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Workers’ Compensation in Florida is defined as disability and medical benefits provided by an employer’s insurance carrier to individuals who have suffered a disability or injury while working. If you have been denied workers’ compensation for an illegitimate reason, or have a genuine workers’ compensation claim, but your claim has been denied in bad faith, it is important to hire an experienced workers’ compensation lawyer in Tampa.
Contact the Germain Law Group at (813) 835-8888 for a consultation about your workers’ compensation claims in Tampa, Florida. Attorney Michael B. Germain is knowledgeable in all areas of Florida’s insurance laws and is experienced in all aspects of workers’ compensation. Call the Germain Law Group today about your workers’ compensation claim or claim denials throughout the areas in Hillsborough County, Pinellas County, Brevard County and Manatee County, Florida.
Tampa Workers’ Compensation Information Center
According to Florida’s Workers’ Compensation Law, Fla. Stat. § 44.03, every employee and employer in the state are eligible for workers’ compensation benefits. Every employer defined in the Florida Statutes is required to carry workers’ compensation insurance.
An employee is defined under Florida law as any person who receives compensation from their employer for work performed while employed under any appointment or contract for hire, and includes, but is not limited to, aliens, minors, sole proprietors, construction contractors and subcontractors, independent contractors engaged in the construction industry, and officers of corporations.
Individuals not considered employees for the purpose of workers’ compensation in Florida include:
Florida law defines employers as all state and political branches, public and semi-public corporations, certain legal representatives, employment agencies, employee leasing companies, and other companies providing employees to other persons.
Usually, pain and other subjective complaints, without another type of treatable injury, are not eligible for compensation.
If an individual has been injured by a disease or some other type of injury from repetitive exposure in the workplace, the exposure in the workplace to support the cause of the injury or the disease must be proven by clear and convincing evidence. This standard of proof basically means the evidence shows the exposure more likely than not caused the illness or injury.
Individuals who suffer an injury or death while working who were intoxicated, under the influence of drugs not prescribed by a physician, commit suicide, or from inflicting the injury on themselves are not eligible for workers’ compensation benefits.
Individuals who are covered by other federal injury or death compensation acts are not eligible for workers’ compensation benefits under Florida law.
When an individual who is an employee is injured or dies while working on activities performed during the job and that are required by the position, the employer must pay or provide compensation and benefits to the employee. Employees are required to report their injury to their employer within 30 days after the date of injury under Fla. Stat. § 440.185.
After sustaining an injury, the employees must fill out several forms required by Florida law to documents the injury and claim for benefits.
In order to receive benefits, the individual’s injuries must be established to a reasonable degree of medical certainty and the accident must be the major contributing cause of any injuries. A major contributing cause is defined in Fla. Stat. § 440.09 as the cause which is more than 50% responsible for the injury as compared to all other causes of the injury.
After receiving notice of the injury, employers are permitted to require employees claiming workers’ compensation benefits to submit to drug or alcohol testing and to have the employee submit to a medical examination to determine the degree of injury.
Workers’ compensation benefits are typically not allowed for the first seven days of disability, but if the injury results in a disability for more than 21 days, the individual can be compensated from the date of injury.
The workers’ compensation insurance carriers are required to pay or deny medical bills or treatment within 45 days after receiving the bill, according to Fla. Stat. § 440.20.
The statute of limitations, or maximum time period allowed by law, to file a claim for workers’ compensation benefits in two years, according to Fla. Stat. § 440.19.
Insurance companies will often find a reason to deny workers’ compensation claims. These reasons can usually include the claim was not filed within the required time period, the paperwork or application was incorrectly or insufficiently completed, or there was a lack of medical documentation.
After a workers’ compensation claim has been totally or partially denied, the insurance company must provide you with a notice of the denial explaining the specific benefits that are being denied and the specific reasons for the denial of the benefits.
After denial of workers’ compensation benefits, you only have a limited time to appeal the denial. It is important to hire an experienced workers’ compensation attorney if your claim was wrongfully denied or your workers’ compensation insurance carrier is acting in bad faith by failing to follow Florida’s procedures for workers’ compensation benefits.
Florida Division of Workers’ Compensation – The Division of Workers’ Compensation seeks to ensure the workers’ compensation system in Florida runs accurately and efficiently by educating and informing stakeholders of their rights and responsibilities, compiling and monitoring data, and making sure parties are responsible for their obligations.
Florida Department of Financial Services – The Office of Insurance Regulation at the Department of Financial Services regulates the insurance industry in Florida.
Florida Statutes Online – This website provides links to Title XXXVII of the Florida Statutes, entitled “Insurance,” which contains the state’s rules insurance companies must follow, definitions of certain insurance terms, and other provisions regarding rates, statutes of limitations and insurance contracts.
Germain Law Group, P.A. | Workers’ Compensation Attorney in Tampa
Contact the Germain Law Group today for a consultation about your workers’ compensation claim in Hillsborough County, Pinellas County, Brevard County and Manatee County. Michael B. Germain is a knowledgeable insurance lawyer in Tampa who will listen to the facts of your situation and help you determine the best recourse in pursuing your workers’ compensation claim. Contact the Germain Law Group at (813) 835-8888 for a consultation about your Workers’ comp issues throughout Central Florida, including Tampa, St. Petersburg, Clearwater, Titusville, Palm Bay, Melbourne, Bradenton, and Palmetto.