Florida Workers’ Compensation Claims Process

For those who suffer debilitating work injuries, workers’ compensation insurance offers a lifeline. Workers comp benefits provide a means to pay your medical bills while out of work and a paycheck to sustain you and your family while you recover. It may even provide permanent total disability payments (PTD) in the event you are unable to work in your former position or any capacity at all.

Workers’ compensation claims become adversarial when the insurance carrier refuses to pay for the full extent of your injuries. If you have been injured, you need to concentrate on getting well. Let your attorney deal with the insurer; your employer is not going to help.

Berlin Law Firm is among Florida’s most trusted workers’ compensation attorneys. We understand the urgency and just how much is at stake in these cases. We’re happy to take you through the state’s workers’ compensation process and help you receive the maximum benefits to which you are entitled.

Confirming Eligibility Requirements

The threshold question in these cases is always whether your work injuries are even covered by a workers’ compensation insurance policy. To be eligible, all of the following must hold true:

• You were injured or became ill at work.
• Your employer has insurance coverage.
• The injury/illness is related to your job.
• Any injuries sustained are reported to the employer within 30 days of the incident.

You may consult with our experienced lawyers at any time free of charge to determine if you meet these criteria. We will personally walk you through this process every step of the way. Please call our workers’ compensation attorneys if you have any questions at 941-777-7000.

You do not have to go through the next steps alone.

Notify Your Employer of Your Work-related Illness or Injury

You must provide your employer with notice of your injury within 30 days of becoming injured. It is a good idea to give written notice of the incident and your intention of pursuing a workers’ compensation claim. In many situations, employers refuse to report your claim to their worker’s compensation insurance carrier. You need to keep copies of all text messages, emails, or anything which confirms that you reported your injury and requested medical treatment to your employer within 30 days of the injury having occurred.

Interacting with your employer about a workers’ comp claim presents an uncomfortable situation for many. However, if you retain counsel soon after your injury, your attorney can help ease that tension and complete the necessary paperwork to move the process along.

Seek Medical Attention

Workers’ comp benefits require claimants to submit to a medical examination. When you see your physician, be sure to tell them that your illness or injury is related to an accident you had at work and that this information is retained in your medical records. If your doctor is not authorized by the insurer, you may be required to submit to another examination by one who is.  Many times, employers will “encourage” injured workers to lie to the initial physicians about how the injury occurred. It is important that you give an accurate history to the initial physician or emergency room as to how the injury occurred, the date it occurred, and that it happened as a result of work-related activity.

Wait to Hear From Your Employer’s Insurer

Once your employer gets notice of your workers’ comp claim, your employer has seven days to file an accident report with the insurer. You should receive a response authorizing or denying your claim at that time.

Insurance companies are known to give their beneficiaries a hard time and deny legitimate claims. Even claims that are authorized are often limited in the amount of benefits they will allow. The carrier might make additional payments contingent on further investigation and legal proceedings such as a deposition. If you haven’t retained counsel by this point in the workers’ compensation process, it is highly advisable to seek representation as soon as possible.

What if There is No Workers’ Compensation Insurance Available?

Even though most Florida employers must carry workers’ compensation insurance, some employers skirt the rules. If your employer isn’t insured, Berlin Law Firm’s attorneys in Tampa and Sarasota can advise you on whether you have grounds for a civil lawsuit against your employer. If so, you may still be able to recover money damages for your medical bills, lost wages, and your pain and suffering.

Attempt to Resolve Benefits Dispute Prior to Filing Petition for Benefits

It’s a good idea to attempt at least one good-faith effort to resolve your dispute with the insurer before jumping to the next step in the workers’ comp process.  However, while Employees are free to plead directly to the insurance adjuster or the Florida Employee Assistance and Ombudsman Office, it is advisable for you to allow us to attempt resolution directly with the insurance company.

The Petition for Workers’ Compensation Benefits

The filing of the petition for benefits is the beginning of a typical Florida litigation process, with events timed out according to the OJCC Rules of Procedure. Once the petition is filed with the Office of the Judges of Compensation Claims and served upon the employer and the workers comp carrier, those parties have a certain number of days to respond.

Litigation Continues

As the parties conduct discovery and build their respective cases, the dispute will more than likely go to mediation. If the case is not settled there, the parties will meet again at the final hearing and wait for the JCC to issue its final decision. Appeals are permitted pursuant to strict rules and time limits, and may even be remanded back to the JCC for further inspection.

Don’t Navigate the Florida Workers’ Compensation Process Without Berlin Law Firm

The workers’ compensation process can be a long road during a time when uncertainty abounds and stress levels run high. We want to take some of that burden off your shoulders.

With offices in Tampa and Sarasota, Berlin Law Firm helps injured employees throughout the state of Florida receive their maximum benefits. Contact us for a free consultation.