Florida Workers’ Compensation Overview
When a worker is injured on the job and is unable to earn at least 80% of what they were making prior to the injury, then they are eligible to receive lost wages from the workers’ compensation insurance carrier. The amount of these benefits vary along with the classification of these benefits. A lot of times, lost wages or the amount of lost wages are in dispute with the employer/carrier.
The amount of your loss of wages is based upon your average weekly wage. This is based upon the average of your wages earned during the 13 weeks prior to your injury, if you have worked substantially the whole of these 13 weeks. Health insurance benefits also need to be factored into this calculation if you were receiving these paid for by the employer at the time of your accident and if they have since been discontinued. Many times, the workers’ compensation insurance company does not calculate this figure correctly and underpays injured workers. A consultation with Joseph M. Rooth would be worthwhile to determine if you are being paid the correct amount. If you are being underpaid, you would be entitled to the difference plus penalties and interest.
If you have been injured at work and are on a “no-work” status from your authorized treating physician, then you are eligible for lost wages called temporary total disability benefits. These benefits known as “TTD” are paid at the rate of 66 2/3% of your average weekly wage. The amount of this benefit is referred to as your compensation rate. Each year, the maximum compensation rate is capped. For example, for the year 2009, the maximum compensation rate has been set at $765 per week.
If you are still recovering from your injury, and undergoing remedial medical treatment, and are unable to earn at least 80% of your average weekly wage, you may qualify to receive these lost wages. Generally, you need work restrictions, and be unable to earn 80% of your average weekly wage due to your work injury.
Once you have been released by your physician at maximum medical improvement, or you have been paid the maximum number of weeks of temporary indemnity benefits, then you may qualify for permanent total disability benefits. In addition to several specifically listed qualifying cases, an injured worker can qualify for this benefit if they are physically unable of engaging in at least sedentary employment within a 50 mile radius of their residence.
Many times, due to a work-place injury, an injured worker can no longer return to his past employment. All injured workers that have permanent restrictions as a result of their injuries and are unable to earn at least 80% of their average weekly wage, should contact the State of Florida regarding possible retraining benefits.
The State of Florida Department of Education’s Division of Vocational Rehabilitation has a Bureau of Rehabilitation and Reemployment Services, which is a program for injured workers. If you are injured on the job, you may be eligible for bureau services.
Some injured workers that are unable to return to their past employment due to their work injuries, may qualify for a training and education program. If this is recommended for the injured worker, then the bureau will pay for the program – including tuition, etc. If accepted into this program, the workers’ compensation insurance carrier will then have to pay the injured worker lost wages called rehabilitation temporary total disability. These benefits are paid at the compensation rate of the injured worker, and are paid while the injured worker receives this training and education up to a maximum of 52 weeks. However, there is still an overall 104 week limitation on the number of temporary wage benefits the carriers have to pay, so it is best to consult with Joseph M. Rooth, if you have any questions regarding this.
You can contact the Department of Education, Division of Vocational Rehabilitation, Bureau of Rehabilitation and Reemployment Services at (850) 245-3470 or visit their website at www.rehabworks.org/
Settlements in workers’ compensation cases are voluntary. No one can force a settlement either of an injured worker or of an insurance carrier. If an injured worker is represented by an attorney for their case, a settlement can be reached at any time. However, there are a lot of factors that need to be considered when discussing and negotiating a lump-sum settlement of your case. Before discussing settlement of your case, you should consult with a board certified workers’ compensation lawyer, such as Joseph M. Rooth to understand the full ramifications of a settlement.
Settlements in workers’ compensation cases generally include all future medical benefits. This means that in a settlement, you will no longer be eligible or entitled to any future medical benefits from the workers’ compensation insurance carrier. This is not something to be taken lightly. You should understand that the insurance carrier’s representative (i.e. adjuster, case manager, etc.) does not represent you or your interests. I strongly advise you to be represented by a workers’ compensation board certified attorney when discussing a settlement of your case. Contact Joseph M. Rooth prior to discussing any settlement with the insurance carrier.
In considering any settlement, you want to make sure that this is in your best interests. Joseph M. Rooth, if he is your attorney, can advise you regarding settlement and help you to negotiate this, the decision ultimately is in the hands of the injured worker. As the injured worker, you want to make sure a settlement is in your best interests.
First of all you should understand that although there although there are some limitations, the employer/carrier is required to provide the injured worker with all medically necessary medical treatment required for their injury. This includes diagnostic tests, surgeries, therapy, medications, etc.
Medical benefits are commonly in dispute as insurance carrier’s will at times deny or delay needed medical benefits. This can cause additional harm to an injured worker as they are trying to recover from their injury. You should consult with Joseph M. Rooth, a Florida bar board certified workers’ compensation attorney if you are being denied needed medical benefits (or these are being delayed by the insurance carrier). Claims can be filed seeking these benefits. In many cases, when the insurance carrier wrongfully denies these medical benefits, after your attorney has filed a claim, then the insurance carrier will be responsible for payment of your attorney fees. It is things like this, that are a benefit of having Joseph M. Rooth, on your side as the claim for payment of your attorney fees and costs, can sometimes spur the insurance carrier into faster action on providing you these needed medical benefits.
Injured workers should understand that although it may seem that they do not have any rights or control of their medical care, they do. Injured workers do have rights! Injured workers have the right to a one time change of treating physician. However, this is a right that should be exercised very cautiously as it can only be done once freely. You should consult with Joseph M. Rooth before even contemplating exercising this right. If this request is done in writing to the insurance carrier (not verbally), and the insurance carrier fails to respond within a certain amount of time, we take the position that we get to select the new treating physician. This can make a big difference in these cases and in the quality of the medical care that you receive.
Do not just let the insurance carrier send you to different doctors whenever they want. Sometimes, they do not like the opinions or the recommendations of your treating doctor and want to send you to someone else. They are not always entitled to do this. Be very careful of “second opinions” that the insurance carrier may try to set up for you. Be careful of any statements that the insurance adjuster or “nurse case manager” make concerning your medical care or your physicians. Realize that these people do not represent you or your best interests. It is important that you consult with Joseph M. Rooth if you have any questions at all regarding your medical benefits through workers’ compensation.