6 Common Mistakes in Workers’ Compensation Claims
In theory, workers’ compensation is a stress-free, no-conflict way for a worker who has been [&helli…
Our workers’ compensation attorneys can assist with your filing for medical payments and/or disability benefits under Florida’s workers’ compensation laws. Work-comp benefits are intended to compensate employees who were injured on the job or became ill due to circumstances of his or her job. When an employer has four or more part-time or full-time employees, the work-comp laws require them to carry workers’ compensation insurance. Our personal injury lawyers specialize in workers’ compensation claims and can provide a no-cost, no-obligation consultation to review the details of your work accident or insurance company’s denial of work-comp benefits.
If you are injured on the job, for example in a ladder accident, roofing accident, or construction site accident, it is important for you to report the accident to your employer as soon as possible. Timely notification to the appropriate persons must occur within 30 days of the accident or your workers’ compensation claim will be denied. No later than seven days after your employer learns of your work-related injuries, he or she must in-turn notify the company’s work-comp insurance carrier of your job-related accident or illness. Should your employer fail to report your injury claim, you can notify the appropriate government agency and ask for free legal assistance. This would also be an opportune time for you to seek the advice of an experienced workers’ compensation attorney to determine the best legal actions for your case.
Under Florida’s workers’ compensation laws, an injured worker is generally entitled to one of two types of workers’ compensation benefits. First, the injured worker can seek the recovery of payments for medically necessary remedial treatments, general care and attendance to include prescribed medications and any medical devices ordered by the work-comp doctor. The second category of workers’ compensation benefits includes payment of money and indemnity benefits for reparation of work-related disability.
Payments for workers’ compensation benefits do not include compensation for the victim’s pain and suffering, loss of enjoyment of life, or similar personal damages. If an injured worker obtains a lump-sum settlement, the worker then assumes responsibility for all future medical expenses related to his or her job-related accident or illness.
The number of regulatory procedures to follow when filing a work-comp claim can intimidate any injured worker, and can add to his or her confusion. We’ve listed some of the standard employee actions to consider when faced with a claim for payment of work-comp benefits (or workers’ compensation disability):
Acting in a timely manner to report all injuries sustained in a work accident is very important when seeking recovery for medical expenses, ongoing coverage or disability benefits. In fact, you should report every work-related accident you’re involved in, even if you aren’t yet sure you’ve sustained an injury. Some injuries are not immediately clear; other times, the extent of the injuries may be underestimated, perhaps significantly. And, even if you aren’t injured, reporting the incident can help your place of work to adjust, improve or implement new safety measures to prevent similar accidents in the future.
Regardless of the type or extent of your injuries, workers’ compensation claims must be filed within two years from the date of an employee’s accidental injuries and one year from the date of the injured worker’s last payment for authorized medical treatments. The employee does not need to prove that the employer was negligent; in fact, sometimes, the employee himself or herself could have been negligent and could still receive workers’ compensation benefits.
This may seem confusing, but a work-comp claim is not the same as a civil lawsuit where you would be suing in response to an ill intention, or a reckless or negligent act. Work-comp claims begin the process for you to request compensation for medical expenses for an injury that occurred while you were working, as well as for any lost wage benefits. This claim can be made because of a specific accident or because of injuries (such as tendonitis) that slowly developed because of repetitive motions. In short, even though negligence may be part of the situation, your situation can be a no-fault case to which workers’ compensation applies.
After the accident, you should see a doctor as soon as possible; ask your employer if you need to see a particular doctor or if you can see one of your choice. If circumstances warrant, go to the emergency room. If you are not satisfied with what the doctor told you, consider getting a second opinion. Sometimes, this visit would be covered under workers’ compensation laws and, even if the visit isn’t covered, the information you gain may be worth the cost as you pursue fair compensation.
If it wasn’t clear whether or not you were injured immediately after the incident—and then you are then diagnosed with an injury—inform your employer so workers’ compensation paperwork can get filed. Follow up to make sure the claim was filed and know that are you are entitled to receive a copy of the paperwork related to the claim.
Workers’ compensation-related mistakes to avoid include:
If you’re injured on the job, there is a Florida statute that means you should have your medical costs covered. In many cases, though, a workers’ comp attorney is needed to ensure the process is appropriately monitored and you receive coverage owed to you.
All too often, the situation is more complicated than it might first seem. Let’s say, for example, that you drive a delivery truck for a living and, one day, as you’re driving down the road, a semi-truck smashes into you. You should be entitled to workers’ compensation, but you may also have a semi-truck accident case.
So, a workers’ comp case isn’t always as simple as the injured party receiving free medical care. This form of law is complex, but the workers’ compensation lawyers at Harrell & Harrell, P.A., are here to help you get the compensation you deserve.
As one more example of a workplace situation that can quickly become quite complicated: What if the workers’ compensation situation involves a subcontractor on a job? In this case, who is responsible for health care costs? Workers’ comp law can intersect with multiple other types of law, which can make it much harder to understand. Fortunately, as personal injury attorneys, we deal with these situations all the time—and can help you with yours.
Workers’ compensation lump-sum settlements are not mandatory but represent a voluntary agreement between the injured employee and the company’s work-comp insurance carrier. Additionally, there are no provisions under the work-comp laws that require your employer to hold your job until you are able to return to work. Existing workers’ compensation laws do, however, prevent your employer from firing you because you have filed or may be attempting to file a workers’ compensation claim for work-related injuries or illness.
Workers’ compensation law is regulated by the Department of Financial Services and the Office of the Judges of Compensation Claims. Relevant Florida states include §440.02 and §440.10. Under certain circumstances, you may be entitled to a variety of benefits, including:
Although work-comp claims are often thought of in connection with falls or falling objects, they can also be because you needed to lift heavy objects and injured yourself. It could be because of exposure to toxic elements that lead to mesothelioma. It could be because your hearing was damaged due to exposure to especially loud noises.
Citing two of our cases, a railroad conductor hurt his shoulder when throwing a railroad switch. In this case, the jury found the railroad liable for numerous federal violations relating to switch and track maintenance; his injuries (rotator cuff and torn labrum) prevented him from returning to work and he was awarded $2,200,000.
In the second case, a bridge tender was operating a drawbridge over the Manatee River. When she showed up to work, she was attacked and received injuries to her face, head, knee, and abdomen. The railroad had not provided sufficient lighting or sufficient security. The award: $1,953,000.
It bears repeating that employer negligence is not a necessary component of workers’ compensation cases. When it does exists, however, this can add to the complexity of the case.
When a workers’ compensation doctor determines that an injured employee cannot perform his or her duties at work (permanently or temporarily), then the employee may be entitled to temporary total disability benefits (TTD). The TTD benefits are typically paid every two weeks for an amount equal to two-thirds of the worker’s pre-injury average weekly wage (AWW). If an injured employee’s doctor determines that he or she can return to work, but with restrictions, then the worker may qualify for temporary partial disability benefits (TPD) as long as he or she is earning less than 80% of his or her pre-injury average weekly wages. Like temporary total disability benefits, the work-comp payments for temporary partial disability cannot exceed 66.66% of the injured worker’s average weekly wage.
A worker’s combined compensation from temporary total disability and temporary partial disability payments are only paid to a maximum of 104 weeks after the work accident or until the work comp doctor determines the injured employee has reached maximum medical improvement. Under Florida’s workers’ compensation laws, you are not paid for the first seven days of either type of work-comp disability. However, when the employee’s temporary and/or partial disability extends beyond 21 days, the workers’ compensation insurance company will reimburse payments for the initial seven days following the work accident.
Once an injured employee has reached the limits for maximum medical improvement, he or she may qualify for impairment benefits (IB). When an employee’s work-related injuries are deemed permanent, the worker is entitled to receive IBs based on the permanent impairment rating assigned by the worker’s doctor. IBs are paid at the rate of 75% of the employee’s average weekly TTD benefits for the following periods: two weeks for each percentage point of impairment up to 10%; three weeks for each percentage point of impairment from 11% up to 15%; four weeks for each percentage point of impairment from 16% up to 20%; and six weeks for each percentage point of impairment from 21% and higher.
As you can see, workers’ compensation law can be very confusing. Call Harrell & Harrell, P.A., today at 904-251-1111 or 1-800-251-1111 to speak with one of our qualified workers’ compensation attorneys in Jacksonville about your case.
Workers’ compensation claims can be a bit confusing if you’re unfamiliar with the process. If you’re like many people who have been injured on the job, you probably have questions. The best way to get information about your specific Florida workers’ compensation claim is to talk with an experienced workers’ comp lawyer. To help you get a basic understanding of the process and your rights, we’re providing answers to some of the questions we hear frequently from our clients.
The full workers’ compensation process can be complicated, but here’s a quick overview. Florida workers’ comp pays medical expenses and provides partial replacement income for people who were injured on the job. The injured worker must promptly notify the employer of the injury, and then see a workers’ comp approved physician. If the physician determines that the injured worker is temporarily unable to return to work, the employee will typically be eligible for weekly benefits equal to ⅔ of average weekly wages.
An employee who is able to return to work part-time or on restricted duty may still receive partial benefits if their earnings are decreased. If the injury creates permanent partial or total disability, the injured worker is entitled to additional benefits, typically paid out as a lump sum settlement.
Every case is different. However, it’s generally not a good idea to settle a workmans’ compensation claim before you have reached maximum medical improvement (MMI).
Then, there is a negotiation process, and if you are not represented by a workmans’ comp attorney, a judge will have to approve your settlement. In total, it can take several months to 1.5 years or more to settle a workers’ comp claim. That may seem like a long time, but rushing a workmans’ comp settlement can mean you don’t get the full value of your claim. And, you typically can’t reopen a workers’ compensation claim if your medical issues turn out to be worse than anticipated.
In Florida, an injured worker can receive temporary total or partial disability payments for up to two years. Permanent total disability payments may continue to age 75, as long as the recipient remains unable to work. A settlement will typically result in a lump sum or structured payment that will terminate other workmans’ comp benefits.
You should be very cautious about accepting the first offer of compensation after a serious work injury. Remember that workers’ compensation benefits and settlements are paid by insurance companies, and an insurance company profits by paying out as little as possible.
Many people receiving workers’ comp settlement offers don’t realize that they have the opportunity to negotiate. And, many understandably want to get the process over with and receive their settlement as quickly as possible. But, settling too quickly may mean that you don’t have adequate compensation to cover your needs later. Keep in mind that what sounds like a large amount of money in the abstract may not seem so large when it has to cover living expenses and medical care for the rest of your life. If you have any doubt at all or there are elements you don’t understand, consult an experienced Florida workers’ compensation lawyer.
It’s generally a good idea to consult a workers’ comp lawyer any time you have been seriously injured and will be unable to work for an extended period. This is especially important if your injury has caused a permanent total or partial disability.
You should also consider hiring a workmans’ comp attorney if your claim is denied, your employer or the insurance company is refusing to move forward on your claim, your claim is complicated by a pre-existing condition, you’ve been offered a settlement that seems inadequate, you plan to file for SSDI benefits, or you believe you may have a personal injury or other claim against a third party in connection with your injury.
Err on the side of protecting your claim. If you’re not sure whether or not you need representation, schedule a consultation with an experienced workers’ comp lawyer to learn more about the process, your rights, and your options.
First, make sure the attorney or law firm you will be working with has extensive experience with workers’ compensation claims. The worker’s comp process is different from other similar legal issues, such as a personal injury claim. If your issue or condition is unusual or more complicated–such as an employer denying that your injury was work-related or a condition resulting from toxic exposure rather than an injury, make sure to ask about the lawyer’s experience with the issues involved in your case.
It is also a good idea to work with a law firm that handles both workers’ comp claims and personal injury claims. That’s because sometimes an injured worker has other possible claims. For instance, if you were on the dock at work and were injured by a delivery driver from an outside company, you will likely have a workmans’ comp claim. But, you may also have a personal injury claim against the company whose employee injured you. That additional claim may provide compensation that workers’ comp doesn’t, from filling in the gap between what workers’ comp pays and your actual average weekly income to compensating you for pain and suffering.
Finally, make sure that you are confident in and comfortable with the attorney. It’s important that you trust your attorney, that you feel you can ask any questions you have and be entirely honest with the lawyer, and that the attorney listens to your concerns and answers your questions in plain English. The best way to measure this is to schedule a free consultation before choosing a workmans’ comp attorney.
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First, starting my journey with Harrell and Harrell, I felt so many mixed emotions. "Is it worth it?" "Do I want to deal with the legal system?" And the list goes on. I am here to tell you that my experience with Jamie Holland, Holt Harrell and their team of professionals could not have been more supportive, helpful, and encouraging. For me, going through a traumatic accident, surgery, and a long recovery process is bad enough. And when you add the stress of a lawsuit and in my case a trial, it’s one of the most difficult things I have had to face. But I will say that I never felt alone. Jamie Holland and Holt Harrell were by my side throughout every obstacle and every triumph I endured. They always kept me involved in the entire process and up to date on what was going on. I never felt like I was left in the dark and any questions that I had were answered promptly. I also really felt their passion for their job as lawyers and that just made my trust and respect for them grow continually on a daily basis. My experience with Harrell and Harrell could not have been a more positive one and although I hope to not have to use their services again anytime soon, I highly recommend them.