Florida workers’ comp is a state-required insurance program that provides benefits to employees who get hurt or sick on the job. These benefits cover medical expenses, lost wages, and rehab costs to help you get back on your feet. Florida law requires most employers to carry workers’ compensation to protect both employees and employers in case of a workplace injury.
In this post, we’ll cover the basics of workers’ comp in Florida, how it works, the benefits it provides, what injured workers face, and why you need to work with an experienced Florida workers’ compensation lawyer to get all the benefits you’re entitled to.
Who Needs Workers’ Comp in Florida?
Understanding who needs workers’ comp in Florida is important for both employers and employees. The law has certain coverage requirements and rules for different industries.
Coverage for Businesses
Most businesses in Florida are required to carry a workers comp policy through private insurers. This applies to businesses with 4 or more employees. But in the construction industry, any business with 1 or more employees must have coverage. So injured workers get the medical care and lost wages they need for work-related injuries.
Special Rules for Construction Companies
The construction industry has its own rules for workers’ comp. As mentioned above, all construction employers must have coverage regardless of the number of employees. This is because construction jobs are at higher risk. Subcontractors must also carry their own workers’ comp insurance so all workers on a construction site are covered.
The high-risk nature of construction jobs significantly influences insurance premiums, often resulting in higher costs for employers.
Opt-Out Options for Corporate Officers and LLC Members
Florida law allows certain individuals to opt out of workers’ comp. Corporate officers and members of limited liability companies (LLCs) can exclude themselves from coverage. However, if they opt out, they will not receive benefits if they get hurt on the job. This should be carefully considered as the risks far outweigh the benefits for most.
What’s Covered Under Workers’ Comp in Florida?
Florida workers’ comp provides benefits to employees who get hurt or sick on the job. Knowing what’s covered will help injured workers navigate the claims process. The system aims to provide these benefits at a reasonable cost to employers.
Medical Expenses
Workers’ comp covers medical expenses related to a work-related injury or illness. This includes hospital visits, surgeries, and rehab services. Injured workers should keep all receipts and medical records to support their claim.
The insurance company plays a crucial role in processing these medical expense claims, ensuring that they are handled promptly and efficiently.
Lost Wages
If an employee can’t work due to their injury, workers’ comp provides benefits to replace a portion of their lost wages. This is usually based on the employee’s average weekly wage before the injury.
Employees can file an insurance claim to receive compensation for lost wages without pursuing a lengthy lawsuit.
Prescription Medications
Costs for prescription medications related to the treatment of a work-related injury are also covered. So injured employees can get the medications they need without financial stress.
Job Replacement Benefits and Vocational Rehabilitation
Employees who can’t return to their previous jobs due to their injuries may be eligible for job replacement benefits. These benefits help find new employment or retrain for a different career. Vocational rehabilitation services help injured employees get back to work.
Understanding the complexities of Florida workers’ compensation claims is crucial, as navigating the claims process and knowing your entitlement to benefits can be challenging. Consulting an attorney can provide valuable guidance.
Death Benefits
If a work-related injury causes an employee’s death, workers’ comp provides death benefits to the employee’s dependents. This helps ease the financial burden during a tough time so families get support.
Benefits
Knowing the different types of workers’ compensation benefits under Florida’s workers’ comp system is important for injured employees. These benefits include coverage for medical expenses and lost wages for workers who got hurt or sick because of their job. Let’s look at the main benefits you may be eligible for.
Temporary Total Disability (TTD)
Temporary Total Disability benefits provide financial support to employees who are completely unable to work due to a work-related injury or illness. This benefit is a portion of your lost wages, usually two-thirds of your average weekly pay. TTD benefits will continue until you reach maximum medical improvement or return to work.
Temporary Partial Disability (TPD)
If you can work but your injury limits your ability to earn your usual wages you may be eligible for Temporary Partial Disability benefits. TPD benefits help cover the difference between what you were earning before the injury and what you can earn in a reduced capacity. Like TTD, TPD benefits are two-thirds of the wage difference subject to certain caps.
Permanent Disability
Permanent Disability benefits kick in when an injury causes lasting impairment. This can be broken down into two:
- Permanent Total Disability (PTD): This is when an employee can’t work at all due to their injury. PTD benefits provide ongoing benefits for the duration of the disability.
- Permanent Partial Disability (PPD): This is when an employee has a permanent injury but can still work. PPD benefits are based on the severity of the injury and how it affects your ability to work.
Eligibility and Coverage
Florida workers’ comp provides support for employees who get work-related injuries or illnesses. To be eligible for benefits, certain criteria must be met.
Work-Related Injuries
To be eligible for workers’ comp the injury or illness must arise out of and in the course of employment. This means incidents that happen during work hours and in the scope of employment. For example, if an employee slips and falls while performing their job, they are likely eligible for benefits. Employers must report these injuries to their insurance carrier ASAP. An injured employee should promptly report the injury to their employer, seek medical attention, document the incident, and consider legal counsel to navigate the workers’ compensation process.
Travel Related Injuries
Employees are also covered for injuries sustained while traveling for work. If a worker is in a car accident on a business trip, they may be eligible for benefits. However, the injury must be work-related, and the employee must be acting in the scope of their employment at the time of the accident.
Exclusions
Not all injuries are covered under Florida’s workers’ comp law. Exclusions include:
- Self-Inflicted Injuries: Any injury an employee intentionally causes to themselves is not covered.
- Intoxication: If an employee is under the influence of drugs or alcohol at the time of the injury, they may be denied benefits.
- Personal Activities: Injuries that occur during personal activities such as breaks or lunch hours may not be eligible unless they are directly related to job functions.
Employer Responsibilities
When it comes to workers’ comp in Florida, employers have many responsibilities. These duties are important for employee safety and to stay in compliance with state law.
Reporting Workplace Injuries
Employers must report any work-related injuries to their insurance carrier ASAP. This includes documenting the incident and providing all the details of how and when the injury occurred. Timely reporting is key, as delays can cause issues in the claims process.
Coverage for All Eligible Employees
Most employers in Florida are required to carry workers’ comp. This coverage should cover all eligible employees, including full-time, part-time, and seasonal employees. Employers must review their policies regularly to stay in compliance with state law and any changes in employee status.
Employee Leasing Agreements
Employers who engage in employee leasing agreements must make sure their leased employees are covered under workers’ comp. This means understanding the leasing contract and communicating clearly with the leasing company regarding coverage responsibilities. Employers should verify the leasing company has sufficient insurance to cover all workers involved.
Premiums and Costs
Understanding the costs of workers’ comp is important for both employers and employees. Premiums can vary greatly, and being informed can help businesses manage their expenses.
Workers compensation insurance provides essential benefits for employees who experience job-related injuries or illnesses, covering medical expenses, lost wages, and permanent disabilities, while also fulfilling legal requirements for employers in Florida.
Premium Factors
Several things impact workers’ comp premiums in Florida. These include:
- Industry Classification: Each business has a classification code that reflects its risk level. High-risk industries like construction have higher premiums than low-risk industries like office work.
- Claims History: A company’s past claims can impact premiums. Frequent claims will increase rates, while a clean record will keep costs down.
- Payroll: A business’s total payroll is directly related to its premiums. A larger payroll means higher premiums as there are more employees to cover.
Additionally, the Bureau of Compliance plays a crucial role in generating significant insurance premiums by processing exemption applications and investigating non-compliance, resulting in $5,893,046 generated in the fiscal year.
Calculation
Carriers use a formula to calculate premiums. The most common is to use the classification code rate and the business’s total payroll. For example, if a business has a classification code rate of $2.00 per $100 of payroll and a total payroll of $500,000, the annual premium would be $10,000.
Classification Code Rate and Experience Modification Number
The classification code rate has a big impact on premiums. Each industry has a rate that reflects its risk level. The experience modification number (EMR) can also adjust premiums. An EMR below 1.0 means a better-than-average safety record and may lower costs. An EMR above 1.0 means higher risk and higher premiums.
Consult With an Experienced Florida Workers’ Comp Attorney ASAP!
If you’ve been injured on the job and need help navigating the workers’ compensation process, don’t go it alone. Our team at Work Injury Rights is here to support you every step of the way. With extensive experience in Florida workers’ compensation law, we are dedicated to protecting your rights and securing the benefits you deserve.
Contact us at 954-829-7077 for a free case consultation today!
