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Workers' Compensation Lawyer South Florida

How to File a Workers’ Compensation Claim in Florida

When you are injured at work, it can be the beginning of a major setback for you, as well as your family. Not only can the injury affect your ability to work and earn a living, but it also affects your physical and, often, your psychological health.

Workers’ Compensation in Florida offers benefits which may include compensation for wages lost, medical treatment, and other financial assistance to help you following your injury and during your recovery.

To obtain the benefits to which you are entitled following a work-related injury, you must file a workers’ compensation claim, following the state of Florida’s requirements. While at first, filing a claim may seem straightforward, but that isn’t always the case. In fact, injured workers are often taken by surprise, when they find their claim held up or even denied. Here are some tips to help you file a workers’ compensation claim in Florida and why you should hire a worker’s compensation lawyer in South Florida.

Understanding the Florida Workers’ Compensation System

Workers’ compensation in each state is unique, but in Florida, most employers are required to have workers’ compensation coverage. Coverage is provided through the purchase of private workers’ compensation insurance or state certification to self-insure. All workers’ compensation claims are managed by The Florida Division of Workers’ Compensation.

Florida’s workers’ compensation system is known as no-fault, which means if injured, you do not have to show your employer acted negligently in order to obtain benefits, but only that your injury occurred at work or was caused by job activities. If eligible, benefits include:

  • Medical care
  • Training/education for a new type job
  • Impairment benefits for permanent limitations

It is also important to note, that you cannot be fired because you filed a workers’ compensation claim. If you believe your employer retaliated against you in this way, it is in your best interest to call on a qualified workers’ compensation attorney to protect your rights and assist you going forward.

Reporting Your Injury

When you are injured at work or during a work-related activity, the first step in your workers’ compensation claim is notification of your employer. Injuries must be reported within 30 days of the incident, while illnesses/conditions should be reported within 30 days of realizing the illness or condition is work related. Missing these deadlines can mean forfeiture of some or all of the workers’ compensation benefits to which you are eligible.

You should always report a work incident, even if you feel you weren’t injured as a result. Some types of injuries aren’t obvious right away, and may manifest later on, which can make it difficult to file a claim if there was no report of the original accident.

When reporting your injury to your employer, you must provide details of how the injury/illness/condition occurred, when they occurred, and your symptoms. Once reported, your employer will send you to the occupational physician of its choice, unless you need emergency care. The doctor chosen must be well-qualified (education, training, etc.) to treat your injury specifically. Be sure to give the doctor all the details regarding your injury and symptoms.

After Your Initial Report, What Comes Next?

After you notify your employer and begin treatment, your employer is required to report your claim to the insurer within seven days. Should your employer refuse, you should contact a workers’ compensation attorney to handle your case while you rest.

Once reported, the insurer will determine your eligibility through an investigation of your medical records and potentially sending you for additional examinations/testing; analysis of your experience, education, wages; and ordering an evaluation of your work-related abilities.

The insurer is required to act promptly in approving or denying your claim to workers’ compensation benefits. If approved, you will begin receipt of payments and other benefits to which you are entitled. If denied, which is often the case, you will need to begin the process of appealing your workers’ compensation claim.

Appealing Your Denied Claim

If your claim is denied, you will need to file a petition for benefits with the Florida Division of Workers’ Compensation. This filing must be completed withing one year of your last medical payment or wage loss, or within two years of your injury.

If you need to file an appeal, it may be in your best interest to call on the team at Benn, Haro, and Isaacs, PLLC to help with your workers’ compensation appeal. Keep in mind, the insurance company will have an attorney, and if you are without, you could be at a disadvantage when your appeal is considered. Often your health, as well as your financial security is at stake, and a well-qualified workers’ compensation attorney can help you get the benefits you deserve.

With offices throughout South Florida, our expert team at Benn, Haro, and Isaacs, PLLC can provide the personalized representation you need when you appeal your workers’ compensation claim. Call now for your free consultation.

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Workers' Compensation Lawyer South Florida

Top 10 Reasons Why You Need a Workers’ Compensation Lawyer in South Florida

When you find yourself facing a workers’ compensation case because of a work related injury, you may wonder if you need to hire an attorney to handle your case. In many cases, the answer is yes, a workers’ compensation lawyer can help you get all the benefits you deserve. While every case is different, the severity of your injury, the complexity of your case, and the actions of your employer and its insurance company can also be factors in whether you need a lawyer. Let’s explore the top 10 reasons you need a workers’ compensation lawyer in South Florida.

1. Your Employer Doesn’t Report Your Injury.

Workers’ compensation benefits are provided by your employer, but they are generally paid by the employer’s insurance company. This means your employer must report your injury to its workers’ compensation insurance carrier. Reporting can be done via phone or email, with paperwork filed as required, and signed by both you and your employer. An employer refusing to report your injury can indicate potential “red flags” – most importantly that you need a workers’ compensation attorney.

2. Your Employer is Refusing to Pay.

When you are injured while performing any activity on behalf of your employer, you are entitled to workers’ compensation benefits. This includes medical care, temporary disability, permanent disability, job retraining as required, and mileage reimbursement for medical treatment. It doesn’t matter who is at fault or the reason for the accident. If you employer is refusing these benefits, you need to speak with a well-qualified workers’ compensation lawyer.

 3. Your Employer Denies Your Claim.

Employers and their insurers often reject workers’ compensation claims, believing workers won’t appeal the decision. If your claim has been denied, a workers’ compensation lawyer can help you appeal and gain a fair settlement.

 4. Your Employer’s Settlement Isn’t Enough.

If your settlement fails to cover your lost wages and/or medical bills, you need to have an attorney fighting for your rights and fair compensation.

 5. You Did Not Receive Disability Benefits.

Similar to the reason above, there are times when your employer agrees to provide compensation for your medical care but refuses your disability benefits which cover your lost wages. If you are unable to work because of your injury, you are entitled to lost wages during your time out of work. If your are unable to work the same number of hours because of you injury, you are also entitled to lost wages. If you aren’t receiving the disability benefits to which you are entitled, a workers’ compensation lawyer can help.

 6. Your Medical Issues Prevent You from Working.

If your disability is permanent – total or partial – you are probably entitled to a lump sum payment or weekly payments to cover your lost wages. Because these settlements are costly, many companies seek to avoid paying them. If your injury or illness resulted in permanent disability, call on a workers’ compensation attorney to see you get the benefits you deserve.

7. You Aren’t Sure You Are Getting the Benefits You Deserve.

Due to the complexity of the workers’ compensation system, many workers are unaware of the benefits due following a work injury or illness. If all of your medical treatments (appointments to surgery, therapy to follow-ups), temporary disability, and permanent disability aren’t being paid, a workers’ compensation attorney can guide you through the system and help you get the benefits you need.

8. You Want to Apply for Social Security Disability Benefits at some Point in the Future.

If your workers’ compensation settlement isn’t handled properly it could limit or lower potential Social Security disability payments in the future. Your workers’ compensation attorney can structure your settlement to help you avoid this scenario.

9. Your Employer Retaliates.

If your employer retaliated – fired you, cut your hours, demoted you, decreased your salary or rate, or discriminated against you – as a result of your workers’ compensation claim, you need an experienced workers’ compensation attorney to protect your rights.

 10. Your Injury is a Result of Serious Misconduct on the Part of a Third Party or Your Employer.

The workers’ compensation system was created to eliminate civil lawsuits related to workplace injuries. Even so, there are circumstances which will allow you to sue, such as when a third party contributed to your injuries, your employer’s negligence causes your injury, or your employer does not carry workers’ compensation insurance. A well-qualified lawyer can explain the specifics in regard to your injury. 

When You Need Assistance

When you are injured and need assistance with your workers’ compensation claim, call on the team at Benn, Haro, and Isaacs, PLLC. With offices throughout South Florida, our expert team can deliver the personalized representation you need when you have been injured on the job. Call now for your free consultation.

 

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Court Reverses Decision: Employer Now Required to Pay Hospital Expenses for Injured Employee

Being injured at work can be frustrating, scary, and confusing. The law is clear, however – if you’re injured at work, you should be compensated for lost work time and medical care. However, the employer and the worker’s compensation carrier must follow the regulations set out by law to properly deny coverage for your claim.

Click below to review the court’s decision reversing the trial outcome. At the trial level, Benn Haro & Isaacs represented the injured employee. The appellate court reversed a decision made by the Judge of Compensation Claims, which denied the injured employee coverage for a hospital stay following an injury.

The appellate court decided that the employer should have formally denied the claim for hospitalization earlier if they were going to deny the claim under the Pay-and-Investigate statute. In other words, the employer was required to pay all benefits due “as if the claim had been accepted as compensable” until they denied the claim outright. Thus, the fact that the employer waited until after the hospital stay to deny the claim means the employer should pay the hospital claim (but not any subsequent costs incurred).

In addition, the appellate court sent the proceedings back to the lower court to investigate other defenses that the employer had that were not addressed by the lower court originally. The appellate court found that the employer was entitled to a 10-day approval period when the injured employee was referred to the hospital for specialist care and surgery. In other words, the employer and insurance carrier have 10 days to deny coverage of referral to a hospital (which the carrier did), and therefore not be liable for payment of the hospital bill, UNLESS the care provided was emergency care. The question remaining for the lower court to determine is – was the care provided constituted “emergency care.”

This appellate decision was a case that Benn, Haro, & Isaacs argued at the trial level. If you are interested in a complimentary consultation to discuss your case we would be pleased to meet with you. Recall, there are no fees or costs unless we win your case for you. 954-324-COMP (2667). [email protected]

 

<<  Click Here To Read The Decision >>

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