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Workers' Compensation

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Workers’ compensation refers to a system of laws outlining specific benefits to which injured employees are entitled, and the procedures for obtaining such benefits.

Workers’ Compensation FAQ’s: 21-40

You should immediately seek the assistance of a workers’ compensation attorney.

If you can never work again as a result of your work-related injury, you are entitled to permanent total disability benefits. For accidents occurring on or before September 30, 2003, an injured worker can collect benefits for life. However, for accidents that occurred on or after October 1, 2003, an injured worker can only collect disability benefits until age 75, unless the injured worker is not eligible for Social Security disability or retirement benefits due to the compensable injury preventing he/she from working sufficient quarters to be eligible for federal benefits. In addition to permanent total disability benefits, supplemental benefits are also available to permanently and totally disabled injured workers. The subject of permanent total disability benefits and supplemental disability benefits can be complicated. Therefore, it is highly recommended that you seek the assistance of a workers’ compensation attorney.

No, an injured worker is not entitled to any temporary total or permanent total disability benefits for any week they have received unemployment compensation benefits. If an employee is entitled to temporary partial benefits and reemployment assistance or unemployment compensation benefits, the reemployment assistance or unemployment compensation benefits shall be primary and the temporary partial benefits shall be supplemental only, the sum of the two benefits cannot exceed the amount of temporary partial benefits which would otherwise be payable.

Typically, workers’ compensation checks are paid bi-weekly.

No, an injured worker is not entitled to any temporary total or permanent total disability benefits for any week they have received unemployment compensation benefits. If an employee is entitled to temporary partial benefits and reemployment assistance or unemployment compensation benefits, the reemployment assistance or unemployment compensation benefits shall be primary and the temporary partial benefits shall be supplemental only, the sum of the two benefits cannot exceed the amount of temporary partial benefits which would otherwise be payable.

Yes. The Social Security Disability and Florida Workers’ Compensation systems both provide benefits for disability and each of them has their own definitions and procedures for obtaining benefits. They are not mutually exclusive, and an individual can make a claim under both programs at the same time. However, if an individual does become entitled to benefits under both programs at the same time, the combined benefits may not exceed a certain amount and the workers’ compensation carrier, or the Social Security Administration, may “offset” or reduce the benefits. Although the offset calculation is very technical, the general rule is that a person cannot receive combined disability benefits totaling more than 80% of either their Average Weekly Wage (a worker’s comp. measure of earnings) or Average Current Earnings (a Social Security measure of earnings.

Some accidents that occur outside of the state of Florida may be covered under Florida Law. The test for whether an out of state accident will be covered under Florida Law is whether the contract of employment was made in Florida or whether the employment was principally localized in Florida.

In Florida, compensation is not payable if the injury was occasioned primarily by the intoxication or the employee, the influence or any drugs, barbituates, or other stimulants not prescribed by a physician. A post-accident drug test creates a presumption that the injury was in fact caused by alcohol or drugs. This means the claimant will have the burden to demonstrate that injury was not caused by alcohol or drug use. If the Employer has taken additional steps to implement a “drug free workplace”, the presumption may only be rebutted by evidence that there is no reasonable hypothesis that the intoxication or drug influence contributed to the injury. In the absence of a “drug free workplace” program, the presumption may be rebutted by clear and convincing evidence that the intoxication or influence of the drug did not contribute to the injury. Generally, a positive drug test may make the case difficult, but an attorney should be consulted to assess the facts and law of your particular situation.or a maximum of 104 weeks. Thereafter, you may be entitled to permanent total disability benefits, which if eligible, you can receive until you are 75 years of age.

You may refuse the drug test. However, under the law if the injured worker refuses to submit to a drug test, it shall be presumed in the absence of clear and convincing evidence to the contrary that the injury was occasioned primarily by the influence of drugs.

There are various benefits payable under Florida workers’ compensation law for the death of an employee. These benefits may be payable to the employee’s spouse and certain family members who were dependent upon the deceased at the time of the accident. Compensation to dependents may not exceed $150,000 and is payable in biweekly amounts that are a percentage of the Employees’ Average Weekly Wage. There are also benefits for funeral expenses not to exceed $7,500 and post-secondary education student fees to a surviving spouse.

In Florida, all employers in the construction industry are required to have workers’ compensation insurance if they have one employee or more. For employers that are not in the construction injury, they are required to have workers’ compensation insurance coverage if they have four or more employees.

No. Federal employees are excluded under Florida worker’s compensation law, but covered under a Federal worker’s compensation law called the Federal Employees Compensation Act.

Any injury covered under the federal Longshore and Harbor Workers’ Compensation Act or Jones Act is excluded from Florida Workers’ Compensation law. Most maritime employment conducted on the navigable waters will meet the “status” and “situs” requirements of the Longshore Act, but this law has many exceptions and specific limitations. The Jones Act covers seamen working in the service of a ship. Waterfront injuries that are not covered by the Jones Act or Longshore and Harbor Workers’ Compensation Act will most-likely be covered under Florida Law.

No. Florida Workers’ Compensation Law provides medical benefits and various compensation benefits, but it does not pay benefits for the pain and suffering of the injured worker.

Generally, the answer is “no ”, but this issue is currently being litigated in the courts. As the law stands now, your exclusive remedy is Florida Workers ’ Compensation Law and you may not sue your employer in tort. However, there is very limited exception if your employer deliberately intended to injure you, or placed you in a situation where there was a virtual certainty that you would be injured or killed, and the employer deliberately concealed or misrepresented the danger such that you could not make an informed decision about whether to perform the work.

If your automobile accident arose out of the course and scope of your employment (i.e. you were working), you have both a workers’ compensation case and a personal injury case. These are not mutually exclusive and you may pursue a claim against the at-fault party and receive workers’ compensation benefits as well.

You are entitled to such medically necessary remedial treatment, care and attendance for such period as the nature of the injury or the process of recovery may require. Some examples of medically necessary care and attendance are hospital treatment, emergency treatment, ambulance, prescription medications, doctor’s visits, physical therapy, durable medical equipment, nursing care, injections, surgery, pain management, home modifications, attendant care, chiropractic treatment for up to 24 visits, transportation to or from your doctor’s visits, etc. If the treatment is reasonable and medically necessary, it should be provided.

Workers’ compensation disputes are head before a Judge of Compensation Claims, not a jury. A Judge of Compensation Claims is an administrative judge that hears only workers’ compensation cases within the jurisdiction of the Office of Judges of Compensation Claims, Division of Administrative Hearings.

Generally, the insurance company gets to select the physician that they offer you for treatment. If you fail to go to their doctor, they can suspend compensation. However, that does not mean that they can send you to multiple doctors or remove you from a treating doctor that you are satisfied with. Additionally, you have the right to request a one-time change of physician if you are not satisfied with the doctor that has been authorized. If the insurance company does not provide you with a doctor within 5 calendar days of your written request, then you may select a doctor of your choice.

Generally, the insurance company gets to select the doctor and is not responsible for paying for any doctor that they did not authorize. For the most part, you cannot choose your doctor. However, if the insurance company does not provide you with a doctor within 5 calendar days of your written request for a one-time change of physician, then you may select a doctor of your choice. Additionally, if the insurance company fails to provide you with medical care in a within a reasonable amount of time from your request, you may have an ability to seek your own physician during the period that medical care is not being authorized.

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