If you or a loved one was injured at work, there are certain complicated steps you need to take towards filing the claim and receiving the workers’ compensation benefits you’re entitled to. It’s important to closely follow the right legal procedures while filing the claim. Your best bet is to work with a workers’ comp lawyer who understands the Spring Hill, Florida Workers’ Compensation Claims Process.
At WorkInjuryRights, our team can ensure that your rights are protected throughout the process, and make sure you get the maximum settlement amount possible.
How Can I Know if My Injury Will Be Covered By a Workers’ Comp Claim?
Workers’ comp benefits are usually available for most work-related injuries. Even if the work injury you suffered was a result of your own mistake, you may still qualify for workers’ comp benefits. But there are certain exceptions where an injury might not qualify.
For instance, if you harm yourself deliberately or suffer a self-inflicted injury, you may not receive compensation benefits. If the injuries suffered occurred while you were under the influence of drugs or alcohol, you might not be eligible for compensation.
For an injury to be considered work-related, it must have occurred while doing work-related duties or while at work. For example, if you were driving from one company office to another and got injured, this will be covered. But if you took a lunch break and got injured at the restaurant, you can’t seek compensation benefits.
Some cases might be a bit more complicated. If you had a sore wrist caused by heavy lifting at home or elsewhere and then ended up falling and breaking your wrist at work, it should still be considered an on-the-job injury. At least 50% of the injury must have happened while on the job. If the details are not clear, the state administrator might have to establish whether or not the injuries qualify for benefits.
It’s also worth noting that your employer should participate in Florida’s workers’ comp insurance program if the following conditions are true:
- The employer is an agency of the local or state government.
- The business employs 4 or more workers, whether part-time or full-time.
- The business is in the construction industry where the employer has one or more employees, including the owner if they work in the business.
- The employer is a farmer with more than 5 regular workers, or 12 or more part-time workers working for 30+ days.
How Long Do You Have to File a Workers’ Comp Claim in Florida?
You should ideally start the process by reporting the workplace illness or injury to your employer within 30 days of being aware of the injury or your doctor telling you that you have a work-related condition. If you don’t meet this deadline, you risk getting your claim denied and therefore not receiving the workers’ comp benefits you’re entitled to.
How To File a Workers’ Comp Claim in Florida?
If you believe that you have a workers’ comp claim, here are the steps you will follow:
Reporting the injury
The first step is to report the injury to your employer within 30 days of becoming aware of the work-related injury or illness.
You should go to a healthcare provider that’s authorized by your employer or your employer’s insurance provider. If it’s an emergency, you can go to the nearest clinic or hospital for treatment.
Employer reporting the injury
Your employer should report the incident to their insurance carrier within 7 days of the injury. This is referred to as the First Report of Illness or Injury or an accident report. The insurer will then send an information packet to you, containing a copy of the incident report and your rights.
The insurance company accepts/denies the claim
The insurance provider will issue the first benefits check within 21 days of the injury being reported. The amount depends on the severity of the injury, and whether it’s partial or permanent. If the claim is denied, they will notify you of their decision within 120 days of receiving the injury report.
Benefits dispute resolution
If the claim is denied, you can talk with the insurance administrator or adjuster in a “good faith effort” to resolve the dispute.
Petition for Benefits
You have to file the petition within 2 years following the date of the incident. You will file the petition with the Office of the Judges of Compensation Claims (OJCC). You must serve copies to your employer and their insurance carrier. The insurer must respond to the petition within 14 days.
In most cases, the OJCC will most likely have the case go to mediation. The mediation will be held within 130 days after the petition is filed.
Case is settled
If both sides can agree on amicable terms, you can reach an agreement at mediation. This may result in a lump sum payment of benefits, which should include a schedule of payments and interest.
In case no settlement is reached via mediation, your attorney will schedule a pre-trial hearing before the JCC. This hearing should be held in the county in which the injury arose. Both parties will get a 14-day advance notice of the hearing date.
This will be held to resolve the benefits dispute, usually within 90 days after the mediation conference, and no later than 210 following the filing of the petition.
JCC delivers a decision
Within 30 days of the final hearing, the JCC will deliver a decision allowing you to receive the benefits claim.
Talk to a Spring Hill Workers’ Comp Lawyer Today
At WorkInjuryRights, our team is passionate about helping injured employees through these tough times. We know that you may not have the capacity to handle the claims process by yourself, especially when dealing with a serious injury.
Our lawyers will go above and beyond to help you get the justice you deserve and obtain the maximum benefits available in your case. Talk to us today to learn more about the Spring Hill, Florida Workers’ Compensation Claims Process, and how we can help. You can reach us at 954-833-5226 or via the form below.