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What Does Florida Workers’ Compensation Insurance Cover?

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What Does Florida Workers’ Compensation Insurance Cover?

Florida requires most employers to provide workers’ compensation for their employers. Over 62,800 workers’ compensation cases were filed in Florida during 2022. The cases resulted in payouts totaling more than $3.7 million. 

If you are injured on the job, it is essential to understand what workers’ compensation insurance covers. It is also wise to seek legal advice about a workers’ comp claim to ensure that you receive all benefits you are entitled to receive by law.

What Is Workers’ Compensation Insurance in Florida?

What Is Workers’ Compensation Insurance in Florida?

Filing a workers’ compensation claim is the process by which an injured employee can receive compensation for injuries sustained while performing their work duties. Workers’ comp also covers occupational illnesses a worker develops because of their employment. 

Workers’ comp is different from a personal injury claim because it does not require the worker to prove fault to receive compensation. Furthermore, a worker can receive full workers’ comp benefits even if they contribute to the cause of their work-related injury.

However, workers’ compensation does not compensate a worker for all damages. Unlike personal injury claims, workers’ comp does not compensate a worker for their non-economic damages, such as pain and suffering. Furthermore, workers’ comp benefits may not compensate the worker for all losses sustained because of a workplace accident.

Most employers purchase workers’ compensation insurance to comply with their requirement to provide workers’ compensation for employees. Some employers are required to purchase Florida workers’ compensation insurance by law, including:

  • Employers with one or more employees in the construction industry
  • Employers with four or more employees outside of the construction industry
  • Agricultural employers with six or more regular employees or 12 or more seasonal employees

When a worker files a workers’ compensation claim, the insurance company handles the claim and pays benefits to the worker. If an employee is injured at work, Florida workers’ compensation laws require the worker to report their injuries or illness within 30 days. Failing to report a workplace injury or illness within 30 days could prevent the employee from receiving benefits.

What Does Florida Workers’ Compensation Insurance Cover?

Workers’ compensation benefits include medical, lost wages, and death benefits. The specific benefits you receive depend on the injuries or illnesses you sustain at work. 

Florida Workers’ Compensation Insurance and Medical Benefits 

If you are injured at work, your employer is responsible for paying for your medical care. The workers’ comp insurance company should pay for all necessary and reasonable medical bills, including but not limited to:

  • Doctor’s visits
  • Emergency room charges
  • Hospitalizations
  • Surgeries
  • Medications 
  • Physical therapy
  • Medical devices and equipment
  • Attendant care
  • Medical tests
  • Prostheses

You can also receive reimbursement for your mileage to and from medical appointments and the pharmacy.

However, the medical provider must be approved by the workers’ comp insurance provider. If not, you could be responsible for paying your medical bills. 

If your workplace injury requires emergency treatment, workers can go to the nearest hospital or emergency medical facility for treatment. Then, the workers’ comp carrier should provide a list of authorized medical providers.

Florida Workers’ Compensation Insurance and Lost Wages 

Workers’ comp insurance compensates workers for lost wages when their injuries prevent them from working during their recovery period. There are two types of temporary disability payments:

Cannot Work – Temporary Total Disability (TTD)

If a doctor states the employee cannot work because of their injuries, the insurance provider should pay TTD benefits. Loss of income benefits for a workers’ comp claim equal 66 2/3% of the employee’s average weekly wage. Workers may receive 80% of their average weekly wages for six months after the accident if they sustain specific severe injuries at work. 

Therefore, you will not receive full reimbursement for all wages you lose because of a work injury. You also do not receive disability payments for the first seven days you miss work unless you are out of work for at least 21 days because of your work injury. TTD benefits can last up to 104 weeks.

Restricted to Light Duty – Temporary Partial Disability (TPD)

An injured worker might be able to return to work after a workplace accident. However, their doctor restricts their duties. This situation is often referred to as light duty.

You can receive TPD benefits if you cannot earn at least 80% of your average weekly wages before the accident. Temporary disability benefits can be paid for up to 104 weeks. 

Total and partial disability benefits are subject to state maximum rates. The rates are adjusted yearly for inflation.

Florida Workers’ Compensation Insurance and Permanent Disability Benefits 

If a worker is totally disabled because of a workplace injury, they can receive permanent total disability (PTD) benefits until they are 75 years old. The standard workers’ comp benefits for a permanent disability is 66 2/3% of the worker’s average weekly wages, subject to the state maximum cap. The worker receives a cost of living increase each year until they reach 62 years of age.

Workers who are not totally disabled can receive impairment income benefits (IIB) based on their impairment ratings. The impairment rating is determined after the worker reaches maximum medical improvement.

Workers’ compensation insurance companies aggressively defend claims for permanent disability benefits. It is in a worker’s best interest to consult a Tampa workers’ compensation lawyer if their workplace injury results in a lifelong impairment. 

Florida Workers’ Compensation Insurance and Death Benefits 

If a workplace accident results in a worker fatality, workers’ compensation pays death benefits to the worker’s family. Workers’ compensation death benefits include:

  • Funeral and burial expenses up to $7,500
  • Compensation for dependents
  • Education benefits for the surviving spouse

In addition to workers’ comp death benefits, the surviving family members might have a wrongful death claim against third parties who caused their loved one’s death.

When Does Workers’ Compensation Insurance Not Apply?

There are some situations in which a worker might not receive workers’ comp for an injury on the job. You might not receive workers’ comp if:

  • You intentionally caused your injury
  • You were drunk or using drugs at the time of your injury
  • Your injuries were self-inflicted to obtain workers’ compensation benefits
  • You refused to use available safety equipment or follow safety rules

Contact a lawyer immediately if your employer or the workers’ compensation insurance carrier denies your claim. You might win on appeal, but you need to act quickly. 

Learn More About Your Rights During a Free Consultation With Our Tampa Workers’ Compensation Lawyers

A work injury can turn your life upside down. You deserve to receive workers’ comp benefits to help you recover and get back to work. If a work injury caused permanent impairments, you deserve a fair settlement from the workers’ compensation insurance company.

Contact our lawyers at Winters & Yonker Personal Injury Lawyers at (813) 223-6200 for a free consultation to discuss your case. Our Tampa workers’ comp lawyers can help you receive the full benefits you’re entitled to under the law.

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