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Florida Workers’ Compensation Claims Process

Need a Florida workers’ compensation lawyer?

  • If you’ve been hurt on the job, we can help
  • We’ve helped thousands recover the benefits they deserve
  • If we don’t win, you don’t pay!

Call 954-833-5226 to get an experienced workers’ comp attorney today.

Eligibility for Workers’ Compensation

man speaking with a worker's comp lawyer

To be eligible for workers’ compensation in Florida, an individual must be an employee who has suffered an injury or illness directly related to their work activities or workplace environment. The eligibility criteria are designed to ensure that injured workers receive prompt and efficient access to medical treatment and compensation for lost wages due to work-related injuries.

Key points include:

  • The injury must occur during the course of employment.
  • The individual must be an employee of a company that carries workers’ compensation insurance.
  • Independent contractors, volunteers, and certain sectors of employees may have different eligibility criteria.

Understanding these criteria is crucial for any injured employee considering filing a workers’ compensation claim in Florida. Immediate seeking of medical attention from an authorized medical provider is also an essential part of validating your claim and ensuring your eligibility for benefits.

Reporting the Injury

Once an injury or illness is sustained, the process of reporting it to your employer is critical in the Florida workers’ compensation claims process. Injured employees must report their injury to their employer within 30 days of the incident or of becoming aware of the work-related condition. Here are the steps to follow:

  • Report the Injury: Inform your employer about the injury as soon as possible. This can be done verbally, but providing written notice is advisable for documentation purposes.
  • Employer Notification: Upon receiving notification, the employer is required to report the injury to their workers’ compensation carrier within seven days. This step initiates the claim process.
  • Seek Medical Attention: Following the report, the injured worker is typically directed to an authorized medical provider for evaluation and treatment. The insurance company will cover medical bills related to the injury if the claim is accepted.
  • Follow-Up: Keep track of all documentation, including medical reports, correspondence with your employer, and any communication from the workers’ compensation insurance carrier. This information will be crucial if your claim goes into dispute or if you need to file a workers’ compensation appeal.

Seeking Medical Treatment

Workers' comp form

After sustaining a work-related injury or illness, promptly seeking medical attention is crucial for your health and the success of your workers’ compensation claim. In Florida, you should see a medical provider authorized by your employer or their workers’ compensation insurance carrier.

This step ensures that your medical attention is covered under the claim and provides the necessary medical documentation to support your case. Remember, receiving timely and appropriate medical care not only aids in your recovery but also solidifies the basis of your workers’ compensation benefits claim.

Filing the Workers’ Compensation Claim

Once you’ve reported your injury or illness to your employer and sought medical attention, the next step is to officially file a workers’ compensation claim. In Florida, your employer is responsible for reporting the injury to their workers’ compensation carrier within seven days of notification.

However, it’s prudent for injured employees to follow up and ensure this step has been completed. Documentation from your medical provider about the injury and the medical attention received will play a crucial role in this process.

If your employer does not report the injury, or if you encounter issues with the claim, consider reaching out to the Florida Division of Workers’ Compensation or seeking assistance from a workers’ compensation attorney to navigate the next steps, including potential disputes or the need for an appeal. Remember, accurate and timely filing is key to receiving your medical benefits and compensation for lost wages efficiently.

Claim Processing by the Insurance Company

Man falling on the job

Once your employer submits your workers’ compensation claim to their insurance company, it undergoes a review phase. The insurer evaluates your work-related injury or illness, examining medical records and incident reports to determine if the claim qualifies for benefits under Florida’s laws.

This review, focusing on the injury’s validity, medical documentation, and any lost wages, must be completed within 14 to 30 days, leading to either claim approval or denial. Efficient and detailed documentation from you and your company can expedite this process.

Receiving Benefits

Once your workers’ compensation claim is approved by the insurance company, you will start to receive benefits. These benefits are designed to cover your medical bills related to the injury or illness and a portion of your lost wages if you’re unable to work.

Medical benefits should cover necessary medical treatment, while wage replacement benefits typically represent a percentage of your average weekly wage. The specific amount and duration of these benefits can vary based on the severity of your injury and your capacity to return to work.

It’s important to maintain communication with both your company and the workers’ compensation carrier during this period to ensure the continuous and correct payment of benefits.

If Your Claim Is Denied

attorney fees being calculated for workers comp based on pay benefits

If your workers’ compensation claim is denied, you can challenge the insurer’s decision. Start by understanding the denial’s reasons, often related to the injury’s work connection or lack of documentation.

In Florida, you have two years to file a petition for benefits with the Division of Workers’ Compensation. Consulting a workers’ compensation attorney can significantly enhance your chances in the appeals process, from gathering evidence to representing you in hearings. Denied claims can be overturned, with resources like the ombudsman office available to assist injured workers through the appeals.

Contact WIR For Help Today

Employee assistance in a workers' compensation case

Navigating the workers’ compensation claims process in Florida can be complex, but understanding each step is our specialty.

If you’re facing challenges with your workers’ comp claim or if it’s been denied, don’t navigate this process alone. Contact Work Injury Rights today at 954-833-5226 for a free consultation to discuss your case and explore your options for appealing a denied claim or addressing any issues with your benefits.