Know Your Rights

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The Florida Workers' Compensation Law was created in 1935. It was designed to be "self executing" in nature, providing medical care and compensation benefits to injured employees, without undue delay or interference. However, since its inception, the workers compensation system has become so complicated that it often becomes necessary for injured employees to secure legal representation, in an effort to obtain the benefits they need, most of which are discussed below.

"What are temporary indemnity or compensation benefits and how do I qualify for them?"

An injured employee is eligible for monetary benefits, referred to as "indemnity" or "compensation" benefits, once he or she suffers an accident arising out of and in the course and scope of employment and misses more than seven (7) days of work. He or she will be eligible for compensation benefits from the beginning of disability, if the injuries suffered in the industrial accident result in more than twenty-one (21) days out of work.

"What is a temporary total disability?"

These benefits are payable to the injured employee while on "no work" status. They are paid at 66 2/3 percent of his or her pre-injury average weekly wage (A.W.W.).

"What if I am injured but still able to work?"

Benefits are payable when the injured employee has been released to work with restrictions, but has not yet improved to the maximum extent possible. They are paid at a rate equal to 80 percent of the injured employee's pre-injury average weekly wage and the salary, wages, and other remuneration he or she is able to earn while on temporary partial disability status. If the injured employee is not working while on temporary partial disability status, the benefits he or she receives will be equal to about 64 percent of his or her pre-injury A.W.W. The injured employee may only receive a maximum of 104 weeks of temporary total and/or temporary partial disability benefits, combined.

"If my doctor says I am okay for work, what happens to my disability benefits?"

Once an injured employee reaches "maximum medical improvement" or "M.M.I.," his or her eligibility for temporary benefits ends, and the eligibility for three (3) different types of permanent benefits, impairment, supplemental and permanent total disability begins.

Impairment Benefits:
These benefits are payable once an injured employee has reached M.M.I., and has been assigned a permanent impairment rating of less than 20 percent to the body as a whole. Specifically, the injured employee will be paid three (3) weeks of impairment benefits for each percentage of impairment assigned by a physician authorized by the workers' compensation carrier/servicing agent. For example, if an injured employee is assigned a permanent impairment of 10 percent to the body as a whole, he or she will be paid 30 weeks of impairment benefits, typically on a bi-weekly basis. These benefits will be paid regardless of whether the injured employee is working or not, but at a rate which is equal to 1/2 of his or her T.T.D. compensation rate, which is roughly equivalent to 1/3 of the injured employee's A.W.W.

Supplemental Benefits:
These benefits are payable once the injured employee reaches M.M.I. and is assigned a permanent impairment rating to the body as a whole of 20 percent, or greater. They are paid at a rate equal to approximately 80 percent of the difference between the injured employee's pre-injury A.W.W. and his or her post injury income. To receive these benefits, the injured employee must be earning less than 80 percent of his or her pre-injury A.W.W., and making a documented, good faith effort to find employment within the assigned medical restrictions. An injured employee's eligibility for temporary benefits, impairment benefits, and supplemental benefits, terminates 401 weeks from the date of injury.

Permanent Total Disability Benefits:
In case an injured employee's disability is adjudged to be permanent within the definitions set forth in the Workers' Compensation Law, he or she will receive benefits equal to 66 2/3 percent of his or her A.W.W., during the continuance of such total disability. In addition, the injured employee will receive additional weekly compensation benefits equal to 5 percent of his or her weekly compensation rate, multiplied by the number of calendar years since the date of injury. Entitlement to these 5 percent supplemental benefits will cease at age 62 if the injured employee is eligible for social security disability benefits

"What other benefits may I be entitled to as a rsult of workplace injury?"

If death results from the accident within one (1) year thereafter or follows continuous disability and results from the accident within five (5) years thereafter, the workers' compensation carrier/servicing agent shall pay within fourteen (14) days after receiving the bill, funeral expenses not to exceed $5,000. Also, the decedent's spouse and/or dependent children may receive monetary benefits on a bi-weekly basis, up to a maximum payout, over time, of $100,000. However, upon the remarriage of the decedent spouse, these payments will stop, and the spouse shall be entitled to receive a lump sum payment equal to 26 weeks of compensation at the appropriate compensation rate.

When it appears that an injured employee who has reached M.M.I. requires training and education to obtain suitable gainful employment, the workers' compensation carrier/servicing agent shall pay him or her additional temporary compensation, known as rehabilitation and retraining benefits, for a period not to exceed 26 weeks. This period may be extended by an additional 26 weeks, if such extended period is determined to be necessary and proper by a judge of compensation claims. The Department of Education will pay for the retraining program itself, provided the injured employee meets the criteria for acceptance into the program in question.

The workers' compensation carrier/servicing agent is also obligated to furnish the injured employee with medically necessary treatment as the nature of his or her injury or process of recovery requires.

"Is there a time limit for claiming a work-related injury?"

Subject to certain limited exceptions, an injured employee must receive workers' compensation indemnity benefits or authorized medical treatment from the workers' compensation carrier/servicing agent within two (2) years from the date of injury, to prevent the statute of limitations from barring his or her claim. After that point, the injured employee must receive workers' compensation indemnity benefits or authorized medical treatment within one (1) year from the last date they were provided. Otherwise, his or her claim may be forever barred by operation of the statute of limitations. Accordingly, any time a dispute arises between an injured employee and his or her workers' compensation carrier/servicing agent which cannot be amicably resolved, he or she should immediately file a "petition for benefits," or workers' compensation lawsuit, to keep the statute of limitations from running against the injured employee's claim.