One question some clients ask our work injury lawyers is what does workers compensation cover? Injured workers are afraid they’ll have to pay their medical bills and other expenses out-of-pocket.
In this blog, we’ll discuss what expenses workers compensation covers in Florida. We will also talk about some of the things that are not covered by workers comp.
Workers Compensation in Florida Covers Most Injuries Suffered on the Job
If your injuries occurred while you were doing your job, they should be covered by worker’s compensation. As long as your Brandon workers comp attorney can prove that your injuries are work-related, you shouldn’t have anything to worry about.
However, there are certain times when workers comp will not cover your injuries.
If you were intoxicated at the time of your injury, you will not be approved for workers comp. The same is true if you suffered your injuries while fighting or roughhousing on company time.
Most Medical Treatment Related to Your Workplace Injuries Will Be Covered
Generally, any medical treatment that is directly related to your workplace accident will be covered by workers compensation insurance.
Any medical expenses related to the following should be covered:
- Ambulance ride
- Emergency room visit
- Diagnostic tests
- Hospital stay
- Physical therapy
- Prescription medication
- Durable medical equipment
Of course, there are some medical procedures or expenses that may not be covered.
Are There Certain Medical Treatments or Expenses That Aren’t Covered?
If you receive treatment from anybody other than your workers’ compensation doctor, their bills may not be covered. Additionally, any treatment that your doctor doesn’t deem medically necessary will not be covered.
There is also the chance that experimental treatments won’t be covered. The odds of your doctor agreeing that this type of treatment is medically necessary are low.
Your Lost Wages Will Be Partially Covered
Depending on the seriousness of your injuries, you may miss a significant amount of time from work. As long as you’re out for more than seven days, you will receive compensation.
The way the law works in Florida, employees who are hurt on the job can collect weekly temporary disability benefits for up to 104 weeks. However, these benefits will end once you achieve maximum medical improvement.
If your injury does not fully heal, you may qualify for permanent partial disability or permanent total disability benefits.
You’ll Only Receive Benefits Equal to 2/3 of Your Average Weekly Wages
Most workers will receive less while on workers compensation than they did working. Workers comp only pays you 2/3 of your average weekly wage.
For example, if your average weekly wages are $1,000, you’ll receive weekly benefits of $666. However, your benefits aren’t taxable. Your “take home” pay may be similar to what you normally receive.
There is also a limit to how much you can receive. The maximum benefit rate in Florida is $1,197 per week. This means that anybody who normally earns more than $1,800 per week will lose money while out on workers compensation.
Is Your Medical Care Still Covered if You Had a Pre-Existing Condition?
Many workers are concerned that their claim will not cover their medical care if they had a pre-existing condition. Generally, the rule is that you won’t be covered for prior injuries or medical conditions.
However, there are times when your workers’ compensation lawyer in Brandon may be able to get your treatment covered.
If your workplace accident made your pre-existing condition worse, your care may be covered. This doesn’t not mean that your total injury will be covered. Workers’ comp will only cover the portion that has been aggravated by your workplace accident.
Florida’s Workers Compensation System Also Provides Death Benefits
If a worker dies as a result of their work injury or illness, they may be entitled to death benefits. These benefits are triggered when one of two things happen.
First, if the employee dies within a year of their workplace accident, the insurance company will pay out death benefits.
These benefits are also available if a worker passes away within five years of suffering a workplace accident. The five years must have involved a continuous disability.
If your loved one meets the criteria spelled out above, the following benefits will become available:
- Up to $7, 500 in funeral expenses
- Educational benefits for the decedent’s spouse
- Compensation to the worker’s dependents up to $150,000
Your attorney will help you file for death benefits. This will give your family a chance to properly grieve.
If You’re Unsure of What Workers Comp Covers, Contact Our Office
All you have to do is call our office at 954-833-5226 and schedule your free, initial consultation. Sit down with one of our attorneys and let them review your case.