How to File a Workers’ Comp Claim in Orlando the Right Way
Getting hurt or sick on the job can leave you stressed, in pain, and unsure of what to do next. Florida law gives injured workers a clear process to follow for receiving medical care and lost wages through the state’s workers’ compensation program.
In this blog, you’ll learn how to file a workers’ comp claim in Orlando, what benefits you may qualify for, and why working with an experienced Orlando workers’ compensation attorney can help you avoid delays, protect your rights, and secure the benefits you deserve.
Step 1: Report the Injury or Illness Immediately
Filing a workers’ comp claim starts with one essential action: telling your employer you are hurt or sick because of your job.
Tell Your Employer Right Away
If you suffer a work-related injury or illness, you must inform your employer as soon as possible. Florida law gives you 30 days to report the incident. This rule is found in Florida Statute § 440.185(1). Waiting longer can cause your workers’ compensation claim to be denied. Reporting early also helps prove the injury happened at work.
Give Accurate Information
Be clear about how the injury happened. Include the date, time, and details of the incident. Explain the job activity that caused the injury or illness. Accurate information helps your employer and the insurance company start the claim process quickly. It also protects your right to receive workers’ compensation benefits.
Put the Report in Writing
While Florida law allows verbal reporting, it is best to give your report in writing. A written notice creates a record. This helps if your claim is denied or if there is a dispute later. Keep a copy of the report for your records.
Know What Counts as a Work Injury
Work-related injuries include sudden accidents, like falling or lifting something heavy. They also include illnesses caused by repeated exposure or stress at work. Even if you are unsure if your injury qualifies, report it. Let the insurance company review your case. You can speak with a workers’ compensation lawyer if you need help understanding your eligibility.
The First Step Affects the Rest
This first step is key to the entire claim process. It affects how fast you can get medical treatment, lost wages, and other workers’ compensation benefits. Do not wait. Reporting the injury is your responsibility and the first move to protect your rights.
Step 2: Seek Authorized Medical Treatment
After reporting your injury, the next step in filing a workers’ comp claim is to get medical care from a doctor approved by your employer or their insurance company.
Only See an Authorized Doctor
Under Florida law, your employer or their insurance carrier chooses the doctor who treats your work-related injury. This rule is in Florida Statute § 440.13(2)(a). If you visit a doctor on your own without approval, the workers’ compensation program may not cover the cost. You could be responsible for the bill. Always ask your employer or the insurance company which doctor to see.
Emergency Exceptions Exist
If you are seriously hurt and need emergency care, you can go to the nearest hospital or emergency room. In these cases, treatment does not have to wait for approval. But after the emergency, follow up with an authorized provider to stay eligible for benefits.
Follow the Doctor’s Instructions
Once treatment starts, you must follow the doctor’s plan. This includes attending appointments, taking medication, and following restrictions. If you ignore medical advice, the insurance company may reduce or stop your workers’ compensation benefits. Keeping all medical records helps protect your claim.
Request a Change If Needed
If you have concerns about your assigned doctor, you have the right to ask for a one-time change. This request must go through the insurance company, not your employer. Florida law allows this once per claim. A workers’ compensation attorney can help you with this process if needed.
Keep Medical Care Connected to the Claim
Make sure all care relates to the injury or illness from your job. Talk to the doctor about your job duties and how the injury affects your work. Clear communication helps you receive the right treatment and speeds up decisions about disability payments and other workers’ compensation benefits.
Step 3: Employer Notifies Insurance Carrier
Once you report the injury, your employer must take action by contacting their workers’ compensation insurance provider.
Employer Must File a Report
Florida law requires your employer to file a First Report of Injury or Illness with their insurance company within seven days of learning about your work-related injury. This rule is part of Florida Statute § 440.185(2). This report starts the official claim process with the insurance company.
Your Claim Cannot Start Without This Step
The insurance company cannot begin reviewing your workers’ compensation claim until they receive this report. Medical treatment, disability payments, and lost wage benefits all depend on the insurance company opening your file. If your employer delays or refuses to report the injury, it can slow or stop your benefits.
Follow Up to Confirm Filing
You have the right to ask for confirmation that your employer filed the report. If you do not hear from the insurance company within a reasonable time, follow up. You can also contact the Florida Division of Workers’ Compensation or a workers’ compensation lawyer to get help.
What If the Employer Does Not Report
If your employer does not file the report, you are not out of options. You can file a complaint with the state or get help from a workers’ compensation attorney. Florida law protects employees and holds businesses accountable when they do not follow the claim process.
Keep Copies of All Paperwork
Always keep records of any reports, emails, or forms related to your injury. These documents support your claim and may help if benefits are delayed or denied. Having accurate information on hand makes it easier to receive benefits and prove your eligibility.
Step 4: Understanding What Benefits You May Receive
After your claim is filed, you may qualify for several types of workers’ compensation benefits based on your injury and ability to work.
Medical Treatment at No Cost
Workers’ compensation covers all necessary medical care related to your injury. This includes doctor visits, hospital stays, prescriptions, therapy, and medical tests. As long as the treatment is approved and connected to your work injury, you should not have to pay. Florida Statute § 440.13 outlines the employer’s duty to provide medical care.
Wage Replacement for Lost Income
If your injury keeps you from working, you may receive wage replacement payments. These are usually two-thirds of your average weekly wage, subject to a state maximum. Payments may begin if you miss more than seven days of work. If you miss more than 21 days, you can receive payment for the first seven days as well.
Types of Disability Payments
Florida law provides several types of disability benefits based on how your injury affects your ability to work:
- Temporary Total Disability (TTD): You cannot work at all for a limited time.
- Temporary Partial Disability (TPD): You can work with restrictions and earn less than 80 percent of your regular wage.
- Impairment Income Benefits (IIB): You have a lasting condition after reaching maximum medical improvement.
- Permanent Total Disability (PTD): You cannot return to work in any capacity.
These benefits are described in Florida Statute § 440.15.
Mileage and Related Costs
You may be paid for travel to and from medical appointments. Keep track of your mileage and save receipts if you use public transportation or need lodging for treatment. Submit these costs to the insurance company for reimbursement.
Death Benefits for Families
If a work injury causes death, the family may receive benefits. This can include funeral costs and financial support for dependents. These benefits are also defined in Florida Statute § 440.16.
Stay Informed About Your Claim
Read all letters from the insurance company. Make sure your payments match what you are owed. If anything is missing or denied, ask for an explanation. You may also contact a workers’ compensation attorney if you need help getting full benefits.
Step 5: Monitor Communication with the Insurance Company
After your employer reports the injury, the insurance company becomes your main point of contact for benefits and medical care.
Respond to All Requests
The insurance company may contact you for statements, medical records, or forms. Respond quickly and give accurate information. Delays or missing documents can slow down your workers’ comp claim. Always keep copies of anything you send or receive.
Attend Required Medical Exams
The insurance company may schedule an Independent Medical Examination (IME) with a doctor of their choice. You must attend. Missing this appointment can affect your eligibility for workers’ compensation benefits. Bring any medical records or notes that explain your injury or treatment.
Track Your Benefits
Review your payment records and medical authorizations. Make sure you are receiving the correct amount of disability payments and coverage for approved treatments. If something seems wrong or you stop receiving checks, contact the adjuster immediately.
Watch for Denial or Delay
The insurance company may deny part or all of your claim. This could include medical treatment, lost wages, or disability payments. A denial must be given in writing. If you disagree with the decision, you have the right to appeal.
Ask Questions if You Are Unsure
If you do not understand something the insurance company says or does, ask. You can also speak with a workers’ compensation lawyer to review your claim, check your benefits, and help you respond to denied claims or missed payments.
Stay Organized
Keep a file with all claim documents, doctor notes, receipts, and letters from the insurance company. This helps protect your rights and supports your case if there is a dispute. Strong records help you stay in control of your claim process.
Contact an Experienced Orlando Workers’ Compensation Lawyer Today!
If you’ve suffered a work-related injury or illness and are unsure how to file a workers’ comp claim, don’t wait to get the help you need. The process can be strict, and even small mistakes may delay or reduce your benefits. Our team at Work Injury Rights understands Florida’s workers’ compensation system and has the experience to handle denied claims, missed payments, and uncooperative employers.
Contact us at 954-388-8616 for a free case consultation today!
