Workers' Compensation Frequently Asked Questions

 

How long after an accident do I have to report it to my employer?

When should my employer report the injury to their insurance company?

My employer will not report my injury to the insurance company. What can I do?

What kind of medical treatment can I get?

Do I have to pay any of my medical bills?

Will I be paid if I lose time from work?

How much will I be paid?

When will I get my first check?

If I'm only temporarily disabled, how long can I get these checks?

Can I receive unemployment compensation and workers' compensation benefits at the same time?

What can I do if I am not receiving my benefit check?

If I am unable to return to work until my doctor releases me, does my employer have to hold my job for me?

Can my employer fire me if I am unable to work because of an injury and am receiving workers' compensation benefits?

My employer and the insurance company have denied my claim for workers' compensation benefits. Do I need legal representation to get my benefits? What should I do?

Can I get a settlement from my claim?

If I settle my claim for medical benefits with the insurance company and my condition gets worse later, who pays for my future medical care, surgeries, etc?


Q: How long after an accident do I have to report it to my employer?

A: You should report it as soon as possible but no later than thirty (30) days or your claim may be denied.

    Reference: Section 440.185 , Florida Statutes


Q: When should my employer report the injury to their insurance company?

A: Your employer should report the injury as soon as possible, but no later than seven (7) days after their knowledge. The insurance company must send you an informational brochure within three (3) days after receiving notice from your employer. The brochure will explain your rights and responsibilities, as well as provide additional information about the workers' compensation law. A copy of the brochure can be viewed on this website under "Publications".

    Reference: Section 440.185 , Florida Statutes


Q: My employer will not report my injury to the insurance company. What can I do?

A: You have the right to report the injury to their insurance company. However, if you need assistance, contact the Employee Assistance Office (EAO) at (800) 342-1741 or e-mail wceao@fldfs.com. Then, you may want to consider consulting with an attorney. At Lopez & Lopez, P.A. we are happy to discuss your case with you and advise you on your rights.

    Reference: Section 440.185 , Florida Statutes


Q: What kind of medical treatment can I get?

A: The medical provider, authorized by your employer or the insurance company, will provide the necessary medical care, treatment and prescriptions related to your injury.

    Reference: Section 440.13(2) , Florida Statutes


Q: Do I have to pay any of my medical bills?

A: No, all authorized medical bills should be submitted by the medical provider to your employer's insurance company for payment.

    Reference: Section 440.13(14) , Florida Statutes


Q: Will I be paid if I lose time from work?

A: Under Florida law, you are not paid for the first seven days of disability. However, if you lose time because your disability extends to over 21 days, you may be paid for the first seven days by the insurance company.

    Reference: Section 440.12 , Florida Statutes


Q: How much will I be paid?

A: In most cases, your benefit check, which is paid bi-weekly, will be 66 2/3 percent of your average weekly wage. If you were injured before October 1, 2003, this amount is calculated by using wages earned during the 91-day period immediately preceding the date of your injury, not to exceed the state limit. If you worked less than 90% of the 91 day period, the wages of a similar employee in the same employment who has worked the whole of the 91-day period or your full-time weekly wage may be used. If you were injured on or after October 1, 2003 , your average weekly wage is calculated using wages earned 13 weeks prior to your injury, not counting the week in which you were injured.

In addition, if you worked less than 75% of the 13 week period, a similar employee in the same employment who has worked 75% of the 13-week period or your full time weekly wage shall be used.

    Reference: Section 440.02(28) & 440.14 , Florida Statutes  


Q: When will I get my first check?

A: You should receive the first check within 21 days after reporting your injury to your employer.

    Reference: Section 440.20 , Florida Statutes  


Q: If I'm only temporarily disabled, how long can I get these checks?

A: You can receive Temporary Total, Temporary Partial Disability payments or a combination of the two benefits during the continuance of your disability for no more than a maximum of 104 weeks.

    Reference: Section 440.15(2) , Florida Statutes


Q: Can I receive unemployment compensation and workers' compensation benefits at the same time?

A: No, not if you are receiving temporary total or permanent total disability benefits as you must be medically able and available for work to qualify for unemployment. For additional information on Unemployment Compensation, you may want to utilize the Unemployment Compensation website at: www.floridajobs.org.

    Reference: Section 440.15(10), Florida Statutes


Q: What can I do if I am not receiving my benefit check?

A: Call the insurance company and ask for the adjuster or claims representative. If you still have questions and don't understand why the checks have stopped, you may want to consider consulting with an attorney. At Lopez & Lopez, P.A. we are happy to discuss your case with you and advise you on your rights.


Q: If I am unable to return to work until my doctor releases me, does my employer have to hold my job for me?

A: No, there is no provision in the law that requires your employer to hold the job open for you.


Q: Can my employer fire me if I am unable to work because of an injury and am receiving workers' compensation benefits?

A: No, it is against the law to fire you because you have filed or attempted to file a workers' compensation claim.

    Reference: Section 440.205 , Florida Statutes


Q: My employer and the insurance company have denied my claim for workers' compensation benefits. Do I need legal representation to get my benefits? What should I do?

A: It is your decision whether or not to hire an attorney, but it may be wise to consult with one to find out your rights. Should you decide to consult with an attorney, please do not hesitate to call Lopez & Lopez, P.A. and schedule an appointment so that we may be able to discuss your case with you.


Q: Can I get a settlement from my claim?

A: Settlements may be made under certain circumstances and are voluntary; not automatic or mandatory.

    Reference: Section 440.20 (11)(a)(b)(c), Florida Statutes


Q: If I settle my claim for medical benefits with the insurance company and my condition gets worse later, who pays for my future medical care, surgeries, etc?

A: You are responsible for your future medical needs after your claim for medical benefits is settled.