Workers’ Compensation

Sustaining a workplace injury can be physically and emotionally devastating. As an injured worker, you could be dealing with serious injuries, significant pain, lost wages, and emotional distress. As if that wasn’t enough to contend with, you face the overwhelming prospect of filing a workers’ compensation claim to pursue fair compensation and pay for your medical bills. Your work-related injuries could be severe enough to force you to take time off work, switch to an entirely different job, or avoid the activities you once enjoyed.

At Lyle B. Masnikoff & Associates, P.A., we are dedicated to helping injured workers throughout Florida pursue compensation according to the state’s workers’ compensation law - including a workers’ comp medical or wage benefit and a lump sum benefit. Our workers’ compensation lawyers and staff are multilingual in Spanish, Creole, French, and Portuguese. As part of our ongoing commitment to providing knowledgeable legal representation to our clients, we have attended thousands of depositions, mediations, arbitrations, hearings, and trials. If you have sustained a workplace injury and don’t know where to turn, contact us at (561) 598-7120 to schedule a free case evaluation. We serve Florida residents in Palm Beach, Miami, Orlando, Ft Lauderdale, Tampa, Sarasota, Fort Pierce, Fort Myers, Vero Beach, Daytona, and Jacksonville.

Let us go the extra mile for you.

Key Takeaways About Workers’ Compensation Claims in Florida

• Florida is a no-fault state. Whether your injury was caused by your employer’s negligence or some other reason, if the accident occurred in the workplace, Florida’s workers’ compensation system covers injuries and illnesses, providing financial support for medical expenses and lost wages occurring due to workplace accidents.
• Workers’ compensation in Florida offers coverage to injured workers for multiple work-related injuries and illnesses, including muscular injuries, aggravation of a pre-existing condition due to a work-related activity, broken bones, head injuries, PTSD, exposure to hazardous materials, and other injuries.
• Florida workers’ compensation benefits could potentially include medical expenses, lost wages, and other expenses connected to your injury.
• If a third party’s negligence caused your on-the-job injury, you may be eligible to pursue more than a worker’s claim. With third party claims, workers have a workers’ comp case, but someone other than their employers caused the accidents. In such situations, you may have a viable personal injury case in addition to a workers’ compensation claim.
• Hiring a workers compensation lawyer with extensive experience and knowledge of Florida’s system will protect your rights and help you file required documentation, including medical records, within mandatory deadlines.

Injuries Covered Under Florida’s Workers’ Compensation System

Florida’s workers’ compensation system provides coverage to injured workers for various work-related injuries and illnesses suffered by employees while performing their job duties. Common workers’ comp eligible injuries include:

1. Traumatic Brain Injuries & Other Severe Injuries: These include injuries caused by accidents or sudden events at the workplace, such as broken bones, sprains, cuts, burns, muscular injuries, or head injuries.
2. Occupational Diseases: Illnesses or health conditions that develop over time due to conditions at work, such as lung diseases, skin disorders, or repetitive stress injuries like carpal tunnel syndrome - or due to chemical exposure to hazardous materials.
3. Neck, Back, Knee, Shoulder, Wrist, Ankle, and Foot Injuries: Herniated or bulging discs, torn meniscus or ACL, torn labrum or rotator cuff, or various injuries to the wrist, ankle, or foot.
4. Psychological Injuries: Mental health conditions like anxiety, depression, or post-traumatic stress disorder (PTSD) due to workplace incidents or conditions are also eligible for coverage.
5. Cumulative Trauma Injuries: Injuries that develop gradually over time due to repetitive motions or exposure to harmful conditions, leading to conditions like tendonitis, bursitis, or degenerative joint diseases.
6. Fatal Injuries: In cases where a work-related injury or illness leads to the death of an employee, benefits may be available to the dependents or beneficiaries of the deceased worker under workers’ compensation.
7. Aggravation of a Pre-Existing Injury: If a pre-existing injury is aggravated or exacerbated by a work-related incident, the consequential medical treatment and disability may be covered under workers’ compensation.

What If an Injured Worker is Left with a Permanent Disability After a Workplace Accident in Florida?

When an injured employee in Florida suffers a permanent disability following an accident in the workplace, the state’s workers’ compensation law provides support and benefits to help them cope with the long-term effects of their injury.

1. Permanent Disability Rating: A medical evaluation determines the extent of the permanent disability and assigns a disability rating, which reflects the impact of the injury on the worker’s ability to perform their job duties.
2. Benefits for Permanent Disability: In Florida, workers with permanent disabilities could potentially be eligible for different types of benefits based on the severity of their impairment, such as:
   • Permanent Total Disability Benefits: If the worker is unable to return to work in any capacity due to the permanent disability, they may be eligible for ongoing compensation.
   • Permanent Partial Disability Benefits: For partial disabilities that allow the worker to work in some capacity but with limitations, provided benefits are based on the extent of the impairment.
3. Vocational Rehabilitation: Workers’ compensation may include vocational rehabilitation services to help the injured worker retrain for a new job or acquire skills suitable for their disability.
4. Lifetime Medical Benefits: Workers with permanent disabilities are typically eligible for lifetime medical benefits to cover necessary medical treatment related to their work injury.
5. Settlements: In some cases, a settlement agreement may be reached between the injured worker and the workers’ compensation insurance carrier, providing a lump-sum payment that considers the permanent disability and future medical needs.
6. Legal Assistance: Seeking guidance from an experienced workers’ compensation attorney who has handled many permanent disability cases can help an injured worker pursue appropriate benefits and support according to Florida’s workers’ compensation laws.

What Should Injured Workers Do Immediately After Workplace Accidents in Florida?

Following workplace accidents, injured employees should take the following steps.

Report the Workplace Injury to Your Employer

As an experienced attorney will tell you, reporting your injury to your employer promptly significantly affects your workers’ compensation claim. Florida workers’ compensation law allows you 30 days from the date of the injury to report it to your employer. If you fail to meet this deadline, your workers’ comp claim could be denied.

When reporting your injury, include important details such as:

• The date, time, and location of the incident
• A description of how the injury occurred
• A description of your injuries and any symptoms you’re experiencing
• The names of any witnesses to the incident

If possible, document your injury by taking photos of visible injuries and collecting witness statements. Hold onto a copy of your injury report and other relevant documentation.

Seek Medical Care Immediately

After reporting your injury, your employer should give you a list of authorized medical experts. In Florida, you must seek treatment from an authorized provider for workers’ compensation to cover your medical expenses. If you choose to seek medical attention from an unauthorized provider, you may be responsible for paying the medical bills yourself. However, in emergency situations, head immediately to the nearest hospital or clinic for treatment.

When seeking medical care, inform the provider that you have sustained a workplace injury. Give them your employer’s information and your claim number, if available. Attending all scheduled medical appointments and following your doctor’s treatment plan is urgent. If you fail to follow your provider’s instructions, your workers’ comp benefits could be suspended or terminated.

Be sure to keep all medical documentation, including:

• Doctor’s notes and treatment plans
• Diagnostic test results (e.g., X-rays, MRIs)
• Prescriptions and receipts for any medications
• Mileage and receipts for travel to and from medical appointments

Our experienced workman’s compensation lawyers can guide you through this process.

Understanding the Processes Involved in Workers’ Compensation Claims

After you have informed your employer about your workplace injury, your employer should notify their workers’ compensation insurance company. At that point, the insurance company will take over the workers’ comp claim process.

From there, an injured worker can expect:

• Information Packet: Within 3 days of receiving the First Report of Injury or Illness from your employer, the workers’ compensation insurance company should send you an information packet containing details about your rights and a copy of the accident report.
• Claim Acceptance or Denial: The workers’ compensation insurance company will investigate your claim and determine whether to accept or deny it. If the insurance company accepts your claim, you should start receiving benefits within 21 days of reporting the injury. If the insurance company denies your claim, they must notify you within 120 days after you reported the injury. Although you have the right to appeal the decision, the appeals process can be complex and time-consuming. For this reason, working with an experienced workers’ compensation lawyer is critical.
• Benefits: If the insurance company accepts your claim, you would be eligible for benefits based on the severity of your injury and your ability to work. These benefits may include medical treatment, temporary total disability (TTD) or temporary partial disability (TPD) payments, and impairment benefits if you’ve reached maximum medical improvement (MMI).
• Dispute Resolution: If the workers’ compensation insurance company denies your claim or if you disagree with any aspect of your benefits, you can seek to resolve the dispute by contacting the insurance adjuster or seeking assistance from the Florida Employee Assistance and Ombudsman Office (EAO).
• Mediation and Hearings: If the dispute cannot be resolved informally, your case may progress to mediation, a pre-trial hearing, and a final hearing before a Judge of Compensation Claims (JCC) who will make a decision on your workers’ compensation benefits.
• Appeals: If either party disagrees with the JCC’s decision, they can appeal to the First District Court of Appeal within 30 days of the decision date.

How Long Do My Workers’ Compensation Benefits Last?

Various factors influence the duration of workers’ compensation benefits.

Maximum Medical Improvement

Per Florida workers’ compensation law, the length of your workers’ comp benefits relies on various factors, including the nature and severity of your injury, your treatment plan, and your medical progress. In general, your workers’ compensation benefits will last for as long as you need to be seen by a doctor and until your doctor determines that you have achieved maximum medical improvement (MMI).

MMI means that you have recovered as much as possible from your injury and any additional treatment won’t significantly improve your condition. At this point, your workers’ compensation benefits will usually end.

Temporary Total Disability Benefits

Temporary Total Disability (TTD) benefits in Florida are available to employees who can’t work due to a work-related injury or illness. These benefits pay you a portion of your lost wages and generally continue for up to 104 weeks or until you reach MMI, whichever occurs first.

• Benefit Amount: If you qualify for TTD, you would be eligible 66.67% of your average weekly wages during this period.
• Special Circumstances for Increased Benefits: In cases of severe injuries like the loss of a limb or paralysis, the benefits can increase to 80% of your average weekly wages for the first 6 months following the injury.
• Continuation Beyond 104 Weeks: While the standard limit for TTD benefits is 104 weeks, in cases where MMI is not reached within this period, the Westphal v. City of St. Petersburg ruling allows these benefits to potentially extend up to 260 weeks (approximately five years).
• Reporting Requirements: Reporting any earned income, including social security disability benefits, while receiving TTD benefits is critical. Failure to report this income can lead to the suspension of these benefits.

TTD benefits in Florida are a key component of workers’ comp, providing financial support while you cannot work due to a work-related injury.

Temporary Partial Disability Benefits

Temporary Partial Disability (TPD) benefits in Florida cover workers who return to work at a reduced capacity due to their injury:

• Benefit Calculation: The benefits are calculated as 80% of the difference between 80% of your pre-injury average weekly wage and your earnings after the injury. However, these benefits cannot exceed 66.67% of your average weekly wage at the time of the accident.
• Duration of Benefits: TPD benefits are available for up to 104 weeks or until you reach Maximum Medical Improvement (MMI), whichever comes first. However, following the Westphal v. City of St. Petersburg decision, if MMI has not been achieved by the end of the 104-week period, these benefits could extend up to 260 weeks, offering extended support for longer recovery periods.
• Eligibility Conditions: To remain eligible for TPD benefits, you must meet specific requirements related to your work status and ongoing medical care.

These provisions offer financial support to partially disabled workers who can only work at a reduced earning capacity.

Permanent Total Disability Benefits

Permanent Total Disability (PTD) benefits in Florida cover workers who have sustained severe injuries, rendering them unable to work in any capacity.

• Benefit Amount and Conditions: PTD benefits are calculated at 66.67% of your average weekly wage. However, you will not be eligible for these benefits if you are engaged in, or physically capable of engaging in, any form of sedentary employment.
• Presumptions of PTD: For certain severe injuries, such as spinal cord injuries leading to paralysis, traumatic brain injuries, significant amputations, major burns, or total blindness, you are presumed to be permanently and totally disabled. In other cases, you must demonstrate that you cannot perform any sedentary work within a 50-mile radius of your residence.
• Duration of Payments: These benefits generally continue until you reach the age of 75. However, payments may stop earlier if evidence demonstrates that you have become capable of returning to work. If your injury occurred after you turned 70, the benefits will last for up to 5 years after the determination of PTD.

PTD benefits seek to support workers who have suffered the most severe injuries, impacting their ability to earn a living.

Medical Benefits

Medical benefits cover necessary treatments related to work injuries, continuing as long as your disability requires. To maintain these benefits, authorized medical treatment is required at least once every 12 months.

Returning to Work After a Workplace Injury

If your doctor clears you to return to work, your employer may offer you light duty or modified job responsibilities. If you turn down your employer’s offer, your workers’ compensation benefits may be suspended or terminated. However, if your doctor has not released you to return to work, or if your employer does accommodate your injuries by offering work within your physical limitations, you could potentially continue to be eligible for temporary disability benefits.

If your work-related injury prevents you from returning to your previous job, you may be eligible for vocational rehabilitation services, which can include job training, education, and job placement assistance to help you find suitable employment within your physical capabilities.

Workers’ Comp Settlements & Their Impact on Future Benefits

Occasionally, employers and workers’ comp insurance companies offer settlements to resolve workplace injury claims. A settlement is a one-time payout a worker accepts in lieu of future medical and wage benefits.

If you accept a settlement, it generally means forfeiting your rights to future workers’ comp benefits. Before you sign anything, consult an experienced attorney who can review the settlement offer to make sure you are being offered fair treatment and coverage for future medical expenses incurred as a consequence of the injury you sustained at work.

How Do Third Party Claims Work?

You can pursue a third party claim in addition to a workers’ comp claim, when someone else other than your employer caused the workplace accident. Also known as a personal injury claim, it can help you seek damages and expenses beyond what you may have otherwise been eligible for through a workers’ comp claim, providing much-needed assistance during a difficult time.

Unlike a workers’ comp claim, which operates under a no-fault system, a personal injury claim against a third party requires you to prove their negligence. Furthermore, this type of claim may allow for the recovery of additional damages, such as pain and suffering - which you cannot recover through workers’ compensation.

Some examples of a third party claim include:

• A defective tool or piece of equipment provided by a subcontractor or supplier harmed construction workers
• Delivery drivers sustained injuries in a car accident caused by another driver’s negligence
• A retail worker slipped and fell due to a spill caused by a cleaning company’s failure to mop it up
• An office worker suffered from repetitive motion injuries due to a vendor’s faulty computer equipment
• Factory workers were exposed to hazardous materials supplied by a third-party chemical supplier and suffered respiratory issues
• A third-party vendor’s medical equipment caused injuries to healthcare workers

Should I Consult Workers’ Compensation Lawyers to Help with My Workers’ Compensation Claim?

Filing workers’ comp claims can be complex and difficult, adding unnecessary stress during a time when workplace injuries have already caused pain, suffering, and inconvenience. However, the choice to hire a workers’ compensation lawyer and law firm should not be taken lightly. Your worker’s claim is too important to leave to chance.

When seeking legal professionals, look for extensive knowledge of the law and experience helping injured workers in Florida seek compensation. During a free consultation, a seasoned workplace injury lawyer will listen to the details of your case, put together an effective strategy, and act as your legal advocate from beginning to end. After suffering workplace injuries, the wisest thing you can do for yourself and your family is to seek the assistance of a workers’ comp law firm staffed with caring legal professionals who will represent your interests and protect your rights.

At Lyle B. Masnikoff & Associates, We Go the Extra Mile for Workers’ Compensation Cases Throughout Florida

At Lyle B. Masnikoff & Associates, we have collectively represented clients in thousands of workers’ comp claims. Every workers’ comp lawyer on our team offers sound legal counsel and honors the attorney-client relationship. Our valued clients are provided the support, guidance, and advocacy they need to navigate the challenging workers’ comp claim process. With our competent legal representation and multilingual staff, fluent in Spanish, Creole, French, and Portuguese, you can focus on your recovery while we pursue justice.

Let us go the extra mile for you. Contact us at (561) 598-7120 or complete our online form to schedule a free consultation