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Originally Posted On: 9 Steps to Filing a Workers Comp Claim in Florida (2019-2020) (firstcoastaccidentlawyers.com)

 

The US Bureau of Labor Statistics reported recently that more than 2.5 million nonfatal workplace injuries and illnesses occurred in the US. This means for every 100 full-time workers, three of them were injured.

If you’ve been injured on the job, filing a workers comp claim is your next step. Check this helpful guide on how to apply for workers compensation in Florida. Follow these steps carefully to protect yourself throughout the process.

Worker’s Compensation Defined

Workers compensation is a group of state regulations that guarantees a worker hurt on the job will receive repayment to cover their medical expenses. Workers Compensation helps an employee avoid suing their employer to recover their costs.

Worker’s compensation covers workers injured on the job site. Under the law in most states, every business must have some form of workers’ compensation insurance to cover injured employees.

All 50 US states have their own individual workers’ compensation regulations. Some states have special laws for federal government employees. Other states have special requirements for employees in specific industries like railway workers.

In recent years, federal and state workers’ compensation laws covered over 135 million workers. The total wages paid to these covered employees was more than seven trillion dollars.

Lawmakers in Florida first passed workers compensation regulations into law in 1935.

Filing a Workers Comp Claim

Since every state has its own group of laws, it’s easy to get confused about how to apply for workers compensation. Each workers comp law, however, contains a basic form of important routine steps:

1. Report Your Injury to Your Employer

Make sure to alert your employer immediately after your injury, in writing or orally. Check to see if your employer has special procedures and deadlines for reporting your injuries.

You must report your injury no later than 30 days after you are aware of your job-related injury.

2. Seek Medical Treatment as Soon as Possible

Schedule an appointment with your physician as soon as you can after your injury. Ask your doctor to include any details they think are necessary so you can prove your workplace accident is directly responsible for your injury.

3. Receive Materials from Employer’s Workers Comp Insurance Carrier

Once you’ve notified your employer of your injury, they will send you a copy of their First Report of Illness or Injury which they also file with their insurance carrier.

If are eligible to receive benefits, you will start receiving repayment within 21 days after your reported injury. These repayment checks will be sent to you every two weeks.

4. Consider Resolving any Disputes Before Filing a Workers Comp Claim

If you do not receive a check or any correspondence from your employer’s insurance carrier, you should notify your employer. If you have a dispute with your employer or their insurance provider over their offer for benefits, try and resolve the matter with them first.

Florida has a “good faith law” that requires workers compensation claimants to try to resolve any disputes with their employer. This step is necessary before heading further into the process.

The Florida Employee Assistance and Ombudsman Office (EAO) can offer you guidance on how to resolve workers compensation disputes with your employer. They can also advise you on the “Managed Care Grievance Procedure.” This is the process to dispute the benefits you have been granted. You must follow this process before formally filing your workers compensation petition.

5. Contact a Workers Comp Attorney

If your direct efforts to resolve your dispute fail, the next step is to formally file a workers comp petition. You will need to hire a workers comp attorney to help you navigate this legal process. These professionals are also sometimes called an accident lawyer or personal injury attorney.

A workers comp attorney represents injured victims who need help proving their injuries occurred on the job. Workers comp lawyers help victims negotiate with their employer’s insurance providers. They can also help guide their clients on how to file a workers comp claim.

6. File Your Formal Workers Compensation Claim

You have thirty (30) days from your accident or thirty (30) days from your doctor’s diagnosis that you are suffering from a work-related injury to notify your employer you plan to seek workers compensation.

Some employers may give you all of the official claim forms you need to submit your claim. Other employers may file your claim with their insurer for you. Once you have the necessary forms, be sure to list the following details on your workers comp claim forms:

• Types of injury and the damaged areas of your body
• Day, time, and address where your injury took place
• Any other witnesses involved in the injury
• How the accident happened and
• All medical treatments received to date.

Once your claim is reviewed, an insurance representative will notify you to tell you if your claim has been approved and for what amount.

7. Worker’s’ Comp Claim Review

Your employer has seven (7) days from the time you notify them of your injury to contact their insurance provider. If your employer doesn’t report your injury, you can notify their insurance company yourself. The insurance carrier will then decide if you are eligible to receive benefits.

The carrier’s review of your claim may include:

• Assessing your medical records
• Researching your work experience, education, and wages
• Requesting a medical examination with their appointed physician to evaluate your condition, and
• Requesting you to perform a functional capacity evaluation that tests your abilities to perform your expected job duties).

Florida law requires insurance carriers to quickly approve or deny a workers compensation benefit request. If your request is approved, you begin to receive your disability payments or other benefits.

If your employer’s insurance provider denies your claim, you have two (2) years to file a petition for benefits with the Employment Assistance Office. You will also need to file your claim with the Office of the Judges of Compensation Claims (OJCC) Clerk’s Office.

If you do file a claim with OJCC, be sure to mail a copy of your claim through certified mail to your employer and their workers compensation carrier.

8. Prepare for Mediation and/or Court Hearing

Within 130 days after your petition filing date, you may be asked to participate in mediation. If you don’t reach a settlement during the mediation process, your claim will be scheduled for a pre-trial hearing. A Judge of Compensation Claim will review your claim.

The judge issues their decision no later than thirty days after your final hearing. If you aren’t satisfied with the judge’s ruling, you appeal that decision to the First District Court of Appeals.

9. Re-Opening Workers Compensation Claims

Workers can also reopen a closed workers compensation claim after it has been closed. Victims may want to reopen their claim if they start to suffer delayed onset injuries.

Delayed-onset injuries won’t show visible symptoms right away. They might take quite a while to manifest into real pain. Headaches and whiplash are two common examples of a delayed-onset injury.

Re-opening a claim will depend on the type of settlement you and your employer negotiated before the onset injuries began. If you agreed to a “compromise and release” agreement, your case can’t be reopened. If you agreed to a “stipulation and award,” your case can be reopened if certain circumstances exist such as errors or miscalculations within the original agreement.

Next Steps

Thinking of filing a workers comp claim? If so, get your own accident records in order. Then, make an appointment with your own physician immediately. Keep them up to date on the progress of your claim and ask them to provide comments on any treatment plans.

Keep a detailed record of your doctor’s visits and recovery. These records may be helpful in case you start to notice any delayed onset injuries in the future.

Give us a call for more helpful information on the top reasons a workers comp attorney is your best first move. You can speak with us for free. Call 904 LAW-1212 anytime, day or night.