WORKERS' COMPENSATION
Workers’ compensation benefits are provided to employees who have been injured on the job. If your employer has four or more employees, part-time or full-time, they are required to have workers’ compensation insurance.
If you are injured on the job, you should report it as soon as possible, but no later than 30 days or your claim may be denied. Your employer, in turn, should report the injury to the workers’ compensation insurance company no later than 7 days after your employer’s knowledge of the injury. If your employer will not report your injury to the insurance company, you may contact the Employee Assistance Office at (800) 342-1741 or email at wceao@fldfs.com for assistance.
In general, an injured worker is entitled to two types of benefits under Florida’s workers’ compensation system: (1) the provision of “medically necessary remedial treatment, care, attendance” including medications and medical devices and (2) compensation for disability (money/indemnity benefits). Workers’ compensation benefits do not include payment for loss of enjoyment of life, pain and suffering, and the like.
Compensation for Disability (money/indemnity benefits)
If an injured employee’s workers’ compensation doctor says that he or she cannot work, at least temporarily, due to the workers’ compensation accident, then the injured employee is entitled to Temporary Total Disability benefits (TTD). These benefits are paid every two weeks in an amount equal to 66 2/3 percentage of the injured employee’s pre-injury “average weekly wage” (AWW).
If an injured employee’s workers’ compensation doctor says that he or she can return to work, but with restrictions caused by the workers’ compensation accident, and the injured employee returns to work with the restrictions and is earning wages less than 80% of the pre-injury AWW, then the injured employee is entitled to Temporary Partial Disability benefits (TPD). These benefits are paid every two weeks in an amount equal to 80% of the difference between 80% of the employee’s AWW and the wages the employee is able to earn post-injury, as compared weekly. TPD benefits cannot exceed 66 2/3 of the “average
The payment of TTD or TPD benefits, combined, are paid to a maximum of 104 weeks or until the injured employee reaches maximum medical improvement (MMI). Under Florida law, you are not paid for the first seven days of disability (TTD or TPD). However, if your disability extends over 21 days, you will be paid for the first seven days by the insurance company.
Once an injured employee reaches MMI, Impairment Benefits (IBs), may be payable. If, at MMI, the injured employee has suffered a “permanent injury”, then the injured employee is entitled to receive IBs based upon the permanent impairment rating assigned by the doctor (i.e., 1%, 5% 14% etc). IBs are paid at the rate of 75% of the employee’s average weekly TTD benefit for the following periods: two weeks for each percentage point of impairment from 1% up to and including 10%; three weeks for each percentage point of impairment from 11% up to and including 15%; four weeks for each percentage point of impairment from 16% up to and including 20%; and six weeks for each percentage point of impairment from 21% and higher.
Is there a period of time after which my claim is no longer open?
A worker’s compensation claim will close two years from the date of accident or one year from the date of the last workers’ compensation authorized medical treatment or payment of compensation, whichever is later.
If I am unable to return to work until my doctor releases me, does my employer have to hold my job for me?
No. There is no provision in the law that requires your employer to hold the job open for you until you return to work. However, the law does not allow your employer to fire you because you have filed or attempted to file a workers’ compensation claim.
Can I choose to take a lump sum settlement of my workers’ compensation claim?
Yes. Settlements are voluntary between the injured employee and the workers’ compensation insurance company. Settlements are not automatic or mandatory. Once a claim is settled, the injured employee would be responsible for any future medical needs related to the workers’ compensation accident.
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