Getting hurt at work is not great, but workers’ compensation laws are set in place to compensate for an injured worker to take care of medical expenses and payment they will eventually miss out on. For someone that is new to the process, it may seem confusing. You may wonder, “will I get a settlement?”
An experienced Florida workers’ comp attorney will make sure you get the compensation that you deserve, including working to get a settlement in a timely manner. The insurance company plays a crucial role in offering and negotiating these settlements. This blog will guide you through the process of workers compensation settlements, so you stay informed of what you’re entitled to if injured on the job.
What is Workers’ Compensation?
Definition of Workers’ Compensation
Workers’ compensation is a state mandated insurance program that pays benefits to employees who get hurt on the job. In Florida, this means injured workers get medical care and a portion of their lost wages without having to prove fault.
Florida Workers’ Compensation System
In Florida, the workers’ compensation system is a no-fault system. This means employees can get benefits regardless of who was at fault. The goal is to get injured workers medical treatment and financial support quickly and get them back to work as soon as possible.
Types of Workers Compensation Benefits
Workers’ compensation in Florida provides:
- Medical Benefits: All medical treatment related to the injury, doctor visits, surgeries, medications, rehabilitation.
- Wage Replacement: Partial wage replacement for employees who can’t work due to the injury. Amount and duration depends on the severity of the injury and the employee’s average weekly wage.
- Permanent Disability Benefits: If an injury causes permanent impairment the worker may get additional benefits based on the extent of the disability.
- Death Benefits: In the event of a work related death, dependents of the deceased worker will get benefits to cover funeral expenses and lost income.
Filing a Workers’ Compensation Claim
To file a workers comp claim in Florida, an injured employee must notify their employer immediately. The employer then must notify their insurance carrier who will investigate the claim and determine benefits. Timely reporting and good documentation is key to a smooth claims process.
Eligibility for Workers’ Compensation in Florida
Who is Eligible
To be eligible for workers’ compensation in Florida, an employee must have an injury or illness that arose out of and in the course of employment. This means the injury must occur while performing job duties. It covers a wide range of situations, from accidents on the job to injuries while performing job duties off site.
Types of Workplace Injuries
Florida workers’ compensation covers:
- Acute Injuries: Sudden injuries from a specific incident, falls, equipment malfunction, vehicle accidents.
- Repetitive Stress Injuries: Injuries that occur over time from repetitive motion or strain, carpal tunnel syndrome, back injuries from lifting.
- Occupational Illnesses: Conditions that develop from exposure to harmful substances or environments at work, respiratory diseases from inhaling toxic fumes.
- Psychological Injuries: If directly related to a physical injury on the job.
Exceptions and Ineligible
Not all injuries are eligible for workers’ compensation in Florida. Some exceptions include:
- Self Inflicted Injuries: Injuries an employee intentionally causes to themselves are not covered.
- Horseplay: If the injury is from fooling around or horseplay it may not be eligible.
- Intoxication: Injuries that occur while the employee is under the influence of drugs or alcohol are generally not covered.
- Non Work Related Activities: Injuries that occur while the employee is not performing job duties, such as commuting to or from work, are generally excluded.
Reporting and Filing Deadlines
To be eligible for workers’ compensation benefits Florida employees must meet the following reporting and filing deadlines:
- Reporting the Injury: The injury must be reported to the employer within 30 days of the incident or when the employee discovers the work related condition.
- Filing the Claim: The workers’ compensation claim must be filed within 2 years of the date of injury or when the injury was discovered.
Documentation
Good documentation is key in the workers’ compensation process. Employees should keep a record of the incident, medical treatment, and communications with their employer and insurance carrier. Proper documentation will help with a smoother claims process and avoid potential disputes or delays in getting benefits.
When to Settle
When to Settle
Settling can be beneficial in many situations. If your injury is severe and results in long term disability, a lump sum payment can provide immediate cash. This is especially helpful if you have big medical bills or ongoing medical care that workers’ compensation won’t cover.
Consider Before Settling
Before you settle:
- Severity of Injury: The extent and impact of your injury on your ability to work is key. Severe injuries that result in permanent disability may require a higher workers comp settlement.
- Future Medical Expenses: Calculate the future medical costs associated with your injury. Make sure the settlement amount will cover those expenses since settling means you’ll give up future medical benefits.
- Financial Situation: Consider your current financial situation and the stability a lump sum settlement can provide. Having immediate cash can help with ongoing expenses and uncertainty.
Impact on Ability to Work and Earn Wages
Your ability to go back to work and earn wages should be a big consideration. If your injury prevents you from working or limits your earning capacity a settlement can compensate for lost wages and future earning potential. Does the settlement amount reflect those losses?
Maximum Medical Improvement (MMI)
Reaching Maximum Medical Improvement (MMI) is a critical part of the settlement process. MMI is the point where your condition has stabilized and no further medical improvement is expected. Settling before MMI can be risky as it may underestimate the total cost of your injury. Make sure you’ve reached MMI or have a clear understanding of your medical prognosis before you settle.
The Process to Get a Settlement in Florida
Reporting the Injury
The first step in the settlement process is reporting the injury to your employer. In Florida you must report your work related injury within 30 days of the incident or when you discover the injury. Timely reporting is key to avoid your claim being denied for late notice.
Medical Treatment
After reporting the injury seek medical treatment. Initial treatment can be from any licensed medical provider but ongoing treatment must be from a medical provider authorized by your employer’s workers’ compensation insurance carrier. Good medical documentation is key to proving your claim.
File a Workers’ Compensation Claim
Next file a workers’ compensation claim with your employer’s insurance carrier. This means filling out the necessary forms and providing all the required documentation including medical records and a detailed description of the injury. The insurance carrier will investigate your claim and determine if you’re eligible for benefits.
Settlement Negotiations
Once your claim is approved, the workers compensation settlement process can begin. You and the insurance carrier will discuss the terms of the settlement including the amount of compensation and how the funds will be paid out. It’s recommended you have a workers’ compensation attorney represent you during these negotiations to get a fair settlement.
Maximum Medical Improvement (MMI)
Before you settle make sure you’ve reached Maximum Medical Improvement (MMI). MMI is the point where your condition has stabilized and no further medical improvement is expected. Settling before MMI can mean an inadequate settlement that doesn’t cover future medical expenses.
Workers Compensation Insurance Company
Workers compensation insurance companies are part of the settlement process. They may offer a lump sum settlement to limit their future liability. But their initial offers aren’t always fair. Be sure to evaluate those offers carefully and negotiate for a settlement that covers all your medical and financial needs.
Settlement Finalization
Once an agreement is reached the settlement must be documented and approved. This means signing a settlement agreement that outlines the terms. In Florida the settlement must be approved by a judge to make sure it’s in your best interest. The judge will review the agreement and medical documentation before approving.
Why You Need an Attorney
Throughout the settlement process, having a workers compensation lawyer is key. A workers’ compensation attorney can guide you through each step, make sure all the paperwork is done correctly and advocate for a fair settlement. Legal expertise will help you navigate the process and avoid the common mistakes.
Meet with an Experienced Florida Workers Comp Lawyer Today!
No one wants to get injured on the job. However, if you do, you deserve compensation for your workers comp case. At Work Injury Rights, we will fight for your settlement so you can prioritize your health and recovery.
Contact us at 954-388-8616 for a free consultation today!
