Frequently Asked Questions
PLEASE READ THE FREQUENTLY ASKED QUESTIONS AND ANSWERS FOR WORKERS' COMPENSATION BELOW:
Q: I was hurt on my job and my employer refused to file an accident report or to send me to the doctor, is there someone I can call?
A: Yes. You should immediately contact an attorney, who has experience with workers' compensation cases. If this scenario is something that you have experienced, I can help you. Please call me at 904-619-9281 or contact me today for a free in-office consultation.
Q: Am I entitled to pain and suffering if I file a workers' compensation claim?
A: No. The statute is a no fault statute. Under the statute, there are only certain benefits available to an injured worker. No workers' compensation judge can order money for pain and suffering be paid to you.
Q: Can I sue my employer for negligence?
A: Workers' Compensation is a no-fault statute. This means that unless you can prove that your employer intended for you to get hurt, then your only remedy is workers' compensation.
Q: What benefits am I entitled to?
A: Under workers' compensation, you are entitled to 104 weeks of Indemnity Benefits. Idemnity benefits are broken down into several categories. The most common are Temporary Total Disability (TTD) and Temporary Partial Disability (TPD). Temporary Total Disability Benefits (TPD). Temporary Total Disability Benefits are paid only if a doctor places you out of work for more than seven (7) days. The amount of money you receive will depend upon what your average weekly wage (AWW) was for the thirteen (13) weeks leading up to the day you were injured. This amount is then compared to a Max Comp Rate, which tells you what you will be receiving each pay period. Usually, the amount is 66 2/3% of your average weekly wage, unless you make more than the Max Comp Rate, then you will receive 66 2/3% of the Max Comp Rate. If the doctor does not take you out of work entirely but, places you on modified or light duty and you are unable to make at least 80% of your regular wages, you are entitled to Temporary Partial Disability Benefits (TPD). These benefits are calculated the same way as temporary total disability benefits.
You are also entitled to medical treatment under workers' compensation. Medical treatment is designed to get you back to work. You are assigned an authorized treating physician who will guide your care under the workers' compensation system. If your physician says you need a special procedure, such as an MRI or Surgery, he will write you a prescription. You should immediately provide this prescription to your claims adjuster so that the requested procedure can be approved. Your adjuster may deny the proceedure. If your workers' compensation insurance company denies the procedure or treatment, it is time for you to hire an attorney. DO NOT WAIT. There is a statute of limitations on workers' compensation claims. It is important that you act quickly to secure your rights. If you were denied a proceedure by your workers' compensation insurance adjuster, please contact me today for a free in-office consultation.
Q: What happens when the doctor tells me that I no longer need treatment?
A: This is called Maximum Medical Improvement (MMI). A couple of different options are available to you. If you do not believe the authorized doctor and you have not ever changed your doctor, you may request a "one-time change" of your authorized treating physician. If you agree with your authorized treating physician's opinion, then you do not have to do anything. Your authorized treating physician will assign you a permanent impairment rating. The calculations depend on your injury and the "1999 Florida Impairment Rating Schedule." Once you are placed at MMI, your TTD/TPD benefits will stop. You are now entitled to Impairment Benefits (IB). These benefits are calculated by taking your permanent impairment rating and multiplying it by two (2) to determine how many weeks of benefits you are entitled to receive. If your rating is higher than 10%, then there are different calculations. A monetary calculation is then made based upon your average weekly wage. This money is then paid to you. You are allowed to obtain follow-up care with the authorized treating physician upon authorization from the insurance company, but will be required to make a co-payment. Your case will remain open so long as you are seen by the workers' compensation doctor at least one time per year and the appointment is paid for by the workers' compensation insurance company.
Q: Is it required that workers' compensation settle my case?
A: No. In workers' compensation no one is required to settle a case. You are not required to accept a settlement and the employer/carrier is not required to make a settlement offer. Furthermore, a judge cannot order a case to be settled. Settlement usually arises when the employee (you) want to remove yourself from the workers' compensation system and the employer/carrier is willing to settle because the adjuster is able to close the; file. If your case does not settle and no benefits are currently due you, then you MUST go back to an authorized workers' compensation doctor at least one time each year for your case to remain open.
Q: Can a workers' compensation judge order the insurance company to pay me a lump sum of money?
A: No. A workers' compensation judge can only order the insurance company to provide you with a benefit, if the required conditions are met. Unlike a personal injury case, such as an automobile accident, no a Judge or a Jury will give you a lump sum of money as a result of your injury.
Q: If I accept a settlement, will I have to quit my job?
A: The answer to this quesiton is most likely, yes. When you agree to settle your workers' compensation claims, you are required to sign a release of all claims and a resignation agreement. You will be asked never to re-apply for employment with the company.
Q: If I settle my case and I owe child support, what will happen?
A: Under the Florida Workers' Compensation Statute, if a claimant owes child support, up to 50% of the child support must be paid from the workers' compensation settlement, if the settlement is less than the amount owed. If the net settlement is more than the amount of the child support owed, then the entire amount of child support will be paid from the claimant's net settlement amount.