiring proof that anyone was at fault for it, which is different from personal injury claims.

However, there is an exception to this general rule explained in paragraph #6.

3) What If the Work Injury Is Serious?

If the authorized doctor says that the employee is unable to work due to the injury, the worker usually qualifies for Temporary Total Disability (TTD) benefits. These would cover part of the worker’s income while they are recovering. If they recover enough to return to work but are restricted, they may qualify for Temporary Partial Disability (TPD) benefits.

If the employee suffers from an injury that permanently affects their ability to work, they may qualify for Permanent Total Disability (PTD). A PTD designation means that the person is unable to return to work at all in the competitive job market due to the injury.  PTD benefits are also meant to replace income, and generally pay up to two-thirds of the worker’s pre-accident average gross weekly wage until the age of 75, with some exceptions.

4) Is PTD the Same as Social Security Disability?

No, and the differences are important. Social Security Disability Insurance (SSDI) is a federal program. It looks at the employee’s lifetime work history and contributions to Social Security. SSDI benefits are based on those earnings and are not exclusive to work-related injuries.

PTD is much stricter. It applies when the injury is permanent and eliminates the ability to perform any job. In these cases, PTD benefits can cover both income and medical care for a very long time, sometimes all the way through retirement age, and in some cases, for life.

5) Do I Have to Prove Fault to Get Workers’ Comp?

No, employees do not have to prove that their employer or a co-worker caused the injury to receive any benefits. As long as the accident happened while performing the job, workers’ comp is generally available. The exceptions are if the employee was under the influence of drugs, breaking any safety rules, or injured outside of work.

6) When Can a Lawsuit Be Filed Instead?

Workers generally cannot sue their employer. However, they may have the option of filing a personal injury lawsuit if someone outside the company caused the injury. This is called a third-party claim. Some examples include:

  • A delivery driver from another company causes a crash that injures an employee on the job while the employee is on the job
  • A contractor on the same worksite creates unsafe conditions that lead to an injury to an employee on the job
  • A defective machine or tool breaks and causes injury to an employee on the job

In these cases, the employee may be able to get workers’ comp benefits and also pursue a lawsuit against the third party. A lawsuit may help cover things workers’ comp does not, such as damages for pain and suffering or complete wage loss.

What to Do After a Serious Work Accident

Some important things to do after experiencing a work-related injury include:

  1. Notify the employer and request/get medical care right away. Waiting may increase the risk of worsened injury and creates gaps in the medical records.
  2. Follow what the doctor orders. Ignoring treatment plans or skipping appointments may hurt a claim.
  3. Save all paperwork including hospital bills, prescriptions, and pay stubs showing missed work. These can all be useful later.
  4. Be careful with recorded statements. Some insurance adjusters call injured employees quickly and  sometimes ask confusing and/or tricky questions and want to settle cheaply as fast as possible. Get legal advice first.
  5. Keep notes. Writing down pain levels and any limits on what can or can’t be done helps document the impact of the injury.

What If The Accident Led To Death?

Unfortunately some work accidents prove to be fatal. If a worker dies due to a job-related injury (within 1 year of the incident or 5 years of disability), survivors may receive up a maximum benefit of $150,000, plus:

  • Up to $7,500 for funeral expenses
  • Education benefits for the surviving spouse

What If the Insurance Company Offers Me a Settlement?

Insurance companies sometimes offer quick settlements after a serious injury and before the injured employee gets a lawyer. While the money can be tempting to take, these offers are usually designed to save the insurer money, not to cover the worker’s future needs. Saying “yes” to a settlement too soon may also close the door on asking for more later. If the injury gets worse or more medical bills show up, the worker could be stuck without any additional relief. A workers’ compensation lawyer can review the offer to advise on the best next steps.

How Long Do Workers’ Compensation Benefits Last?

The length of benefits an employee receives depends on the injury and the recovery. Generally, payments last until the person reaches Maximum Medical Improvement (MMI) in the treating doctor’s opinion. When this is reached, the worker may not be fully recovered from their injury, but their condition is considered stable by their doctors and it’s unlikely to improve any further. This is a very critical stage in a workers’ comp case because it affects whether benefits will continue, if the employee can go back to work, or if long-term disability benefits (like Permanent Total Disability) will apply.

What If My Workers’ Comp Claim Is Denied?

Even strong claims can get denied if paperwork is provided late or details are unclear, or even if it’s disputed how the injury happened. Insurance companies will sometimes argue that the injury happened outside of work, or state that there isn’t enough medical proof to back up the employee’s statement. A denial doesn’t mean the case is over. The employee has the right to contest the denial, and a workers’ compensation attorney can help with that process.

Workers’ Compensation Help in Florida

Workers’ compensation can be extremely confusing, especially if a claim is denied or the injury is serious enough to affect the rest of an employee’s work life. Florida does provide resources to employees, like the Employee Assistance Office (EAO), to provide free help with disputes, but we believe that having an experienced lawyer makes all the difference in a case.

Since 1976, Daniel L. Hightower, work accident lawyer, has been standing up for injured workers across Florida. Workers’ compensation law provides important protections, like medical treatment, prescription coverage, and wage loss reimbursement when someone can’t work. However, just because employers carry this insurance, it doesn’t mean the process is easy, fast or efficient for injured employees. We’re available to walk you through it.

If you’ve been injured at work and have questions about your legal rights, we invite you to call Hightower and Hightower for a free consultation. There are no fees or costs to you unless a settlement is recovered on your behalf. Call us today at 352-629-7777.