If you suffered an injury while on the job, you may be eligible for workers’ compensation benefits from your employer’s insurance company. Workers’ compensation benefits will help cover your accident-related medical expenses and lost wages. At the Law Firm of Anidjar & Levine, our Port St. Lucie personal injury lawyers have helped numerous Florida workers get back on their feet financially after a workplace injury.
Does My Employer Have Workers’ Compensation Coverage?
Most likely, yes. Most employers in Florida must carry workers’ compensation coverage. The laws surrounding covered individuals are complex. However, the Law Firm of Anidjar & Levine can determine whether your employer owes you compensation for injuries and lost income.
How Does the Workers’ Compensation Claim Process Work?
If you suffer an injury at work, there are certain steps you must take to recover Workers’ Compensation. These steps are as follows:
- Notice: Your first step will be to file a notice with your employer. You must do so within 30 days of the accident or first signs of illness/injury. Your employer must then pass this information along to its Workers’ Compensation insurer within seven days of receiving notice. You must also seek medical treatment as soon as possible.
- File Claim: Next, you will file a claim for benefits with your employer’s insurance company providing it with information about how the accident and your injuries happened. Remember, insurance companies are not your friends and will try to find as many reasons as possible to avoid paying you benefits. Their goal is to close your claim by paying out as little as possible. By providing supporting documentation, we can make it more difficult for the insurer to deny your claim.
- Submit to an exam: To analyze your injuries, the insurer may require you to submit to an Independent Medical Examination (IME). For an IME, the insurer will choose a physician to examine you and review your records. The findings of an IME will reveal the severity of the injuries and what treatments are necessary.
- Evaluation: Insurers will use the information you provide as well as the IME results to determine whether you should recover benefits and if so, how much you should get. (Because the insurer hires the doctor who performs the IME, you might want to seek a second opinion.) Once the insurer has made its decision, you can decide whether to accept it as is or reject it and file an appeal.
Timeline For Workers’ Comp Claims In Port St. Lucie
Florida uses a strict timeline to handle workers’ compensation claims throughout the state. Generally, you only have 30 days to report your accident officially to your employer. After you’ve notified your employer, the state expects your employer to report the injury to its insurance company as quickly as possible.
The state gives your employer seven days to report the injury. After the insurance company receives information about your injury, it should send an informational brochure to you. The insurer has three days to send this packet of information.
The brochure provides information about the workers’ compensation program, your rights, and your responsibilities after an accident.
What Happens If Your Employer Refuses To Report Your Injury?
Some employees face a challenge if their employers refuse to communicate the accident with their insurance company. In this situation, you have the option to report the incident on your own. You can review the steps to report your injury with a Port St. Lucie workers’ comp attorney.
Who Covers Medical Expenses For On-The-Job Injuries In Florida?
The program should cover your medical expenses if you sustained an injury while working and your employer carries workers’ comp coverage. However, you might need to visit an approved healthcare facility to get a diagnosis to receive compensation for your losses.
However, you may also have the right to visit a healthcare professional of your choice to receive a second opinion regarding your injuries. The workers’ comp coverage should handle all your healthcare expenses for injuries sustained on the job.
Your Lost Wages And Workers’ Comp Insurance In Florida
Many people realize that workers’ comp insurance provides coverage for their medical expenses after an accident. However, did you know that you can also receive damages to cover your lost income during your recovery period?A workers’ comp attorney serving Port St. Lucie can help you go over the steps to secure this form of compensation. Generally, you only receive coverage for lost income if you miss more than a week of work.
Additionally, you only receive compensation for the first seven days of work that you miss if your condition prevents you from returning to the job for more than 21 days. At this point, you can request compensation for the initial week you spent recovering.
Workers’ Comp Only Covers Part Of Your Wages
The workers’ comp program covers some of your lost income after an accident. However, it does not provide 100% of the pay you would receive if you worked. Instead, most people receive around two-thirds of their average weekly wage through the workers’ comp program in Port St. Lucie.
You can work with a workers’ comp lawyer to determine how much compensation you’d receive. In addition, you could review your old pay stubs to assess your average weekly wage.
Why Would An Insurer Reject My Claim?
Insurance companies, much like other businesses, are focused on making money. By partially or fully rejecting your claim for benefits, the insurer saves money. Here are some common reasons why an insurer will reject a Workers’ Compensation claim:
- Failure to meet deadlines: If you fail to report your accident within 30 days or miss any of the multiple deadlines throughout the claim process, the insurer may deny your claim.
- Injuries resulted from an exception: Insurers could deny your claim if your injuries occurred while you were intoxicated, committing a crime, engaging in horseplay, or attempting to injure yourself or others.
- Injuries unrelated to accident: If you had a prior medical condition or suffered another accident outside of work, the insurer may argue that your injuries are unrelated to your workplace accident.
- Failure to cooperate: If you fail to submit to the IME or fail to provide requested information to the insurer, the insurer may reject your claim for not providing enough information or cooperating with the investigation.
- Exaggerated injuries: The insurer may claim that you exaggerated when describing your injuries and that the treatment you received was unnecessary.
Our attorneys are all too familiar with the tactics insurers use to avoid paying out benefits. We use our knowledge and experience to protect your rights throughout the claim process.
What If My Workers’ Compensation Benefits Are Not Enough?
Workers’ compensation benefits can help keep a family afloat while an injured worker is unable to earn a living. Workers’ Compensation benefits generally cover all medical expenses and a portion of lost wages (usually two-thirds of your weekly wages).
However, this is not always enough. You may have another option. If a third party was responsible for your injuries in some way, you may be able to recover the remainder of your lost wages, as well as noneconomic damages such as pain and suffering. These third parties might include:
- Equipment manufacturers
- Property owners
- Negligent drivers
- Other companies onsite (common on construction sites)
Keep in mind that if you receive money in a third-party claim, you will likely not get to keep it all. The workers’ compensation insurer will assert a lien on the money you recover to repay itself for the benefits it already paid out. Our attorneys will work to negotiate the lien and make sure that the insurer does not take more than it deserves.
How Can Our Attorneys Help?
Our attorneys can help you maximize the amount of damages you receive by filing a claim for workers’ compensation benefits and determining if you qualify to file a claim against any liable third parties. Our attorneys will:
- Conduct a thorough investigation of your accident and collect evidence to support your case
- Handle all correspondence with your company’s insurer and provide it with the necessary information to decide your claim
- Make sure you comply with all deadlines.
- File a claim against third parties responsible for your accident.
- Negotiate the lien with the insurance company if you receive a third-party claim settlement.
If you suffered injuries in a workplace accident, you may find yourself struggling to provide for your family and unsure what steps to take to support yourself financially. However, the attorneys at the Law Offices of Anidjar & Levine are here to help. Our team will make sure you recover the benefits you deserve from your insurer. In addition, if a third party’s negligence caused your accident and injury, we can file a claim to supplement your workers’ compensation benefits.
We Can Help.
